Vascular disease in younger-onset diabetes: comparison of European, Asian and American Indian cohorts of the WHO multinational study of vascular disease in diabetes

Lee, E. T.; Lu, Mengji; Bennett, P. H.; Keen, H.

doi:10.1007/pl00002943

Cited by 28 publications

(18 citation statements)

References 10 publications

(11 reference statements)

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“…Fifty-seven studies published from 1990 to 2008 met the inclusion criteria: 13 European studies on AMD (4 multicentre studies [13,[22][23][24] , 6 prevalence studies from the Netherlands [25] , Germany [26] , France [27] , the UK [28] , the European North of Russia [29] and Bulgaria [2] , and 3 incidence studies from Rotterdam [22,30] and Germany [31] ), 23 studies of diabetic retinopathy (1 global [32] , 3 European [33][34][35] ; 2 multicentre European [15,36,37] and 2 multicentre from Spain [38] and Germany [26,39] , 1 long-term follow-up study from Germany [40] ; 7 population-based studies [2,30,31,[41][42][43][44][45] , 5 cross-sectional studies from Germany [39] , France [46] , Europe [27,37] , Spain [47] and 2 literature reviews [16,35] ), 5 studies of ocular hypertension, including 4 cross-sectional studies: 1 from Spain [48] , 2 from France [49,50] , 1 cross-sectional study of high intraocular pressure ...…”

Section: Resultsmentioning

confidence: 99%

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Epidemiology of Major Eye Diseases Leading to Blindness in Europe: A Literature Review

Prokofyeva

Zrenner²

2011

Ophthalmic Res

173

103

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The objective of this work was to study the epidemiology of major eye diseases leading to blindness in Europe through a systematic literature review. The literature search was performed using the Medline database (PubMed), with MeSH and free text search terms. Inclusion criteria for the studies were: (a) performed on a healthy population of Caucasian origin aged between 50 and 75 years; (b) diagnosed by ophthalmological examination in accordance with the International Classification of Diseases 10; (c) contained a detailed description of the sampling and diagnostic procedures and data resources; (d) sample size >500, and (e) published between 1990 and 2008. The results of 57 studies on the prevalence and incidence of age-related macular degeneration, diabetic retinopathy and glaucoma are reported, providing an up-to-date and comprehensive overview of these diseases in Europe from an epidemiological perspective.

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Section: Resultsmentioning

confidence: 99%

“…Moreover, existing studies focus for the most part only on a single eye disorder, such as AMD [12][13][14] , diabetic retinopathy [15][16][17] , glaucoma [18,19] or cataract [20,21] . Despite the high value of the data from these studies, there is still a pressing need for a complete picture of the epidemiological status of age-related eye diseases in Europe.…”

mentioning

confidence: 99%

Epidemiology of Major Eye Diseases Leading to Blindness in Europe: A Literature Review

Prokofyeva

Zrenner²

2011

Ophthalmic Res

173

103

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“…These include age, glycemic control, smoking, hypertension, and male sex (5,6,9,10,14,18). Participants were considered hypertensive if they had a systolic blood pressure Ն140 mmHg, a diastolic blood pressure Ն90 mmHg, or if they were taking antihypertension medication.…”

Section: Measurement Of Baseline Risk Factorsmentioning

confidence: 99%

“…Work restrictions are common, and most individuals with LEA require extensive life-long health services. Lowerextremity amputations occur with significantly greater frequency in diabetic American Indians than in diabetic people of other ethnicities (5,6).…”

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confidence: 96%

Relation of Lower-Extremity Amputation to All-Cause and Cardiovascular Disease Mortality in American Indians

et al. 2004

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OBJECTIVE -To compare risk of all-cause and cardiovascular disease (CVD) mortality in people with a lower-extremity amputation (LEA) attributable to diabetes and people without an LEA. RESEARCH DESIGN AND METHODS -The Strong HeartStudy is a study of CVD and its risk factors in 13 American-Indian communities. LEA was ascertained at baseline by direct examination of the legs and feet. Mortality surveillance is complete through 2000.RESULTS -Of 2,108 participants with diabetes at baseline, 134 participants (6.4%) had an LEA. Abnormal ankle-brachial index (53%), albuminuria (87%), and long diabetes duration (mean 19.8 years) were common among diabetic subjects with LEA. Mean diabetes duration among diabetic participants without LEA and in those with toe and below-the-knee amputations was 11.9, 18.6, and 21.1 years, respectively. During 8.7 (Ϯ2.9) years of follow-up, 102 of the participants with LEA (76%) died from all causes and 35 (26%) died from CVD. Of the 1,974 diabetic participants without LEA at baseline, 604 (31%) died from all causes and 206 (10%) died from CVD. The unadjusted hazard ratios (HRs) for all-cause and CVD mortality in diabetic participants with LEA compared with those without were 4.0 and 4.1, respectively. Adjusting for known and suspected confounders, LEA persisted as a predictor of all-cause (HR 2.2, 95% CI 1.7-2.9) and CVD mortality (HR 1.9, 95% CI 1.3-2.9). We observed a significant interaction between baseline LEA and sex on CVD mortality, with female sex conferring added risk of CVD mortality.CONCLUSIONS -LEA is a potent predictor of all-cause and CVD mortality in diabetic American Indians. The combination of female sex and LEA is associated with greater risk of CVD mortality than either factor alone.

