Microvascular and macrovascular complications in type 2 diabetes Ghanaian residents in Ghana and Europe: The RODAM study

Abstract

To compare microvascular and macrovascular complication rates among Ghanaians with type 2 diabetes (T2D) living in Ghana and in three European cities (Amsterdam, London and Berlin). METHODS: Data from the multicenter Research on Obesity and Diabetes among African Migrants (RODAM) study were analyzed. 650 Ghanaian participants with T2D (206 nonmigrant and 444 migrants) were included. Logistic regression analyses were used to determine the association between migrant status and microvascular (nephropathy and retinopathy) and macrovascular (coronary artery disease (CAD), peripheral artery disease (PAD) and stroke) complications with adjustment for age, gender, socioeconomic status, alcohol, smoking, physical activity, hypertension, BMI, total-cholesterol, and HbA1c. RESULTS: Microvascular and macrovascular complications rates were higher in nonmigrant Ghanaians than in migrant Ghanaians (nephropathy 32.0% vs. 19.8%; PAD 11.2% vs. 3.4%; CAD 18.4% vs. 8.3%; and stroke 14.5% vs. 5.6%), except for self-reported retinopathy (11.0% vs. 21.6%). Except nephropathy and stroke, the differences persisted after adjustment for the above-mentioned covariates: PAD (OR 7.48; 95%CI, 2.16-25.90); CAD (2.32; 1.09-4.93); and retinopathy (0.23; 0.07-0.75). CONCLUSIONS: Except retinopathy, the rates of microvascular and macrovascular complications was higher in non-migrant than in migrant Ghanaians with T2D. Conventional cardiovascular risk factors did not explain the differences except for nephropathy and stroke.

Association between C reactive protein and microvascular and macrovascular dysfunction in sub-Saharan Africans with and without diabetes: the RODAM study

“…Indeed, we have previously reported that the higher rates of microvascular and macrovascular dysfunction in sub-Saharan Africans living in Africa compared with their peers in Europe are not fully explained by glycemic control or the conventional cardiovascular risk factors. 38 39 …”

Microvascular and macrovascular complications in type 2 diabetes in a multi-ethnic population based in Amsterdam. The HELIUS study

“…Globally, the prevalence of type 2 diabetes (T2D) is rising [1]. T2D increases the risk of macrovascular complications, such as coronary heart disease (CHD), peripheral artery disease (PAD), and stroke, and microvascular complications such as retinopathy, nephropathy, and neuropathy [2,3]. These microvascular and macrovascular complications of diabetes contribute to repeated hospitalization, disability, and early mortality [4].…”

Global warming and neurological practice: systematic review

“…Three observational studies compared data on cerebrovascular disease in migrant populations with data from non-migrant populations ( Hayfron-Benjamin et al, 2019 ; Chiu et al, 2010 ; Wolfe et al, 2006 ). Two studies reported a higher prevalence of stroke in non-migrant groups living in China ( Chiu et al, 2010 ) and Ghana ( Hayfron-Benjamin et al, 2019 ), as opposed to migrant populations living in Hong Kong, Singapore, Taiwan, Western Europe, and North America. After adjusting for conventional cardiovascular risk factors, results were no longer significant in one study ( Hayfron-Benjamin et al, 2019 ).…”

“…Two studies reported a higher prevalence of stroke in non-migrant groups living in China ( Chiu et al, 2010 ) and Ghana ( Hayfron-Benjamin et al, 2019 ), as opposed to migrant populations living in Hong Kong, Singapore, Taiwan, Western Europe, and North America. After adjusting for conventional cardiovascular risk factors, results were no longer significant in one study ( Hayfron-Benjamin et al, 2019 ). In contrast, Wolfe et al observed a higher incidence of stroke in migrants from Barbados moving to South London, including an increased incidence for specific stroke subtypes such as total anterior cerebral infarctions, posterior cerebral infarctions and SAH ( Wolfe et al, 2006 ).…”