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Clinical macrovascular disease in Caucasoid diabetic subjects: logistic regression analysis of risk variables
Insights
Macrovascular disease is common in diabetic individuals, with age being a key risk factor. For Type 2 diabetes, elevated creatinine, glucose, and cholesterol levels, along with blood pressure changes, increase macrovascular disease risk.
Area of Science:
- Endocrinology and Metabolism
- Cardiovascular Disease Epidemiology
- Diabetes Mellitus Research
Background:
- Diabetes mellitus is a significant global health concern.
- Macrovascular complications represent a major cause of morbidity and mortality in diabetic patients.
- Understanding risk factors for macrovascular disease in different diabetes types is crucial for prevention.
Purpose of the Study:
- To determine the prevalence of clinical macrovascular disease in a Caucasoid diabetic population in Western Australia.
- To identify age-related and independent risk factors for macrovascular disease in Type 1 and Type 2 diabetes.
- To explore associations between specific metabolic and clinical parameters and macrovascular complications.
Main Methods:
- A cross-sectional study involving 1084 Caucasoid diabetic subjects.
- Prevalence rates for coronary heart disease, stroke, and peripheral vascular disease were calculated.
- Logistic regression and forward stepwise selection were used to identify risk factors in Type 1 and Type 2 diabetes.
Main Results:
- High prevalence of macrovascular disease (46%) observed, including coronary heart disease (13%), stroke (8%), and peripheral vascular disease (38%).
- Age was the primary risk factor for total and peripheral vascular disease in both diabetes types.
- In Type 2 diabetes, independent risk factors included age, plasma creatinine, plasma glucose, HDL cholesterol, total cholesterol, and systolic blood pressure difference.
Conclusions:
- Macrovascular disease is highly prevalent in this diabetic cohort, with age being a universal risk factor.
- Specific metabolic factors like plasma creatinine, glucose, and cholesterol levels are significant independent risk factors for macrovascular disease in Type 2 diabetes.
- High-density lipoprotein cholesterol showed a strong negative association with coronary heart disease in Type 2 diabetes.
Abstract:
A cross-sectional study of 1084 Caucasoid diabetic subjects in rural Western Australia revealed a high rate of clinical macrovascular disease (46%), including coronary heart disease (13%), stroke (8%), and peripheral vascular disease (38%). Age was the major time-related variable for total macrovascular disease and for peripheral vascular disease, with identical prevalence rates in Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetes when age was taken into account. In 179 Type 1 diabetic subjects, logistic regression analysis showed no associated risk factors other than age. In 905 Type 2 diabetic subjects the independent risk factors for total macrovascular disease, identified by a forward step-wise selection procedure, were age as the major contributor, with plasma creatinine levels and plasma glucose levels (all p less than 0.001), high-density lipoprotein cholesterol levels, serum total cholesterol levels, and the (supine-erect) systolic blood pressure difference (all p less than 0.05). There were no direct associations with percentage desirable weight, cigarette smoking or male sex. Type 2 diabetic subjects demonstrated a very strong negative association between high-density lipoprotein cholesterol levels and coronary heart disease, and significant associations were found also between plasma glucose levels and coronary heart disease (p less than 0.01), and glycosylated haemoglobin levels and peripheral vascular disease (p less than 0.001).