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The association between anthropometric measures and glycated haemoglobin (HbA1c) is different in Russian, Somali and Kurdish origin migrants compared with the general population in Finland: a cross-sectional population-based study
Persons of African and Middle-Eastern origin living in European countries have a high prevalence of type 2 diabetes, accompanied by high prevalence of obesity among women but not always among men. The aim of this study was to examine whether there are differences in the association between anthropom...
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Published in: | BMC public health 2019-04, Vol.19 (1), p.391-12, Article 391 |
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description | Persons of African and Middle-Eastern origin living in European countries have a high prevalence of type 2 diabetes, accompanied by high prevalence of obesity among women but not always among men. The aim of this study was to examine whether there are differences in the association between anthropometric measures and glucose levels measured with glycated haemoglobin and fasting blood glucose among persons of migrant origin in Finland.
Cross-sectional population-based data of the 30-64 year-old participants in the health examination of the Migrant Health and Wellbeing Study was used, selecting persons without diabetes (Russian origin n = 293, Somali origin n = 184, Kurdish origin n = 275). The reference group were non-diabetic participants in the Health 2011 Survey (n = 653), representative of the general Finnish population. Anthropometric measures included body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR, available for Maamu Study participants only).
Depending on whether continuous or categorical anthropometric measures were used, age, sex and anthropometrics explained 13-18% of variation in HbA1c among persons of Russian origin, 5-10% among persons of Somali origin, 1-3% among persons of Kurdish origin and 11-13% among the general population. Also depending on whether continuous or categorical anthropometric measures were used, age, sex and anthropometrics explained 13-19% of variation in fasting blood glucose among persons of Russian origin, 15-20% among persons of Somali origin, 13-17% among persons of Kurdish origin and 16-17% among the general population. With exception for BMI, strength of the association between continuous anthropometric measures and HbA1c was significantly lower among persons of Kurdish origin compared with the general Finnish population (p = 0.044 for WC and p = 0.040 for WHtR).
A low degree of association between anthropometric measures and HbA1c was observed among persons of Kurdish origin. Findings of this study suggest caution is warranted when using HbA1c as a screening tool for glucose impairment among persons without diabetes in populations of diverse origin. |
doi_str_mv | 10.1186/s12889-019-6698-0 |
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Cross-sectional population-based data of the 30-64 year-old participants in the health examination of the Migrant Health and Wellbeing Study was used, selecting persons without diabetes (Russian origin n = 293, Somali origin n = 184, Kurdish origin n = 275). The reference group were non-diabetic participants in the Health 2011 Survey (n = 653), representative of the general Finnish population. Anthropometric measures included body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR, available for Maamu Study participants only).
Depending on whether continuous or categorical anthropometric measures were used, age, sex and anthropometrics explained 13-18% of variation in HbA1c among persons of Russian origin, 5-10% among persons of Somali origin, 1-3% among persons of Kurdish origin and 11-13% among the general population. Also depending on whether continuous or categorical anthropometric measures were used, age, sex and anthropometrics explained 13-19% of variation in fasting blood glucose among persons of Russian origin, 15-20% among persons of Somali origin, 13-17% among persons of Kurdish origin and 16-17% among the general population. With exception for BMI, strength of the association between continuous anthropometric measures and HbA1c was significantly lower among persons of Kurdish origin compared with the general Finnish population (p = 0.044 for WC and p = 0.040 for WHtR).
