Abdominal Obesity and Ethnic Differences in Diabetes Awareness, Treatment, and Glycemic Control

Okosun, Ike S.; Dever, G. E. Alan

doi:10.1038/oby.2002.169

Cited by 39 publications

(29 citation statements)

References 39 publications

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“…Similar to our results, previous studies have shown a positive association between glycemic control and adiposity (39,42,43) and cholesterol levels (21,44). Studies in individuals without diabetes have also shown similar correlations between lipids and A1C (45)(46)(47)(48).…”

Section: Multivariable Analysessupporting

confidence: 81%

Glycemic Control, Atherosclerosis, and Risk Factors for Cardiovascular Disease in Individuals With Diabetes

et al. 2005

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OBJECTIVE -Glycemic control (HbA 1c [A1C]) is strongly associated with microvascular disease in individuals with diabetes, but its relation to macrovascular disease and atherosclerosis is less clear. This study examines the relationship between A1C, carotid intima-media thickness (IMT), and traditional cardiovascular risk factors in individuals with diabetes. RESEARCH DESIGN AND METHODS-A cross-sectional study of 2,060 people with diagnosed and undiagnosed (unrecognized) diabetes in the Atherosclerosis Risk in Communities study was performed.RESULTS -LDL and HDL cholesterol, plasma triglycerides, and waist-to-hip ratio were significantly associated with A1C after multivariable adjustment. African Americans with undiagnosed and diagnosed diabetes had significantly elevated A1C values compared with whites, even after adjustment for potentially confounding factors. There was a graded association between A1C and carotid IMT. In a fully adjusted model in individuals with undiagnosed diabetes, the odds ratio (OR) of being in the highest quartile of IMT versus the lowest was 2.46 (95% CI 1.16 -5.03, comparing the highest quartile of A1C to the lowest). In people with diagnosed diabetes, the comparable OR was 2.62 (1.36 -5.06).CONCLUSIONS -This study identified several important associations between A1C and known risk factors for cardiovascular disease and suggested that A1C is independently related to carotid IMT. Chronically elevated glucose levels may contribute to the development of atherosclerosis in people with diabetes, independent of other risk factors. Diabetes Care 28:1965-1973, 2005R ecent estimates suggest that there are ϳ18 million individuals with diabetes in the U.S., affecting ϳ9% of the total adult population (1). Glycemic control is a focus of clinical treatment of diabetes. HbA 1c (A1C), a measure of long-term glycemic control, is used to monitor and guide clinical treatment in individuals with diabetes. Elevated A1C levels are strongly associated with diabetes-related microvascular disease (2-4), but whether A1C is independently associated with the progression of atherosclerosis (5) and cardiovascular events (6) in individuals with diabetes remains controversial.The U.K. Prospective Diabetes Study (UKPDS) showed an overall 25% reduction (P ϭ 0.0099) in the risk of microvascular disease end points in the intensively treated group (median A1C ϭ 7.0%) compared with the conventionally treated group (7.9%) after 10 years of follow-up (2). There is some evidence from epidemiologic studies that similar reductions in A1C may also reduce the risk of cardiovascular disease in people with diabetes (6,7). In the UKPDS trial, there was a 16% reduction (P ϭ 0.052) in myocardial infarction observed for the intensively treated group compared with the conventionally treated group. Although the findings were only of borderline statistical significance, the UKPDS provided intriguing evidence of glycemic control as a possible modifiable risk factor for coronary heart disease.Few studies have explicitly examined the asso...

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Section: Multivariable Analysessupporting

confidence: 81%

Glycemic Control, Atherosclerosis, and Risk Factors for Cardiovascular Disease in Individuals With Diabetes

et al. 2005

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“…6 Also there are several studies proved that level of awareness depends on socioeconomic gradient, culture and ethnic variation. [7][8][9] The results of the present study were similar to the findings of study conducted on knowledge on risk factors of diabetes in a different population. 10 The majority of study respondents agreed that sugar level in uncontrolled diabetes mellitus will be high and accurate method of checking sugar is through blood investigations.…”

supporting

confidence: 81%

Knowledge and perception of diabetes among patients with type 2 diabetes mellitus attending rural health care centre, Tamil Nadu, India

Srisanthanakrishnan

Shah

2016

Int J Community Med Public Health

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“…Racial-ethnic differences in the relationship between BMI, percent body fat, and body-fat distribution among whites, Hispanics, and African Americans also have been reported and may contribute to the sex and ethnic variations in NAFLD prevalence. 41,42 Although waist circumference was not measured in our study, persons with an increased waist circumference have been shown to be more likely to exhibit type 2 diabetes, dyslipidemia, and other components of metabolic X syndrome than persons with a normal waist circumference independent of race, BMI, age, income, socioeconomic class, or physical activity. 43 Although waist-to-hip ratio generally is thought to correlate with visceral adiposity, Conway et al 44 have shown that waist-to-hip ratio correlates with visceral adiposity in white women but not in African-American women, again highlighting the existence of racial variability in these anthropometric parameters.…”

Section: Discussionmentioning

confidence: 85%

Racial and ethnic distribution of nonalcoholic fatty liver in persons with newly diagnosed chronic liver disease†

Weston¹,

Leyden²,

Murphy³

et al. 2005

Hepatology

333

237

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We performed a cross-sectional study of newly diagnosed cases of nonalcoholic fatty liver disease (NAFLD) identified between December 1998 and December 2000 in the Chronic Liver Disease Surveillance Study. We compared the demographic and clinical features of NAFLD in a racially diverse representative U.S. population (Alameda County, CA). Diagnostic criteria for probable NAFLD were persistent unexplained elevation of serum aminotransferase levels, radiology (ultrasound or computed tomography scan) consistent with fatty liver, and/or two or more of the following: (i) body mass index of 28 kg/m 2 or more, (ii) type 2 diabetes, or (iii) hyperlipidemia, in the absence of significant alcohol use. Definite NAFLD cases required histological confirmation. Of the 742 persons with newly diagnosed chronic liver disease, 159 (21.4%) had definite or probable NAFLD. The majority were nonwhite: Hispanics (28%), Asians (18%), African Americans (3%), and other race(s) (6%). African Americans with NAFLD were significantly older than other racial or ethnic groups (P < .001), and in Asians, NAFLD was 3.5 times more common in males than in females (P ‫؍‬ .016). Clinical correlates of NAFLD (obesity, hyperlipidemia, diabetes) were similar among racial and ethnic groups, except that body mass index was lower in Asians compared with other groups (P < .001). Compared with the base population (Kaiser Permanente members), Hispanics with NAFLD were overrepresented (28% vs. 10%) and whites were underrepresented (45% vs. 59%). In conclusion, these racial and gender variations may reflect differences in genetic susceptibility to visceral adiposity, including hepatic involvement, and may have implications for the evaluation of persons with the metabolic syndrome. Clinicians need to be aware of the variable presentations of NAFLD in different racial and ethnic groups. (HEPATOLOGY 2005;41:372-379.)

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Abdominal Obesity and Ethnic Differences in Diabetes Awareness, Treatment, and Glycemic Control

Cited by 39 publications

References 39 publications

Glycemic Control, Atherosclerosis, and Risk Factors for Cardiovascular Disease in Individuals With Diabetes

Glycemic Control, Atherosclerosis, and Risk Factors for Cardiovascular Disease in Individuals With Diabetes

Knowledge and perception of diabetes among patients with type 2 diabetes mellitus attending rural health care centre, Tamil Nadu, India

Racial and ethnic distribution of nonalcoholic fatty liver in persons with newly diagnosed chronic liver disease†

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