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01.12.2012 | Original investigation | Ausgabe 1/2012 Open Access

Cardiovascular Diabetology 1/2012

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

Zeitschrift:
Cardiovascular Diabetology > Ausgabe 1/2012
Autoren:
Louise J Maple-Brown, Joan Cunningham, Bernard Zinman, Mary Mamakeesick, Stewart B Harris, Philip W Connelly, Jonathan Shaw, Kerin O'Dea, Anthony J Hanley
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

KOD and LMB designed and conducted the remote Australian study, JC, JS, KOD and LMB designed and conducted the DRUID study. AJH, SBH, MM, PC and BZ designed and conducted the Canadian study. LMB designed and performed the statistical analyses guided by AH, JC and KOD. LMB drafted the manuscript and all authors contributed important intellectual content. All authors approved the final version for publication. All authors read and approved the final manuscript.

Abstract

Background

Indigenous 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.

Methods

We 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).

Results

The 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.

Conclusions

Although 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.
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