Lower Extremity Peripheral Arterial Disease Is an Independent Predictor of Coronary Heart Disease and Stroke Risks in Patients with Type 2 Diabetes Mellitus in China

Coronary heart disease (CHD) and stroke are common complications of type 2 diabetes mellitus (T2DM). We aimed to explore the differences in the risks of CHD and stroke between Chinese women and men with T2DM and their association with metabolic syndrome (MS). This study included 1514 patients with T2DM. The Asian Guidelines of ATPIII (2005) were used for MS diagnosis, and the UKPDS risk engine was used to evaluate the 10-year CHD and stroke risks. Women had lower CHD risk (15.3% versus 26.3%), fatal CHD risk (11.8% versus 19.0%), stroke risk (8.4% versus 10.3%), and fatal stroke risk (1.4% versus 1.6%) compared with men with T2DM (p<0.05–0.001). The CHD risk (28.4% versus 22.6%, p<0.001) was significantly higher in men with MS than in those without MS. The CHD (16.2% versus 11.0%, p<0.001) and stroke risks (8.9% versus 5.8%, p<0.001) were higher in women with MS than in those without MS. In conclusion, our findings indicated that Chinese women with T2DM are less susceptible to CHD and stroke than men. Further, MS increases the risk of both these events, highlighting the need for comprehensive metabolic control in T2DM.

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Apolipoprotein E genotype and mortality in Southern European and Anglo-Celt patients with type 2 diabetes: the Fremantle Diabetes Study

Acta Endocrinologica ◽

10.1530/eje-10-0474 ◽

2010 ◽

Vol 163 (4) ◽

pp. 559-564 ◽

Cited By ~ 4

Author(s):

Wendy A Davis ◽

Eunice Chin ◽

Adelle Jee ◽

Jen Martins ◽

David G Bruce ◽

...

Keyword(s):

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Heart Disease ◽

Cardiac Death ◽

Arterial Disease ◽

Male Gender ◽

Community Based ◽

All Cause Mortality ◽

Peripheral Arterial

ObjectiveTo determine whether cardiac and all-cause mortality are lower in Southern European (SE) patients than in Anglo-Celt (AC) patients with type 2 diabetes in an urban Australian setting, and, if so, whether ethnicity-specific differences in apolipoprotein E (APOE) genotypes are contributory.DesignLongitudinal observational cohort study.MethodsWe analysed detailed data from 1057 patients from the community-based Fremantle Diabetes Study, 238 were of an SE migrant background and 819 of AC ethnicity. Cox proportional hazards modelling was used to identify independent predictors of cardiac and all-cause mortality.ResultsDuring 9.8±3.5 years of follow-up, 411 (38.9%) participants died, 161 (39.2%) from cardiac causes. Significant positive baseline independent predictors of cardiac death were age, male gender, coronary heart disease, cerebrovascular disease, peripheral arterial disease, retinopathy and peripheral neuropathy (P≤0.004), while maternal history of diabetes was protective (P=0.014). After adjusting for these variables,APOE4carriage was predictive (hazard ratio (95% confidence interval) 1.61 (1.01–2.58);P=0.048). SE ethnicity did not add significantly to the model either as a single variable or as an interaction term withAPOE4carriage (P≥0.86). Significant independent predictors of all-cause mortality were age, male gender, smoking, coronary heart disease, cerebrovascular disease, peripheral arterial disease, retinopathy, peripheral neuropathy and microalbuminuria (P≤0.047), while overweight/obesity, lipid-lowering therapy and recent exercise were protective (P≤0.008).APOE4carriage, SE ethnicity and their interaction did not add to the model (P≥0.32).ConclusionsSE ethnicity does not confer an independent survival advantage in community-based Australian type 2 diabetic patients, butAPOE4carriers are at higher risk of cardiac death.

