Cardiovascular disease risk profile and microvascular complications of diabetes: comparison of Indigenous cohorts with diabetes in Australia and Canada

Cardiovascular Diabetology

Original Investigation

Jonathan Shaw¹  Stewart B Harris²  Philip W Connelly³  Bernard Zinman⁴  Anthony J Hanley⁵  Joan Cunningham⁶  Louise J Maple-Brown⁷  Mary Mamakeesick⁸  Kerin O'Dea⁹ 

[1] Baker IDI Heart and Diabetes Institute, Melbourne, Australia;Centre for Studies in Family Medicine at The Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada;Keenan Research Centre in the Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Canada;Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada;Leadership Sinai Centre for Diabetes, Mt Sinai Hospital, Toronto, Canada;Division of Endocrinology, University of Toronto, Toronto, Canada;Leadership Sinai Centre for Diabetes, Mt Sinai Hospital, Toronto, Canada;Division of Endocrinology, University of Toronto, Toronto, Canada;Department of Nutritional Sciences and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada;Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia;Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia;Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia;Leadership Sinai Centre for Diabetes, Mt Sinai Hospital, Toronto, Canada;Sandy Lake Health and Diabetes Project, Sandy Lake First Nation, London, ON, Canada;Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia;

关键词: Aboriginal;    Retinopathy;    Albuminuria;    Peripheral neuropathy;    Perhipheral vascular disease;   

DOI  :  10.1186/1475-2840-11-30

 received in 2012-02-13, accepted in 2012-03-28,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundIndigenous populations of Australia and Canada experience disproportionately high rates of chronic disease. Our goal was to compare cardiovascular (CVD) risk profile and diabetes complications from three recent comprehensive studies of diabetes complications in different Indigenous populations in Australia and Canada.MethodsWe compared participants from three recent studies: remote Indigenous Australians (2002-2003, n = 37 known diabetes), urban Indigenous Australians (2003-2005, n = 99 known diabetes), and remote Aboriginal Canadians (2001-2002, n = 188 known diabetes).ResultsThe three groups were similar for HbA1c, systolic BP, diabetes duration. Although leaner by body-mass-index criteria, remote Indigenous Australians displayed a more adverse CVD risk profile with respect to: waist-hip-ratio (1.03, 0.99, 0.94, remote Indigenous Australians, urban Indigenous Australians, remote Canadians, p < 0.001); HDL-cholesterol (0.82, 0.96, 1.17 mmol/L, p < 0.001); urine albumin-creatinine-ratio (10.3, 2.4, 4.5 mg/mmol); and C-reactive protein. With respect to diabetes complications, microalbuminuria (50%, 25%, 41%, p = 0.001) was more common among both remote groups than urban Indigenous Australians, but there were no differences for peripheral neuropathy, retinopathy or peripheral vascular disease.ConclusionsAlthough there are many similarities in diabetes phenotype in Indigenous populations, this comparison demonstrates that CVD risk profiles and diabetes complications may differ among groups. Irrespective, management and intervention strategies are required from a young age in Indigenous populations and need to be designed in consultation with communities and tailored to community and individual needs.

【 授权许可】

CC BY   
© Maple-Brown et al; licensee BioMed Central Ltd. 2012