Ethnicity influences cardiovascular outcomes and complications in patients with type 2 diabetes

J Diabetes Complications. 2018 Feb;32(2):144-149. doi: 10.1016/j.jdiacomp.2017.10.016. Epub 2017 Nov 6.

Abstract

Aim: To determine whether cardiovascular outcomes in type 2 diabetes (T2D) differ according to ethnicity, and whether ethnicity influences the effect of gender on these outcomes in Caucasians, East-Southeast-Asians, Middle-Easterners, South-Asians and Pacific-Islanders.

Methods: We compared demographics, HbA1c, lipid profile, renal function markers, and prevalence of macrovascular and microvascular complications between ethnic groups. Cross-sectional data was prospectively collected from 204 consecutive patients at Westmead Hospital's T2D clinic from April-October 2015. Univariate analysis was performed using chi-squared test for categorical data, and Mann-Whitney-U or Kruskal-Wallis test for continuous data.

Results: Compared to Caucasians, South-Asians were diagnosed younger, were currently younger, had lower body-mass-index (BMI) and better renal function but higher rates of non-ST-elevation myocardial infarction (STEMI, 21.7% versus 3.5%, p<0.05). East-Southeast-Asians had lower BMI but more nephropathy than Caucasians (59% versus 39%, p<0.05). East-Southeast-Asian males had fewer CVD than Caucasians, but this protection was absent in East-Southeast-Asian females. Middle-Easterners had more non-STEMI than Caucasians (5.3% vs 3.5%, p<0.05). Middle-Eastern females were not at lower CVD risk than males. Caucasians had most PVD (20% versus 6%, p<0.05).

Conclusions: Ethnicity influences rates of diabetes-related complications. Female CVD protection is altered in some groups. Ethnicity should be considered in assessing CVD and complications risk.

Keywords: Cardiovascular disease; Disparity; Ethnicity; Myocardial infarct; Type 2 diabetes.

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / ethnology*
  • Cardiovascular System / physiopathology
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / ethnology*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetic Angiopathies / ethnology*
  • Ethnicity / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors