Clustering of cardiovascular risk factors with diabetes in Chinese patients: the effects of sex and hyperinsulinaemia

Objective: This study was designed to investigate factors which affect the clustering of cardiovascular risk factors with diabetes in Chinese patients . Research Design and Methods: Six hundred and fifty-four patients with diabe tes were assessed comprehensively for diabetes complications and cardiovasc ular risk factors in a metropolitan hospital in Beijing, China. Insulin res istance and secretion were also evaluated by measurement of glucose and ins ulin levels before and after a meal tolerance test. Results were analysed a ccording to patient groups stratified by the number of cardiovascular risk factors coexisting with diabetes. Results: Cardiovascular risk factors were common in Chinese diabetic patien ts. The clustering of three or more of these factors with diabetes occurred more often than by chance alone and was associated with postprandial hyper insulinaemia, Patients with a high number of risk factors were more prone t o macrovascular events but did not have higher albuminuria. Using the commo nly adopted lower threshold for diagnosing obesity and central obesity in w omen, there were more women with multiple risk factors. However, this disap peared if the same criteria were used for men and women. Even in the presen ce of diabetes, cardiovascular risk factors were inadequately controlled in most patients. Conclusions: The concurrence of diabetes and other cardiovascular risk fact ors which constitute the metabolic syndrome is a common phenomenon in urban Chinese diabetic patients. It is associated with hyperinsulinaemia and pos sibly the female sex. This study emphasises the importance of public health measures to control cardiovascular risk factors in patients with diabetes.