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Carotid atherosclerosis and its relationship to coronary heart disease and stroke risk in patients with type 2 diabetes mellitus

Medicine ◽

10.1097/md.0000000000008151 ◽

2017 ◽

Vol 96 (39) ◽

pp. e8151 ◽

Cited By ~ 4

Author(s):

Yan Wu ◽

Jie He ◽

Xue Sun ◽

Yi-Ming Zhao ◽

Han-Yu Lou ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Type 2 Diabetes Mellitus ◽

Heart Disease ◽

Carotid Atherosclerosis ◽

Stroke Risk

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Prevalence and Risk Factors of Coronary Heart Disease in Chinese Patients with type 2 Diabetes Mellitus, 2013-2018

10.21203/rs.3.rs-42382/v1 ◽

2020 ◽

Author(s):

Chenchen Wang ◽

Zuoling Xie ◽

Xi Huang ◽

Zheng Wang ◽

Haiyan Shangguan ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Regression Analysis ◽

Heart Disease ◽

Diabetic Patients ◽

Population Census ◽

Chd Risk ◽

Chd Risk Factors

Abstract Background: Coronary heart disease (CHD) is the most common cause of death in patients with type 2 diabetes (T2DM). We aim to estimate the prevalence of CHD and cardiovascular risk factors in Chinese diabetic inpatients.Methods: A total of 66536 diabetic inpatients from 2013 to 2018 were investigated, demographic and clinical data were gathered from 30693 patients with T2DM. The age-standardized prevalence of CHD was calculated on the basis of data from Chinese population census in 2010. Multiple imputation was used to impute missing values and logistic regression analysis was used to analyze the risk factors.Results: The crude prevalence of CHD was estimated to be 23.5% and a standardized prevalence was 13.9% (16.0% in men and 11.9% in women). More than half of diabetic patients with CHD have 4 or above of the 5 traditional risk factors, which is much higher than 38.96% of diabetic patients (p<0.01). Multivariate regression analysis showed that diabetes duration, hypertension, smoking, underweight, overweight, obesity, hypoglycemia were significantly associated with a higher risk of CHD (all p<0.05). The odds ratio of CHD in patients having 3, 4, or 5 CHD risk factors were 2.35 (95%CI 1.81- 3.04), 2.96 (95%CI 2.28- 3.85), and 5.29 (95%CI 4.04- 6.93), compared with diabetes patients without any other risk factors.Conclusions: The prevalence of CHD was rather high in Chinese T2DM inpatients, aggregation of CHD risk factors was more seriously, hierarchical CHD prevention strategies based on risk factors are needed for them.

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Association of plasma fetuin-a levels with peripheral arterial disease and lower extremity arterial calcification in subjects with type 2 diabetes mellitus

Journal of Diabetes and its Complications ◽

10.1016/j.jdiacomp.2016.11.006 ◽

2017 ◽

Vol 31 (3) ◽

pp. 599-604 ◽

Cited By ~ 11

Author(s):

Ioanna Eleftheriadou ◽

Pinelopi Grigoropoulou ◽

Alexander Kokkinos ◽

Iordanis Mourouzis ◽

Despoina Perrea ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Peripheral Arterial Disease ◽

Lower Extremity ◽

Arterial Disease ◽

Arterial Calcification ◽

Fetuin A ◽

Peripheral Arterial

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Sex Differences in the Risk of Coronary Heart Disease Associated With Type 2 Diabetes: A Mendelian Randomization Analysis

10.2337/figshare.13135781 ◽

2020 ◽

Author(s):

Tricia M. Peters ◽

Michael V. Holmes ◽

J. Brent Richards ◽

Tom Palmer ◽

Vincenzo Forgetta ◽

...

Keyword(s):

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Heart Disease ◽

Genome Wide Association Study ◽

Mendelian Randomization ◽

Causal Effect ◽

Sensitivity Analyses ◽

Chd Risk ◽

Unit Increase

Objective: Observational studies have demonstrated that type 2 diabetes is a stronger risk factor for coronary heart disease (CHD) in women compared with men. However, it is not clear whether this reflects a sex differential in the causal effect of diabetes on CHD risk or results from sex-specific residual confounding. Methods: Using 270 single nucleotide polymorphisms (SNPs) for type 2 diabetes identified in a type 2 diabetes genome-wide association study, we performed a sex-stratified Mendelian randomization (MR) study of type 2 diabetes and CHD using individual participant data in UK Biobank (N=251,420 women and 212,049 men). Weighted-median, MR Egger, MR-PRESSO and radial MR from summary-level analyses were used for pleiotropy assessment. Results: MR analyses showed that genetic risk of type 2 diabetes increased the odds of CHD for women (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.08-1.18 per 1-log unit increase in odds of type 2 diabetes) and men (OR 1.21, 95% CI 1.17-1.26 per 1-log unit increase in odds of type 2 diabetes). Sensitivity analyses showed some evidence of directional pleiotropy, however, results were similar after correction for outlier SNPs. Conclusions: This MR analysis supports a causal effect of genetic liability to type 2 diabetes on risk of CHD that is not stronger for women than men. Assuming a lack of bias, these findings suggest that the prevention and management of type 2 diabetes for CHD risk reduction is of equal priority in both sexes.

