Microvascular and macrovascular complications in type 2 diabetes Ghanaian residents in Ghana and Europe: The RODAM study
Hayfron-Benjamin, Charles; van den Born, Bert-Jan; Maitland-van der Zee, Anke H; Amoah, Albert G B; Meeks, Karlijn A C; Klipstein-Grobusch, Kerstin; Bahendeka, Silver; Spranger, Joachim; Danquah, Ina; Mockenhaupt, Frank; Beune, Erik; Smeeth, Liam; Agyemang, Charles
(2019) Journal of Diabetes and its Complications, volume 33, issue 8, pp. 572 - 578
(Article)
Abstract
AIMS: To compare microvascular and macrovascular complication rates among Ghanaians with type 2 diabetes (T2D) living in Ghana and in three European cities (Amsterdam, London and Berlin). METHODS: Data from the multicenter Research on Obesity and Diabetes among African Migrants (RODAM) study were analyzed. 650 Ghanaian participants with T2D (206
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non-migrant and 444 migrants) were included. Logistic regression analyses were used to determine the association between migrant status and microvascular (nephropathy and retinopathy) and macrovascular (coronary artery disease (CAD), peripheral artery disease (PAD) and stroke) complications with adjustment for age, gender, socioeconomic status, alcohol, smoking, physical activity, hypertension, BMI, total-cholesterol, and HbA1c. RESULTS: Microvascular and macrovascular complications rates were higher in non-migrant Ghanaians than in migrant Ghanaians (nephropathy 32.0% vs. 19.8%; PAD 11.2% vs. 3.4%; CAD 18.4% vs. 8.3%; and stroke 14.5% vs. 5.6%), except for self-reported retinopathy (11.0% vs. 21.6%). Except nephropathy and stroke, the differences persisted after adjustment for the above-mentioned covariates: PAD (OR 7.48; 95% CI, 2.16-25.90); CAD (2.32; 1.09-4.93); and retinopathy (0.23; 0.07-0.75). CONCLUSIONS: Except retinopathy, the rates of microvascular and macrovascular complications were higher in non-migrant than in migrant Ghanaians with T2D. Conventional cardiovascular risk factors did not explain the differences except for nephropathy and stroke.
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Keywords: Diabetes complications, Ethnic minority groups, Ghana, Macrovascular, Microvascular, RODAM study, Endocrinology, Internal Medicine, Endocrinology, Diabetes and Metabolism, Journal Article
ISSN: 1056-8727
Publisher: Elsevier Inc.
Note: Funding Information: This work was supported by the European Commission under the Framework Programme (Grant Number: 278901 ). K.M. is supported by the Intramural Research Program of the National Institutes of Health in the Center for Research on Genomics and Global Health (CRGGH). The CRGGH is supported by the National Human Genome Research Institute , the National Institute of Diabetes and Digestive and Kidney Diseases , the Center for Information Technology , and the Office of the Director at the National Institutes of Health ( 1ZIAHG200362 ). The study sponsor was not involved in the design of the study; the collection, analysis and interpretation of data; writing the report; nor the decision to submit the report for publication. Funding Information: We are grateful to the research assistants, interviewers, and other staff of the 5 research locations who have taken part in gathering the data and, most of all, the Ghanaian volunteers participating in the RODAM study (Research on Obesity and Diabetes Among African Migrants). We gratefully acknowledge the advisory board members for their valuable support in shaping the RODAM study methods, Jan van Straalen from the Amsterdam University Medical Centre with standardization of the laboratory procedures, and the Amsterdam University Medical Centre Biobank for their support in biobank management and high-quality storage of collected samples. This work was supported by the European Commission under the Framework Programme (Grant Number: 278901). K.M. is supported by the Intramural Research Program of the National Institutes of Health in the Center for Research on Genomics and Global Health (CRGGH). The CRGGH is supported by the National Human Genome Research Institute, the National Institute of Diabetes and Digestive and Kidney Diseases, the Center for Information Technology, and the Office of the Director at the National Institutes of Health (1ZIAHG200362). The study sponsor was not involved in the design of the study; the collection, analysis and interpretation of data; writing the report; nor the decision to submit the report for publication. All authors have contributed substantially to this article and approved the submission. C.H.-B. B.B. A.H.M. A.G.B.A. and C.A. conceived the idea. C.H.-B. E.B. and C.A. were responsible for data acquisition; C.H.-B. and C.A. were responsible for statistical analysis. C.H.-B. B.B. A.H.M. A.G.B.A. K.A.C.M. K.K.-G. S.B. J.S. I.D. F.M. E.B. L.S. and C.A. were responsible for data analysis/interpretation. Each author contributed important intellectual content during article drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved. C.H.-B. takes responsibility for the fact that this study has been reported honestly, accurately and transparently, that no important aspects of the study have been omitted, and that any discrepancies from the study as planned have been explained. Publisher Copyright: © 2019 Elsevier Inc.
(Peer reviewed)