Macrovascular Complications in Mexican Americans With Type II Diabetes

Mexican Americans have a threefold greater prevalence of non-insulin-dependent (type II) diabetes mellitus than non-Hispanic whites in the San Antonio Heart Study, a population-based study of diabetes. In addition, Mexican-American diabetic subjects (n = 365) have greater fasting glycemia than non-Hispanic white diabetic subjects (P < 0.001). Despite these findings, and despite a higher prevalence of microvascular complications among Mexican Americans, there does not appear to be a marked difference in prevalence of macrovascular complications between Mexican-American and non-Hispanic white diabetic subjects. Mexican-American diabetic subjects have only a moderate excess of peripheral vascular disease (as judged by ankle-arm blood pressure ratios) relative to non-Hispanic white diabetic subjects (sex-adjusted Mantel-Haenszel odds ratio 1.84, 95% confidence interval 0.75–4.49). Mexican-American diabetic subjects actually reported fewer myocardial infarctions than non-Hispanic white diabetic subjects (sex-adjusted Mantel-Haenszel odds ratio 0.73, 95% confidence interval 0.31–1.71). Duration was not associated with either peripheral vascular disease or myocardial infarction. Severity of glycemia was only mildly associated with presence of peripheral vascular disease and negatively associated with self-reported myocardial infarction. This latter finding may represent a survival bias in that more severe diabetic subjects have already died and are not ascertained in a prevalence study. The absence of an ethnic difference in the prevalence of macrovascular disease contrasts with our previous reports from the San Antonio Heart Study, in which the prevalence of both retinopathy and proteinuria was observed to be higher in Mexican-American diabetic subjects. (ABSTRACT TRUNCATED AT 250 WORDS)

[1]  B. Swinburn,et al.  Low incidence of fatal coronary heart disease in Pima Indians despite high prevalence of non-insulin-dependent diabetes. , 1990, Circulation.

[2]  W. A. J. Heuven,et al.  Effect of Socioeconomic Status on Hyperglycemia and Retinopathy Levels in Mexican Americans With NIDDM , 1989, Diabetes Care.

[3]  R. Klein,et al.  Diabetic Retinopathy in Mexican Americans and Non-Hispanic Whites , 1988, Diabetes.

[4]  K. Beach,et al.  Progression of Lower-Extremity Arterial Occlusive Disease in Type II Diabetes Mellitus , 1988, Diabetes Care.

[5]  W. Knowler,et al.  Lower-Extremity Amputations in NIDDM: 12-Yr Follow-Up Study in Pima Indians , 1988, Diabetes Care.

[6]  M. Stern,et al.  Secular decline in death rates due to ischemic heart disease in Mexican Americans and non-Hispanic whites in Texas, 1970-1980. , 1987, Circulation.

[7]  S. Haffner,et al.  Do Upper-Body and Centralized Adiposity Measure Different Aspects of Regional Body-Fat Distribution? Relationship to Non-Insulin-Dependent Diabetes Mellitus, Lipids, and Lipoproteins , 1987, Diabetes.

[8]  W J Schull,et al.  Individual admixture estimates: disease associations and individual risk of diabetes and gallbladder disease among Mexican-Americans in Starr County, Texas. , 1986, American journal of physical anthropology.

[9]  S. Haffner,et al.  Coffee consumption, diet, and lipids. , 1985, American journal of epidemiology.

[10]  M Rosenthal,et al.  Sex difference in the effects of sociocultural status on diabetes and cardiovascular risk factors in Mexican Americans. The San Antonio Heart Study. , 1984, American journal of epidemiology.

[11]  W. Mueller,et al.  The Diabetes Alert study: growth, fatness, and fat patterning, adolescence through adulthood in Mexican Americans. , 1984, American journal of physical anthropology.

[12]  S. Haffner,et al.  Evaluation of Three Potential Screening Tests for Diabetes Mellitus in a Biethnic Population , 1984, Diabetes Care.

[13]  J. Relethford,et al.  Prevalence of Diabetes in Mexican Americans: Relationship to Percent of Gene Pool Derived from Native American Sources , 1984, Diabetes.

[14]  W J Schull,et al.  Diabetes among Mexican Americans in Starr County, Texas. , 1983, American journal of epidemiology.

[15]  R J Jarrett,et al.  Mortality from coronary heart disease and stroke in relation to degree of glycaemia: the Whitehall study. , 1983, British medical journal.

[16]  H. Morgenstern,et al.  Epidemiologic Research: Principles and Quantitative Methods. , 1983 .

[17]  K. Beach,et al.  Prevalence of Severe Arteriosclerosis Obliterans in Patients with Diabetes Mellitus: Relation to Smoking and Form of Therapy , 1982, Arteriosclerosis.

[18]  J. Albers,et al.  Dextran sulfate-Mg2+ precipitation procedure for quantitation of high-density-lipoprotein cholesterol. , 1982, Clinical chemistry.

[19]  Classification and Diagnosis of Diabetes Mellitus and Other Categories of Glucose Intolerance , 1979, Diabetes.

[20]  Daniel L. McGee,et al.  Diabetes and cardiovascular disease. The Framingham study. , 1979, JAMA.

[21]  D L McGee,et al.  Diabetes and Glucose Tolerance as Risk Factors for Cardiovascular Disease: The Framingham Study , 1979, Diabetes Care.

[22]  J. Medalie,et al.  Angina pectoris among 10,000 men. II. Psychosocial and other risk factors as evidenced by a multivariate analysis of a five year incidence study. , 1976, The American journal of medicine.

[23]  S. Carter.  Clinical measurement of systolic pressures in limbs with arterial occlusive disease. , 1969, JAMA.

[24]  Robertson Wb,et al.  Atherosclerosis in persons with hypertension and diabetes mellitus. , 1968 .

[25]  F. Epstein,et al.  EPIDEMIOLOGICAL STUDIES OF CARDIOVASCULAR DISEASE IN A TOTAL COMMUNITY--TECUMSEH, MICHIGAN. , 1965, Annals of internal medicine.

[26]  G. Mann,et al.  The epidemiology of coronary heart disease. , 1957, The American journal of medicine.

[27]  S. Haffner,et al.  Excess incidence of treatment of end-stage renal disease in Mexican Americans. , 1988, American journal of epidemiology.

[28]  D. Rao,et al.  Relationship of prevalence of non‐insulin‐dependent diabetes mellitus to Amerindian admixture in the Mexican Americans of San Antonio, Texas , 1986, Genetic epidemiology.

[29]  S. Haffner,et al.  Upper body and centralized adiposity in Mexican Americans and non-Hispanic whites: relationship to body mass index and other behavioral and demographic variables. , 1986, International journal of obesity.

[30]  S. Haffner,et al.  A comparison of three indicators for identifying Mexican Americans in epidemiologic research. Methodological findings from the San Antonio Heart Study. , 1986, American journal of epidemiology.

[31]  H. Langford.  The hypertension detection and follow-up program. , 1984, New York state journal of medicine.

[32]  R. Jarrett.  Diabetes, hyperglycaemia and arterial disease. , 1971, Acta diabetologica latina.

[33]  J. Strong,et al.  Atherosclerosis in persons with hypertension and diabetes mellitus. , 1968, Laboratory investigation; a journal of technical methods and pathology.