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The Association between Plasma Levels of Trimethylamine N-Oxide and the Risk of Coronary Heart Disease in Chinese Patients with or without Type 2 Diabetes Mellitus

Disease Markers ◽

10.1155/2018/1578320 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Zengxiang Dong ◽

Zhaoguang Liang ◽

Meihua Guo ◽

Shuang Hu ◽

Zhaoqian Shen ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Type 2 Diabetes Mellitus ◽

Heart Disease ◽

Plasma Levels ◽

Independent Predictor ◽

Chinese Patients ◽

Creatine Kinase Mb

Aim. Trimethylamine N-oxide (TMAO) has been demonstrated as an independent risk factor for cardiovascular disease. Our objective was to determine the plasma levels of TMAO in Chinese coronary heart disease (CHD) patients with or without type 2 diabetes mellitus (T2DM). Methods. A total of 132 control participants, 243 CHD patients, and 175 CHD patients with T2DM were enrolled. Plasma levels of TMAO in all patients were measured and analyzed. Results. The plasma levels of TMAO were significantly higher in CHD patients than in control subjects (3.08 ± 0.13 μM versus 1.49 ± 0.05 μM; P<0.01). In addition, plasma levels of TMAO were remarkably increased in CHD patients with T2DM compared with CHD patients (7.63 ± 0.97 μM versus 3.08 ± 0.13 μM; P<0.01). The receiver operating characteristic analysis revealed that the area under the curve of TMAO was 0.794 and 0.927 to predict CHD or CHD-T2DM patients (P<0.01). Univariate and multivariate logistic regression analysis showed that TMAO was an independent predictor in CHD patients with or without T2DM. The level of TMAO was correlated with high-sensitive troponin I (hs-TnI) and creatine kinase MB (CKMB). Conclusions. TMAO was an independent predictor of CHD in Chinese patients; moreover, the TMAO levels were highly associated with diabetes in CHD patients.

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Sex Differences in the Risk of Coronary Heart Disease Associated With Type 2 Diabetes: A Mendelian Randomization Analysis

10.2337/figshare.13135781.v1 ◽

2020 ◽

Author(s):

Tricia M. Peters ◽

Michael V. Holmes ◽

J. Brent Richards ◽

Tom Palmer ◽

Vincenzo Forgetta ◽

...

Keyword(s):

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Heart Disease ◽

Genome Wide Association Study ◽

Mendelian Randomization ◽

Causal Effect ◽

Sensitivity Analyses ◽

Chd Risk ◽

Unit Increase

Objective: Observational studies have demonstrated that type 2 diabetes is a stronger risk factor for coronary heart disease (CHD) in women compared with men. However, it is not clear whether this reflects a sex differential in the causal effect of diabetes on CHD risk or results from sex-specific residual confounding. Methods: Using 270 single nucleotide polymorphisms (SNPs) for type 2 diabetes identified in a type 2 diabetes genome-wide association study, we performed a sex-stratified Mendelian randomization (MR) study of type 2 diabetes and CHD using individual participant data in UK Biobank (N=251,420 women and 212,049 men). Weighted-median, MR Egger, MR-PRESSO and radial MR from summary-level analyses were used for pleiotropy assessment. Results: MR analyses showed that genetic risk of type 2 diabetes increased the odds of CHD for women (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.08-1.18 per 1-log unit increase in odds of type 2 diabetes) and men (OR 1.21, 95% CI 1.17-1.26 per 1-log unit increase in odds of type 2 diabetes). Sensitivity analyses showed some evidence of directional pleiotropy, however, results were similar after correction for outlier SNPs. Conclusions: This MR analysis supports a causal effect of genetic liability to type 2 diabetes on risk of CHD that is not stronger for women than men. Assuming a lack of bias, these findings suggest that the prevention and management of type 2 diabetes for CHD risk reduction is of equal priority in both sexes.

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