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Differences in coronary heart disease prevalence and risk factors in African and White patients with type 2 diabetes

W John Kalk1, Barry I Joffe

  • 1Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa. john.kalk@derbyhospitals.nhs.uk

Diabetes Research and Clinical Practice
|December 5, 2006
PubMed

Insights

Coronary heart disease (CHD) is rare in African diabetic populations. Lower total cholesterol and triglyceride levels, reduced insulin resistance, and renal disease contribute to this lower prevalence in African patients with type 2 diabetes.

Area of Science:

  • Cardiology
  • Diabetology
  • Epidemiology

Background:

  • Coronary heart disease (CHD) is uncommon in sub-Saharan Africans, with limited data available for African populations with diabetes.
  • Type 2 diabetes is a significant risk factor for cardiovascular disease, including CHD.

Purpose of the Study:

  • To evaluate the prevalence of CHD and associated risk factors in African and White European individuals with type 2 diabetes.
  • To identify factors contributing to the lower incidence of CHD in African diabetic populations.

Main Methods:

  • A comparative study involving 744 individuals with type 2 diabetes (448 African, 296 White European).
  • Assessment of CHD prevalence, lipid profiles (total cholesterol, triglycerides, HDL-C, LDL-C), and other conventional risk factors.
  • Regression analysis to determine associations between CHD and risk factors in different ethnic groups.

Main Results:

  • CHD prevalence was significantly lower in African subjects (4%) compared to White European subjects (23%).
  • African individuals exhibited lower total cholesterol and triglyceride levels, and reduced triglyceride to HDL-C ratios, indicating less insulin resistance.
  • Serum creatinine was identified as a risk factor for CHD in African subjects, while triglycerides were a risk factor in White European subjects.

Conclusions:

  • The lower prevalence of CHD in African patients with type 2 diabetes can be attributed to lower lipid levels and reduced insulin resistance.
  • Renal disease may represent an additional significant risk factor for CHD in this population.

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