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 type 2 diabetes mellitus (T2DM). This study aimed to compare cardiometabolic risk profiles between Chinese and Finnish older adults of central obesity with prediabetes or T2DM. 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 of central obesity with prediabetes (n = 298), fasting and 2-h glucose, and fasting insulin and insulin resistance were significantly higher in Chinese than in Finnish (p < 0.0001–0.016). In addition, triglyceride (TG) level was higher and the low-density lipoprotein cholesterol (LDL) and LDL to high-density lipoprotein cholesterol (HDL) ratio were lower in Chinese than in Finnish (p < 0.0001–0.003). Among subjects of central obesity with T2DM (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 of central obesity with prediabetes and T2DM had similar β-cell function. However, Chinese individuals with prediabetes are prone to insulin resistance. Meanwhile, lipid metabolism dysfunction is also different between Chinese and Finnish. Chinese older adults of central obesity with prediabetes showed higher TG, but Finnish showed higher LDL and LDL/HDL. Strategic for T2DM prevention and treatment should be ethnically specific.

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

“…The physical examination showed that the population was mostly healthy, with LDL levels within the normal range (< 120 mg/dL) [ 41 ]; hence this study cautiously speculates that the effect of LDL on islet function was insignificant. Moreover, previous studies 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.…”

Association between tea consumption and glucose metabolism and insulin secretion in the Shanghai High-risk Diabetic Screen (SHiDS) study

“…Details of this study have been described previously. [18][19][20][21][22] Briefly, the SHiDS study was initiated in 2002 aiming to identify diabetes in subjects with known risk factors, that is, family history of diabetes, overweight or obesity, previously identified impaired fasting glucose or impaired glucose tolerance, history of gestational diabetes, polycystic ovary syndrome, hypertension, and dyslipidemia. Patients with previously diagnosed diabetes were not invited.…”