Cardiometabolic Risk Profiles Associated with Chronic Complications in Overweight and Obese Type 2 Diabetes Patients in South China

Abstract

BackgroundType 2 diabetes is often accompanied by altered cardiometabolic risk profiles, including abdominal obesity, hypertension, and dyslipidaemia. The association of altered cardiometabolic risk profiles with chronic complications of diabetes is not well investigated.MethodsWe recruited 2954 type 2 diabetes patients with a body mass index ≥25 kg/m2 who visited the diabetes clinics of 62 hospitals in 21 cities in Guangdong province of China from August 2011 to March 2012. Demographic characteristics, personal and family medical histories, and data on chronic complications of diabetes were collected. Clinical examinations and laboratory assessment were conducted.ResultsAbdominal obesity was found in 91.6% of the study population, elevated blood pressure in 78.3%; elevated serum triacylglycerols in 57.8%, and reduced serum HDL-C in 55.9%. Among the cardiometabolic risk factors, elevated blood pressure was significantly associated with almost all the chronic complications of diabetes. After adjusting for age, gender, duration of diabetes, and HbA1c, elevated blood pressure was significantly associated with diabetic retinopathy (OR 1.63, 95% CI: 1.22–2.19), diabetic nephropathy (OR 3.16, 95% CI: 2.25–4.46), cardiovascular disease (OR 2.71, 95% CI: 1.70–4.32), and stroke (OR 1.90, 95% CI: 1.15–3.12). Abdominal adiposity was significantly associated with diabetic nephropathy (OR 1.39, 95% CI: 1.11–1.74). Elevated triacylglycerols was significantly associated with diabetic retinopathy (OR 1.29, 95% CI: 1.05–1.58) and diabetic nephropathy (OR 1.30, 95% CI: 1.05–1.58). Reduced HDL-C was significantly associated with stroke (OR 1.41, 95% CI: 1.05–1.88).ConclusionsAltered cardiometabolic risk profiles, and elevated blood pressure in particular, were significantly associated with chronic complications in overweight and obese patients with type 2 diabetes. Future studies on the prevention of chronic complications of diabetes might make lowering blood pressure a primary target.

Associations between diabetic retinopathy and systemic risk factors

“…[4][5][6][7][8]10,19,21,22,24,28,30,34,[38][39][40][42][43][44][47][48][49][50][51][52][53] 69 This is consistent with other genome-wide association studies in Caucasian and Mexican-American patients. 70,71 As the relationship between genetic polymorphisms and diabetic retinopathy is still a new and emerging field, some studies have demonstrated new associations between single nucleotide polymorphisms, but these studies have not yet been replicable.…”

“…Likewise, in a large-scale study of 2535 patients with type 2 DM, retinopathy was not significantly associated with triglyceride or high-density lipoprotein (HDL) cholesterol levels after adjustment of confounding factors. 45 In contrast, Cheng at al 4 found that in overweight type 2 DM patients, elevated triacylglycerol levels were significantly associated with diabetic retinopathy (OR=1.29; 95% CI, 1.05-1.58; P<0.05).…”

“…4,[6][7][8]30 The LALES study found an OR of 1.26 (P=0.002) for every 20 mm Hg increase in blood pressure. 10 The Hoorn study estimated that patients with hypertension had more than double the risk of developing retinopathy after 10 years when compared with diabetic patients with normal blood pressure.…”

“…2 It has also been well established that DM increases the risk of cardiovascular disease. 3 Cheng et al 4 found that the prevalence of diabetic retinopathy associated with one, two, three, or four cardiometabolic risk factors was 16.0%, 17.6%, 21.3%, or 25.1%, respectively (P=0.001). This implies a relationship between systemic health conditions and diabetic retinopathy.…”

The Impact of Diet Counselling on Type 2 Diabetes Mellitus: An Indian Case Study

“…Many persons with T2DM are overweight, insulin resistant and also have dyslipidaemia and hypertension [41][42][43][44][45][46][47][48][49]. Therefore, medical nutrition therapy for T2DM should emphasize lifestyle strategies, to reduce hyperglycemia, dyslipidemia, and blood pressure [50] that result in reduced energy intake and increased energy expenditure through physical activity.…”