Differences in coronary heart disease prevalence and risk factors in African and White patients with type 2 diabetes

Diabetes Res Clin Pract. 2007 Jul;77(1):107-12. doi: 10.1016/j.diabres.2006.10.014. Epub 2006 Dec 4.


Coronary heart disease (CHD) is rare in sub-Saharan Africans; there are few data in African diabetic populations. We therefore evaluated the prevalence of CHD and conventional risk factors in 744 consecutive African (A, n=448) and White European (W, n=296) subjects with type 2 diabetes. CHD was present in 4% of A and in 23% of W (p<0.001). Compared with W, the A groups had lower total cholesterol (TC) and triglyceride (TG) levels: men: TC-W, 5.76 (S.D., 1.36) and A, 4.98 (1.29)mmol/l; TG-W, 2.10 (IQR,1.40-3.00) and A, 1.60 (1.10-2.55)mmol/l; women: TC-W, 5.85 (1.31) and A, 5.20 (1.24); TG-2.00 (1.40-2.90) and A, 1.40 (1.00-2.03)mmol/l (p< or =0.0022 for each comparison). The A had significantly lower TG:HDL-C ratios (an index of insulin resistance) (p=0.004) and were less likely to have (estimated) small dense LDL-C particles (p< or =0.038). In subjects with established CHD traditional risk factors were similar in A and W. Regression analysis revealed that CHD associated in A with serum creatinine (p=0.0015) and TC (p=0.038) and with TG in W (p=0.0072). We conclude that the rarity of CHD in diabetic Africans can be explained by contributions of low TC levels and probably lesser insulin resistance and its consequences; renal disease may be an important additional risk factor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Black People / statistics & numerical data*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Coronary Disease / epidemiology*
  • Diabetes Mellitus, Type 2 / complications*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • South Africa / epidemiology
  • Triglycerides / blood
  • White People / statistics & numerical data*


  • Cholesterol, HDL
  • Cholesterol, LDL
  • Triglycerides