Dataset Information

Trends in cardiovascular disease risk factors in people with and without diabetes mellitus: a Middle Eastern cohort study.

ABSTRACT:

Aims/hypothesis

To investigate secular trends in cardiovascular disease (CVD) risk factors during a decade of follow-up in a Middle Eastern cohort, and to compare observed trends between diabetic and non-diabetic populations.

Methods

In a population of 6181 participants (2622 males and 3559 females), diabetes status and CVD risk factors were evaluated in 4 study phases from 1999-2011. 1045 subjects had type 2 diabetes mellitus at baseline and 5136 participants were diabetes-free. To examine the trends of CVD risk factors, generalized estimation equation models were constructed. The interaction between the diabetes status and each phase of the study was checked in a separate model.

Results

During the follow-up period diabetic females significantly gained better control of their blood pressure, serum low density lipoprotein cholesterol and general and central obesity measures compared to non-diabetic counterparts, although 60% of them had high BP and 64% had high serum LDL-C levels till the end of the study. Diabetic males however, experienced significantly better control on their serum LDL-C and general and central obesity measures compared to their non-diabetic controls; but 24% of them were still smoker, 63% had high BP and 60% had high serum LDL-C levels at the end of the follow-up (all Ps interaction <0.05). Use of lipid-lowering and antihypertensive medications increased consistently in both diabetic and non-diabetic populations.

Conclusions/interpretation

Although CVD risk factors have been controlled to some extent among diabetic population in Iran, still high numbers of people with diabetes have uncontrolled CVD risk factors that prompt more attention.

SUBMITTER: Jahangiri-Noudeh Y

PROVIDER: S-EPMC4251920 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Studies evidenced that reduction in cardiovascular disease (CVD) mortality in diabetic patients can be attributed to improvements in major CVD risk factors and evidence-based treatments. Furthermore, studies showed that the relative risk of CVD mortality associated with diabetes compared with non-diabetes is stronger in women than in men. Hence, we aimed to examine trends in CVD risk factors and intervention measures by sex and diabetic status.Analysis of 5 distinct cross-sectional National Health and Nutrition Examination Surveys, 1988-1994, 1999-2002, 2003-2006, 2007-2010, and 2010-2014. Since detailed information on nontraditional risk factors such as sleep apnea was not available in each NHANES survey, traditional CVD risk factors including obesity, hypertension, and dyslipidemia were assessed in the study. To assess whether changes throughout the 27-year period differed by diabetes status, a logistic regression analysis was utilized to examine potential interaction effects between survey and diabetes. The similar process was repeated for sex.Means of all risk factors except body mass index and waist circumference decreased and the prevalence of antihypertensive and lipid-lowering medication use increased over time among diabetic and non-diabetic men and women. For both men and women, survey?×?diabetes status interaction terms for changes in HDL-cholesterol and triglyceride levels were not statistically significant, while the prevalence of antihypertensive and lipid-lowering medication use increased more in diabetic than in non-diabetic persons (all P?<?0.001). For women, survey?×?diabetes status interaction terms indicated that compared with the first survey, total cholesterol, LDL-cholesterol, and non-HDL-cholesterol fallen more in diabetic than in non-diabetic persons (all P?<?0.001). In the diabetic state, men experienced similar changes in means of all CVD risk factors and the prevalence of antihypertensive and lipid-lowering medication use as women (all P for interactions between survey and sex were >0.01).The major traditional CVD risk factors in diabetic men decreased to the same extent that they did for non-diabetic men. The magnitude of changes in the favorable trends in diabetic women was of similar or greater compared with those among non-diabetic women. Diabetic women had as good an improvement in CVD risk factors as diabetic men.

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