A low degree of association between anthropometric measures and HbA1c was observed among persons of Kurdish origin. Findings of this study suggest caution is warranted when using HbA1c as a screening tool for glucose impairment among persons without diabetes in populations of diverse origin.</description><identifier>ISSN: 1471-2458</identifier><identifier>EISSN: 1471-2458</identifier><identifier>DOI: 10.1186/s12889-019-6698-0</identifier><identifier>PMID: 30971258</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Abdomen ; Adult ; Anthropometry ; Blood ; Blood glucose ; BMI ; Body mass ; Body Mass Index ; Body measurements ; Body size ; Complications and side effects ; Control ; Cross-Sectional Studies ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes Mellitus, Type 2 - ethnology ; Diagnosis ; Epidemiology ; Ethnicity ; Ethnicity - statistics & numerical data ; Fasting ; Female ; Finland - epidemiology ; Glucose ; Glycated Hemoglobin - analysis ; Glycosylated hemoglobin ; HbA1c ; Health ; Health Surveys ; Hemoglobin ; Hemoglobins ; Hip ; Humans ; Kurds ; Library cataloging ; Male ; Medical examination ; Men ; Metabolic syndrome ; Middle Aged ; Migrant ; Migrants ; Migration ; Obesity ; Population ; Population studies ; Population-based studies ; Prevalence ; Prevention ; Risk Factors ; Russia - ethnology ; Sex ; Somalia - ethnology ; Studies ; Transients and Migrants - statistics & numerical data ; Type 2 diabetes ; Waist Circumference ; Waist-Height Ratio ; Waist-Hip Ratio ; Women</subject><ispartof>BMC public health, 2019-04, Vol.19 (1), p.391-12, Article 391</ispartof><rights>COPYRIGHT 2019 BioMed Central Ltd.</rights><rights>2019. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s). 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c560t-fe4aabbb6aeb18df73dca1d6580206a1436649c334fb5546025468d1335c96413</citedby><cites>FETCH-LOGICAL-c560t-fe4aabbb6aeb18df73dca1d6580206a1436649c334fb5546025468d1335c96413</cites><orcidid>0000-0002-8829-4159</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458679/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2211531732?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25732,27903,27904,36991,36992,44569,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30971258$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Skogberg, Natalia</creatorcontrib><creatorcontrib>Laatikainen, Tiina</creatorcontrib><creatorcontrib>Lilja, Eero</creatorcontrib><creatorcontrib>Lundqvist, Annamari</creatorcontrib><creatorcontrib>Härkänen, Tommi</creatorcontrib><creatorcontrib>Koponen, Päivikki</creatorcontrib><title>The association between anthropometric measures and glycated haemoglobin (HbA1c) is different in Russian, Somali and Kurdish origin migrants compared with the general population in Finland: a cross-sectional population-based study</title><title>BMC public health</title><addtitle>BMC Public Health</addtitle><description>Persons of African and Middle-Eastern origin living in European countries have a high prevalence of type 2 diabetes, accompanied by high prevalence of obesity among women but not always among men. The aim of this study was to examine whether there are differences in the association between anthropometric measures and glucose levels measured with glycated haemoglobin and fasting blood glucose among persons of migrant origin in Finland.
Cross-sectional population-based data of the 30-64 year-old participants in the health examination of the Migrant Health and Wellbeing Study was used, selecting persons without diabetes (Russian origin n = 293, Somali origin n = 184, Kurdish origin n = 275). The reference group were non-diabetic participants in the Health 2011 Survey (n = 653), representative of the general Finnish population. Anthropometric measures included body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR, available for Maamu Study participants only).
Depending on whether continuous or categorical anthropometric measures were used, age, sex and anthropometrics explained 13-18% of variation in HbA1c among persons of Russian origin, 5-10% among persons of Somali origin, 1-3% among persons of Kurdish origin and 11-13% among the general population. Also depending on whether continuous or categorical anthropometric measures were used, age, sex and anthropometrics explained 13-19% of variation in fasting blood glucose among persons of Russian origin, 15-20% among persons of Somali origin, 13-17% among persons of Kurdish origin and 16-17% among the general population. With exception for BMI, strength of the association between continuous anthropometric measures and HbA1c was significantly lower among persons of Kurdish origin compared with the general Finnish population (p = 0.044 for WC and p = 0.040 for WHtR).
