Coronary heart disease in type 2 diabetes mellitus in Isfahan, Iran: prevalence and risk factors.

摘要

OBJECTIVE: To estimate the prevalence and risk factors of CHD in people with type 2 diabetes mellitus. METHODS AND RESULTS: A cross-sectional study of type 2 diabetic patients was conducted from 2001 to 2004. 1566 consecutive diabetic patients (524 men and 1042 women) from the Isfahan Endocrinology and Metabolism Research Centre outpatient clinics, Iran, have been examined. Part of the examination included an assessment of CHD including 12-lead resting electrocardiogram and a positive response to the angina pectoris section on the Rose questionnaire and self-reported medical history. The mean (SD) age of participants was 50.6 (12.3) years with a mean (SD) duration of diabetes of 7.6 (6.9) years. The prevalence of CHD was 28.0% [95% confidence interval (CI) 25.8, 30.2]. The prevalence of CHD increased with age (P < 0.001). It was associated with gender (P < 0.01), age at diagnosis of diabetes, duration of diabetes, systolic blood pressure (P < 0.001), low density lipoprotein cholesterol, body mass indexand smoking (P < 0.05). The age- and gender-adjusted prevalence rate of CHD was 45% higher among insulin-treated patients, 49% higher among patients with BMI >30, and it was positively associated with increasing triglyceride levels and duration of diabetes. Using a stepwise binary logistic regression model, age, BMI, smoking, and insulin treatment were significant independent predictors of CHD. Gender, duration of diabetes, cholesterol and triglycerides had no significant independent association with CHD when other covariates were considered. CONCLUSION: These findings indicate that there is a high prevalence of CHD among the Iranian type 2 diabetic patients, which underlines the need for more programmes of health promotion and lifestyle changes.