Diabetes mellitus abolishes ethnic differences in cardiovascular risk factors: lessons from a multi-ethnic population

Aims: To compare cardiovascular risk factors in diabetic subjects of differ ent ethnic groups, and between new and known diabetic subjects, in the Sing apore National Health Survey '92. Methods: Disproportionate stratified samp ling followed by systematic sampling were used in 3568 (total) respondents of whom 2743 were non-diabetics, 179 newly diagnosed diabetics and 150 know n diabetics. Amongst the diabetics, there were 185 Chinese, 66 Malays and 7 8 Asian Indians. Diagnosis of diabetes mellitus (DM) was based on the 2 h g lucose alone, after a 75 g oral glucose tolerance test. Blood pressure (BP) , lipid profile, glucose, insulin and anthropometric indices were obtained from all subjects. Results: Subjects with diabetes (new and known) exhibite d significantly higher triglyceride (TG), lower high density lipoprotein ch olesterol (HDL-C) and low density lipoprotein (LDL)/apolipoprotein B (apo B ) ratio (LDL size) compared with normoglycaemic subjects. They were more ob ese (generalised and central) and had higher systolic and diastolic BP. The re was no difference in lipid risk factors between the two groups with diab etes although those with new diabetes were more obese whilst those with kno wn diabetes had higher fasting glucose. Amongst subjects with diabetes, the re were no significant differences between ethnic groups in TG, HDL-C, LDL/ apo B ratio, or waist to hip ratio (WHR). Female Malays with diabetes had h igher total cholesterol and were more obese whilst male Asian Indians with diabetes had higher fasting insulin. Conclusion: Asian Indians had lower HD L-C and LDL/apo B ratio than Chinese or Malays amongst normoglycaemic subje cts. However, these differences between ethnic groups were not seen in subj ects with DM. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.