A low degree of association between anthropometric measures and HbA1c was observed among persons of Kurdish origin. Findings of this study suggest caution is warranted when using HbA1c as a screening tool for glucose impairment among persons without diabetes in populations of diverse origin.</description><subject>Abdomen</subject><subject>Adult</subject><subject>Anthropometry</subject><subject>Blood</subject><subject>Blood glucose</subject><subject>BMI</subject><subject>Body mass</subject><subject>Body Mass Index</subject><subject>Body measurements</subject><subject>Body size</subject><subject>Complications and side effects</subject><subject>Control</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetes Mellitus, Type 2 - ethnology</subject><subject>Diagnosis</subject><subject>Epidemiology</subject><subject>Ethnicity</subject><subject>Ethnicity - statistics & numerical data</subject><subject>Fasting</subject><subject>Female</subject><subject>Finland - epidemiology</subject><subject>Glucose</subject><subject>Glycated Hemoglobin - analysis</subject><subject>Glycosylated hemoglobin</subject><subject>HbA1c</subject><subject>Health</subject><subject>Health Surveys</subject><subject>Hemoglobin</subject><subject>Hemoglobins</subject><subject>Hip</subject><subject>Humans</subject><subject>Kurds</subject><subject>Library cataloging</subject><subject>Male</subject><subject>Medical examination</subject><subject>Men</subject><subject>Metabolic syndrome</subject><subject>Middle Aged</subject><subject>Migrant</subject><subject>Migrants</subject><subject>Migration</subject><subject>Obesity</subject><subject>Population</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Prevalence</subject><subject>Prevention</subject><subject>Risk Factors</subject><subject>Russia - ethnology</subject><subject>Sex</subject><subject>Somalia - ethnology</subject><subject>Studies</subject><subject>Transients and Migrants - statistics & numerical data</subject><subject>Type 2 diabetes</subject><subject>Waist Circumference</subject><subject>Waist-Height Ratio</subject><subject>Waist-Hip Ratio</subject><subject>Women</subject><issn>1471-2458</issn><issn>1471-2458</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkm9r1TAUxosobk4_gG8k4JsJdiZtk6a-EC7DueFA0Pk65M9pby5tc01ax76wn8PT3Tl3xRSScvKc30lOnix7yegJY1K8S6yQsskpa3IhGpnTR9khq2qWFxWXjx_8H2TPUtpQymrJi6fZQUmbmhVcHma_rtZAdErBej35MBID0zXASPQ4rWPYhgGm6C0ZQKc5QsK4I11_Y_UEjqw1DKHrg_EjOT43K2bfEJ-I820LEcaJYPzrnJLX41vyLQy697eAz3N0Pq1JiL5DyeC7iPUSsWHY6ojgaz-tyYRH62CEqHuyDdu5350QE8782CPnPdHExpBSnsAue3vC3OiEqDTN7uZ59qTVfYIXd-tR9v3s49XpeX755dPF6eoyt1zQKW-h0toYIzQYJl1bl85q5gSXtKBCs6oUompsWVat4bwStMBJOlaW3DaiYuVRdrHjuqA3ahv9oOONCtqr20CIndJx8rYH1RiHQ3AnsaotuClqaThrK8mBmrJC1ocdazubAZzFfmIn9qD7O6Nfqy78VAJfXNQNAo7vADH8mCFNavDJQo-tgzAnVRQUVbIqFunrf6SbMEfs56JijJesLou_qk7jBfzYBqxrF6hacYkaUcuFdfIfFX4OBm_DCK3H-F4C2yXcvmWE9v6OjKrF6GpndIVGV4vRFcWcVw-bc5_xx9nlb2d0_bk</recordid><startdate>20190411</startdate><enddate>20190411</enddate><creator>Skogberg, Natalia</creator><creator>Laatikainen, Tiina</creator><creator>Lilja, Eero</creator><creator>Lundqvist, Annamari</creator><creator>Härkänen, Tommi</creator><creator>Koponen, Päivikki</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>L6V</scope><scope>M0S</scope><scope>M1P</scope><scope>M7S</scope><scope>PATMY</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-8829-4159</orcidid></search><sort><creationdate>20190411</creationdate><title>The association between anthropometric measures and glycated haemoglobin (HbA1c) is different in Russian, Somali and Kurdish origin migrants compared with the general population in Finland: a cross-sectional population-based study</title><author>Skogberg, Natalia ; Laatikainen, Tiina ; Lilja, Eero ; Lundqvist, Annamari ; Härkänen, Tommi ; Koponen, Päivikki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c560t-fe4aabbb6aeb18df73dca1d6580206a1436649c334fb5546025468d1335c96413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdomen</topic><topic>Adult</topic><topic>Anthropometry</topic><topic>Blood</topic><topic>Blood glucose</topic><topic>BMI</topic><topic>Body mass</topic><topic>Body Mass Index</topic><topic>Body measurements</topic><topic>Body size</topic><topic>Complications and side effects</topic><topic>Control</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetes Mellitus, Type 2 - ethnology</topic><topic>Diagnosis</topic><topic>Epidemiology</topic><topic>Ethnicity</topic><topic>Ethnicity - statistics & numerical data</topic><topic>Fasting</topic><topic>Female</topic><topic>Finland - epidemiology</topic><topic>Glucose</topic><topic>Glycated Hemoglobin - analysis</topic><topic>Glycosylated hemoglobin</topic><topic>HbA1c</topic><topic>Health</topic><topic>Health Surveys</topic><topic>Hemoglobin</topic><topic>Hemoglobins</topic><topic>Hip</topic><topic>Humans</topic><topic>Kurds</topic><topic>Library cataloging</topic><topic>Male</topic><topic>Medical examination</topic><topic>Men</topic><topic>Metabolic syndrome</topic><topic>Middle Aged</topic><topic>Migrant</topic><topic>Migrants</topic><topic>Migration</topic><topic>Obesity</topic><topic>Population</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Prevalence</topic><topic>Prevention</topic><topic>Risk Factors</topic><topic>Russia - ethnology</topic><topic>Sex</topic><topic>Somalia - ethnology</topic><topic>Studies</topic><topic>Transients and Migrants - statistics & numerical data</topic><topic>Type 2 diabetes</topic><topic>Waist Circumference</topic><topic>Waist-Height