Type 2 diabetes among Circassians in Israel.

BACKGROUND The Muslim Circassians in Israel represent a unique ethnic community, distinct from Jews and Arabs. This endogamous group has a limited genetic variability that allows studying risk factors associated with type 2 diabetes. OBJECTIVES To estimate the prevalence of type 2 diabetes among Israeli Circassians and its correlation to obesity and genetic susceptibility. METHODS Israeli Circassian women (n = 450) and men (n = 289) older than 35 were included in the study. They were classified as having or not having diabetes, and their risk factors (including hypertension, body mass index, family history of diabetes) and laboratory tests, were examined retrospectively. RESULTS The age-adjusted prevalence of diabetes among the 739 participants was 12% (men 14.6%, women 10.7%). It was higher among those with BMI > 30 than in those with lower BMI and a family history of diabetes without high BMI. But the risk of diabetes with BMI > 30 plus a family history was three times higher than when these factors were missing (odds ratio 2.96, 95% confidence interval 1.30-6.6). Multivariate analysis, however, found familial history of diabetes to be the strongest risk factor, independent of obesity (OR 2.47, 95% CI 1.45-4.20). CONCLUSIONS The results yielded by this homogeneous Circassian population, sharing the same environmental influences and having an endogamous pattern of marriage, suggest a role of genetic risk factors for diabetes. Israeli Circassians are suitable for additional genetic studies that may lead to the identification of susceptibility genes for type 2 diabetes.