Differences in Cardiometabolic Risk Profiles Between Chinese and Finnish Older Adults with Glucose Impairment and Central Obesity

Abstract

Background Obesity and ethnicity play important roles in cardiovascular complications in patients with T2DM. This study aimed to compare cardiometabolic risk profiles between Chinese and Finnish older adults with prediabetes or type 2 diabetes mellitus (T2DM) and central obesity. Methods Study subjects were 60-74 years old and originated from two population samples. The Finnish subjects came from the Kuopio Ischemic Heart Disease (KIHD) study (n = 1089), and the Chinese subjects came from the Shanghai High-risk Diabetic Screen (SHiDS) study (n = 818). The KIHD and SHiDS studies used similar questionnaires to determine participants’ baseline characteristics regarding the history of medication use and diseases and lifestyle factors. All study subjects participated in glucose tolerance tests and anthropometry assessments, including waist circumference measurements. Results Among study subjects with prediabetes and central obesity (n = 298), fasting glucose, 2-h glucose, fasting insulin, insulin resistance, and triglyceride (TG) levels were significantly higher while the low-density lipoprotein cholesterol (LDL) and LDL to high-density lipoprotein cholesterol (HDL) ratio were lower in Chinese individuals than Finnish individuals (p <0.0001-0.003). Among subjects with T2DM and central obesity (n = 251), Chinese subjects had significantly less proportions of antihypertensive, glycaemic control medication, and statin users as well as lower level of physical activity (p < 0.0001 for all), while higher blood pressure (p = 0.002 for systolic blood pressure and p < 0.0001 for diastolic blood pressure), TG levels (p < 0.05) and HDL (p = 0.002) than the Finnish counterparts. There were no differences in β-cell function (HOMA-β) between Chinese and Finnish both in prediabetes and T2DM. Conclusions Our results indicated that Chinese and Finnish older adults with prediabetes and T2DM had similar β-cell function. However, Chinese individuals with prediabetes are prone to lipid metabolism dysfunction and insulin resistance. Strategies for preventing prediabetes from developing into diabetes in Chinese individuals should be focused on interventions such as exercise to increase insulin sensitivity and prevent insulin resistance. For Finnish individuals with prediabetes, more attention should be given to weight control.

Association of four lipid-derived indicators with the risk of developing type 2 diabetes: a Chinese population-based cohort study

“…A, B and C are ROC curves predicting the 3-year risk of T2D for all, male and female populations. D, E and F are ROC curves predicting the 5-year risk of T2D for all, male and female populations have shown a significant association between LDL and diabetes in the Western population, whereas high TG levels were observed in the Chinese population [42]. In this study, the effect of obesity and high glucose level exceeded the effects of LDL and non-HDL on T2D risk in the Chinese population.…”