Ratio</topic><topic>Waist-Hip Ratio</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Skogberg, Natalia</creatorcontrib><creatorcontrib>Laatikainen, Tiina</creatorcontrib><creatorcontrib>Lilja, Eero</creatorcontrib><creatorcontrib>Lundqvist, Annamari</creatorcontrib><creatorcontrib>Härkänen, Tommi</creatorcontrib><creatorcontrib>Koponen, Päivikki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Database (Proquest)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central</collection><collection>British Nursing Database</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Engineering Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Engineering Database</collection><collection>Environmental Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering collection</collection><collection>Environmental Science Collection</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Skogberg, Natalia</au><au>Laatikainen, Tiina</au><au>Lilja, Eero</au><au>Lundqvist, Annamari</au><au>Härkänen, Tommi</au><au>Koponen, Päivikki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The association between anthropometric measures and glycated haemoglobin (HbA1c) is different in Russian, Somali and Kurdish origin migrants compared with the general population in Finland: a cross-sectional population-based study</atitle><jtitle>BMC public health</jtitle><addtitle>BMC Public Health</addtitle><date>2019-04-11</date><risdate>2019</risdate><volume>19</volume><issue>1</issue><spage>391</spage><epage>12</epage><pages>391-12</pages><artnum>391</artnum><issn>1471-2458</issn><eissn>1471-2458</eissn><abstract>Persons of African and Middle-Eastern origin living in European countries have a high prevalence of type 2 diabetes, accompanied by high prevalence of obesity among women but not always among men. The aim of this study was to examine whether there are differences in the association between anthropometric measures and glucose levels measured with glycated haemoglobin and fasting blood glucose among persons of migrant origin in Finland.
Cross-sectional population-based data of the 30-64 year-old participants in the health examination of the Migrant Health and Wellbeing Study was used, selecting persons without diabetes (Russian origin n = 293, Somali origin n = 184, Kurdish origin n = 275). The reference group were non-diabetic participants in the Health 2011 Survey (n = 653), representative of the general Finnish population. Anthropometric measures included body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR, available for Maamu Study participants only).
Depending on whether continuous or categorical anthropometric measures were used, age, sex and anthropometrics explained 13-18% of variation in HbA1c among persons of Russian origin, 5-10% among persons of Somali origin, 1-3% among persons of Kurdish origin and 11-13% among the general population. Also depending on whether continuous or categorical anthropometric measures were used, age, sex and anthropometrics explained 13-19% of variation in fasting blood glucose among persons of Russian origin, 15-20% among persons of Somali origin, 13-17% among persons of Kurdish origin and 16-17% among the general population. With exception for BMI, strength of the association between continuous anthropometric measures and HbA1c was significantly lower among persons of Kurdish origin compared with the general Finnish population (p = 0.044 for WC and p = 0.040 for WHtR).
A low degree of association between anthropometric measures and HbA1c was observed among persons of Kurdish origin. Findings of this study suggest caution is warranted when using HbA1c as a screening tool for glucose impairment among persons without diabetes in populations of diverse origin.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>30971258</pmid><doi>10.1186/s12889-019-6698-0</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-8829-4159</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Abdomen Adult Anthropometry Blood Blood glucose BMI Body mass Body Mass Index Body measurements Body size Complications and side effects Control Cross-Sectional Studies Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - ethnology Diagnosis Epidemiology Ethnicity Ethnicity - statistics & numerical data Fasting Female Finland - epidemiology Glucose Glycated Hemoglobin - analysis Glycosylated hemoglobin HbA1c Health Health Surveys Hemoglobin Hemoglobins Hip Humans Kurds Library cataloging Male Medical examination Men Metabolic syndrome Middle Aged Migrant Migrants Migration Obesity Population Population studies Population-based studies Prevalence Prevention Risk Factors Russia - ethnology Sex Somalia - ethnology Studies Transients and Migrants - statistics & numerical data Type 2 diabetes Waist Circumference Waist-Height Ratio Waist-Hip Ratio Women |
title | The association between anthropometric measures and glycated haemoglobin (HbA1c) is different in Russian, Somali and Kurdish origin migrants compared with the general population in Finland: a cross-sectional population-based study |
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