Atherosclerotic Vascular Disease and Its Risk Factors in Non-Insulin-Dependent Diabetic and Nondiabetic Subjects in Finland

Abstract

A cross-sectional study on the prevalence of atherosclerotic vascular disease (ASVD) and its risk factors in non-insulin-dependent diabetic and nondiabetic subjects was carried out from 1982 to 1984 in East Finland (Kuopio) and West Finland (Turku), two areas known to differ markedly in prevalence of ASVD in the nondiabetic population. A total of 510 diabetic and 649 nondiabetic subjects aged 45-64 yr were examined in East Finland and 549 diabetic and 724 nondiabetic subjects of the same age in West Finland. In both areas and in both sexes the prevalence of coronary heart disease (CHD), stroke, and intermittent claudication was higher in diabetic than in nondiabetic subjects. Both in diabetic and nondiabetic subjects the prevalence of ASVD was higher in East Finland than in West Finland. In men, the East-West difference in the prevalence of symptomatic CHD and claudication was greater in diabetic than in nondiabetic subjects. In both areas and in both sexes the serum lipid pattern was more atherogenic and hypertension was more frequent in diabetic than in nondiabetic subjects. In both diabetic and nondiabetic subjects, serum total-cholesterol level was somewhat higher and hypertension was more frequent in East Finland than in West Finland. The East-West difference in serum total-cholesterol was greater in diabetic than in nondiabetic subjects. In multiple logistic analyses including cardiovascular risk factors, diabetes status, and area of residence, residence in East Finland was found to be, in addition to diabetes, a strong independent factor associated with CHD, particularly in men.

Plasma triglyceride and coronary heart disease.

“…68 In a separate publication, multivariate analyses in the same sample of diabetic subjects was reported, including TC and/or HDL-C as covariates. 69 In these models, triglyceride was not independently associated with definite MI, probable CHD, or angina pectoris in men or women from either area of Finland studied. 69 Based on a sample from the Paris Prospective Study, 70 men aged 43-54 years with either impaired glucose tolerance or diabetes were followed up for an average of 11 years.…”

“…69 In these models, triglyceride was not independently associated with definite MI, probable CHD, or angina pectoris in men or women from either area of Finland studied. 69 Based on a sample from the Paris Prospective Study, 70 men aged 43-54 years with either impaired glucose tolerance or diabetes were followed up for an average of 11 years. Baseline triglyceride levels were significantly higher in men with death caused by CHD, and this association persisted after adjustment for a number of other risk factors including TC, systolic blood pressure, body mass index, and cigarette smoking.…”

Diagnosis of Type 2 Diabetes at an Older Age

“…A weakness of the study was that we were unable to adjust for cardiovascular risk factors at baseline. However, we might expect a poorer profile in the diabetic cohort (14,15), with adjustment resulting in even less of a difference between the two cohorts. The proportion of cardiovascular deaths was relatively low; however, we used "underlying cause of death" to determine whether a death had a cardiovascular cause, and this may underestimate cardiovascular mortality.…”

Proteinuria and metabolic syndrome as predictors of cardiovascular death in non-diabetic and type 2 diabetic men and women

“…Patients A detailed description of study participants has been published previously [22]. Altogether 1,059 subjects (581 men, 478 women) with type 2 diabetes, aged 45-64 years, born and living in the Turku University Hospital district in West Finland and in the Kuopio University Hospital district in East Finland were identified through a national drug reimbursement register.…”

“…Baseline study The baseline examination, conducted in 1982-1984, has been described in detail previously [22]. Two investigators (T. Rönnemaa, M. Laakso) reviewed the hospital records of those participants who reported that they had been hospitalised for CVD.…”