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Nontraditional risk factors for coronary heart disease incidence among persons with diabetes: the Atherosclerosis Risk in Communities (ARIC) Study.

TitleNontraditional risk factors for coronary heart disease incidence among persons with diabetes: the Atherosclerosis Risk in Communities (ARIC) Study.
Publication TypeJournal Article
Year of Publication2000
AuthorsSaito I, Folsom AR, Brancati FL, Duncan BB, Chambless LE, McGovern PG
JournalAnn Intern Med
Volume133
Issue2
Pagination81-91
Date Published2000 Jul 18
ISSN0003-4819
KeywordsApolipoproteins, Body Constitution, Cholesterol, HDL, Coronary Disease, Diabetes Mellitus, Type 2, Factor VIII, Female, Fibrinogen, Follow-Up Studies, Humans, Incidence, Leukocyte Count, Male, Middle Aged, Prospective Studies, Risk Factors, Serum Albumin, von Willebrand Factor
Abstract

BACKGROUND: Major risk factors explain much of the excess risk for coronary heart disease produced by diabetes, but nontraditional factors may also relate to incident coronary heart disease.

OBJECTIVE: To examine the association of traditional and nontraditional risk factors with incidence of coronary heart disease in adults with diabetes.

DESIGN: Prospective cohort study.

SETTING: The Atherosclerosis Risk in Communities (ARIC) Study.

PARTICIPANTS: 1676 middle-aged persons who had diabetes but no history of prevalent coronary heart disease.

MEASUREMENTS: Multiple risk factors were recorded at baseline. Follow-up was from 1987 through 1995.

RESULTS: 186 participants developed incident coronary heart disease events during follow-up. As expected, the incidence of coronary heart disease in participants with diabetes was associated positively with traditional risk factors (hypertension, smoking, total cholesterol level, and low high-density lipoprotein [HDL] cholesterol level). After adjustment for sex, age, ethnicity, and ARIC field center, incident coronary heart disease was also significantly associated with waist-to-hip ratio; levels of HDL3 cholesterol, apolipoproteins A-I and B, albumin, fibrinogen, and von Willebrand factor factor VIII activity; and leukocyte count. However, after adjustment for traditional risk factors for coronary heart disease, only levels of albumin, fibrinogen, and von Willebrand factor; factor VIII activity; and leukocyte count remained independently associated with coronary heart disease (P

CONCLUSIONS: Levels of albumin, fibrinogen, and von Willebrand factor; factor VIII activity; and leukocyte count were predictors of coronary heart disease among persons with diabetes. These associations may reflect 1) the underlying inflammatory reaction or microvascular injury related to atherosclerosis and a tendency toward thrombosis or 2) common antecedents for both diabetes and coronary heart disease.

DOI10.7326/0003-4819-133-2-200007180-00007
Alternate JournalAnn Intern Med
PubMed ID10896647
Grant ListN01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States