Cardiometabolic risk profiles associated with chronic complications in overweight and obese type 2 diabetes patients in South China

PLoS One. 2014 Jul 3;9(7):e101289. doi: 10.1371/journal.pone.0101289. eCollection 2014.

Abstract

Background: Type 2 diabetes is often accompanied by altered cardiometabolic risk profiles, including abdominal obesity, hypertension, and dyslipidaemia. The association of altered cardiometabolic risk profiles with chronic complications of diabetes is not well investigated.

Methods: We recruited 2954 type 2 diabetes patients with a body mass index ≥25 kg/m2 who visited the diabetes clinics of 62 hospitals in 21 cities in Guangdong province of China from August 2011 to March 2012. Demographic characteristics, personal and family medical histories, and data on chronic complications of diabetes were collected. Clinical examinations and laboratory assessment were conducted.

Results: Abdominal obesity was found in 91.6% of the study population, elevated blood pressure in 78.3%; elevated serum triacylglycerols in 57.8%, and reduced serum HDL-C in 55.9%. Among the cardiometabolic risk factors, elevated blood pressure was significantly associated with almost all the chronic complications of diabetes. After adjusting for age, gender, duration of diabetes, and HbA1c, elevated blood pressure was significantly associated with diabetic retinopathy (OR 1.63, 95% CI: 1.22-2.19), diabetic nephropathy (OR 3.16, 95% CI: 2.25-4.46), cardiovascular disease (OR 2.71, 95% CI: 1.70-4.32), and stroke (OR 1.90, 95% CI: 1.15-3.12). Abdominal adiposity was significantly associated with diabetic nephropathy (OR 1.39, 95% CI: 1.11-1.74). Elevated triacylglycerols was significantly associated with diabetic retinopathy (OR 1.29, 95% CI: 1.05-1.58) and diabetic nephropathy (OR 1.30, 95% CI: 1.05-1.58). Reduced HDL-C was significantly associated with stroke (OR 1.41, 95% CI: 1.05-1.88).

Conclusions: Altered cardiometabolic risk profiles, and elevated blood pressure in particular, were significantly associated with chronic complications in overweight and obese patients with type 2 diabetes. Future studies on the prevention of chronic complications of diabetes might make lowering blood pressure a primary target.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Pressure
  • Body Mass Index
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / pathology
  • China
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Chronic Disease
  • Demography
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / complications*
  • Overweight*
  • Prevalence
  • Risk Factors
  • Triglycerides / blood

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Triglycerides

Grants and funding

This study was supported by the Diabetes Society of Guangdong Provincial Medical Association and a special grant for overweight and obese type 2 diabetic patients in Guangdong province (No. 2011-DM-01). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. PLease update this information in the Financial Disclosure.