The prevalence of diabetes, hypertension and obesity among immigrants from East Africa and the former Soviet Union: A retrospective comparative 30-year cohort study

Background: Previous studies have reported an increasing prevalence of metabolic abnormalities in immigrants who moved from low-cardiovascular-risk regions to Western countries, but little is known about time trends following immigration. Methods: A retrospective cohort study of immigrants from Ethiopia in east Africa (EAI), the former Soviet Union (FSUI) and native-born Israelis (NBI) over a 35-year period. EAI were divided into three groups by date of immigration. Associations between ethnicity, age, sex and metabolic risk factors were assessed using logistic regression models. Results: The study included 58,901 individuals (20,768 EAI, 20,507 FSUI, and 17,626 NBI). The multivariate odds ratios (OR) for diabetes were 2.4 (95 % CI 2.1-2.6), 2.1 (95 % CI 1.9-2.2) and 1.5 (95 % CI 1.3-1.7), respectively, for the three waves of EAI immigrations (P < 0.001 for trend) and 1.1 (95 % CI 0.9-1.2) for FSUI. For hypertension, the corresponding ORs were 1.8 (95 % CI 1.6-1.9), 1.4 (95 % CI 1.3-1.5), and 1.1 (95 % CI 0.9-1.2), respectively (P < 0.001) for EAI, and 2.1 (95 % CI 1.9-2.2) for FSUI. For obesity the ORs were -0.5 (95 % CI 0.4-0.6), 0.5 (95 % CI 0.4-0.6), and 0.3 (95 % CI 0.2-0.3), respectively (P < 0.001) for EAI, and 1.2 (95 % CI 1.1-1.3) for FSUI. The prevalence of diabetes in NBI with a BMI of 30 was identical to a BMI of 23.4 for EAI and 28.9 for FSUI. Conclusions: The prevalence of diabetes and hypertension was higher in EAI and increased over the years, despite a lower prevalence of obesity. It exceeded the prevalence rates in NBI.