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“…Previous studies have shown that hyperglycemia (5,6,9,10), duration of diabetes (5,6), male sex (2,5,6,10), and prevalent microvascular disease (5,6,10) contribute to LEA risk in American Indians.…”

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Incidence of Lower-Extremity Amputation in American Indians

et al. 2004

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OBJECTIVE -To define incidence and predictors of nontraumatic lower-extremity amputation (LEA) in a diverse cohort of American Indians with diabetes. RESEARCH DESIGN AND METHODS -The Strong HeartStudy is a study of cardiovascular disease and its risk factors in 13 American-Indian communities. Data on the presence/ absence of amputations were collected at each of three serial examinations (1989 -1992, 1993-1995, and 1997-1999) by direct examination of the lower extremity. The logistic regression model was used to quantify the relationship between risk of LEA and potential risk factors, including diabetes duration, HbA 1c , peripheral arterial disease, and renal function.RESULTS -Of the 1,974 individuals with diabetes and without prevalent LEA at baseline, 87 (4.4%) experienced an LEA during 8 years of follow-up, and a total of 157 anatomical sites were amputated among these individuals. Amputation of toes was most common, followed by belowthe-knee and above-the-knee amputations. Age-adjusted odds of LEA were higher among individuals with unfavorable combinations of risk factors, such as albuminuria and elevated HbA 1c . Multivariable modeling indicated that male sex, renal dysfunction, high ankle-brachial index, longer duration of diabetes, less than a high school education, increasing systolic blood pressure, and HbA 1c predicted LEA risk.CONCLUSIONS -The 8-year cumulative incidence of LEA in American Indians with diabetes is 4.4%, with marked differences in risk by sex, educational attainment, renal function, and glycemic control. Diabetes Care 27:1885-1891, 2004D ata from the baseline examination of the Strong Heart Study (SHS) show that lower-extremity amputation (LEA) due to diabetes was present in 3% of the cohort and 6.3% of individuals with diabetes (1), findings that are generally consistent with previous studies (2-4) in other American-Indian tribes.Rates of incident LEA have been reported for several American-Indian tribes (5-8). Previous studies have shown that hyperglycemia (5,6,9,10), duration of diabetes (5,6), male sex (2,5,6,10), and prevalent microvascular disease (5,6,10) contribute to LEA risk in American Indians.The purpose of this study is to define the incidence of first LEA due to diabetes in a diverse, population-based cohort of American Indians with diabetes. We hypothesized that among SHS participants with diabetes, increasing age, diabetes duration, glycemic control, smoking, peripheral arterial disease, renal dysfunction, and male sex would predict incident LEA and that combinations of risk factors, such as poor glycemic control and renal dysfunction, would interact to increase LEA risk. RESEARCH DESIGN AND METHODS -The SHS was initiated in 1988 to investigate cardiovascular disease and its risk factors in American Indians (11). The design, methods, and laboratory techniques of the SHS have been previously reported (12,13). The SHS cohort consists of 4,549 participants aged 45-74 years from 13 AmericanIndian communities in Oklahoma, the Dakotas, and Arizona who were seen at the basel...

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Vascular disease in younger-onset diabetes: comparison of European, Asian and American Indian cohorts of the WHO multinational study of vascular disease in diabetes

Cited by 28 publications

References 10 publications

Epidemiology of Major Eye Diseases Leading to Blindness in Europe: A Literature Review

Epidemiology of Major Eye Diseases Leading to Blindness in Europe: A Literature Review

Relation of Lower-Extremity Amputation to All-Cause and Cardiovascular Disease Mortality in American Indians

Incidence of Lower-Extremity Amputation in American Indians

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