Adult-onset diabetes in Middle Eastern immigrants to Sweden : Novel subgroups and diabetic complications—The All New Diabetes in Scania cohort diabetic complications and ethnicity
(2021) In Diabetes/Metabolism Research and Reviews 37(6).- Abstract
Background: Middle Eastern immigrants to Europe represent a high risk population for type 2 diabetes. We compared prevalence of novel subgroups and assessed risk of diabetic macro- and microvascular complications between diabetes patients of Middle Eastern and European origin. Methods: This study included newly diagnosed diabetes patients born in Sweden (N = 10641) or Iraq (N = 286), previously included in the All New Diabetes in Scania cohort. The study was conducted between January 2008 and August 2016. Patients were followed to April 2017. Incidence rates in diabetic macro- and microvascular complications were assessed using cox-regression adjusting for the confounding effect of age at onset, sex, anthropometrics, glomerular... (More)
Background: Middle Eastern immigrants to Europe represent a high risk population for type 2 diabetes. We compared prevalence of novel subgroups and assessed risk of diabetic macro- and microvascular complications between diabetes patients of Middle Eastern and European origin. Methods: This study included newly diagnosed diabetes patients born in Sweden (N = 10641) or Iraq (N = 286), previously included in the All New Diabetes in Scania cohort. The study was conducted between January 2008 and August 2016. Patients were followed to April 2017. Incidence rates in diabetic macro- and microvascular complications were assessed using cox-regression adjusting for the confounding effect of age at onset, sex, anthropometrics, glomerular filtration rate (eGFR) and HbA1c. Findings: In Iraqi immigrants versus native Swedes, severe insulin-deficient diabetes was almost twice as common (27.9 vs. 16.2% p < 0.001) but severe insulin-resistant diabetes was less prevalent. Patients born in Iraq had higher risk of coronary events (hazard ratio [HR] 1.84, 95% CI 1.06–3.12) but considerably lower risk of chronic kidney disease (CKD) than Swedes (HR 0.19; 0.05–0.76). The lower risk in Iraqi immigrants was partially attributed to better eGFR. Genetic risk scores (GRS) showed more genetic variants associated with poor insulin secretion but lower risk of insulin resistance in the Iraqi than native Swedish group. Interpretation: People with diabetes, born in the Middle East present with a more insulin-deficient phenotype and genotype than native Swedes. They have a higher risk of coronary events but lower risk of CKD. Ethnic differences should be considered in the preventive work towards diabetes and its complications.
(Less)
- author
- Bennet, Louise LU ; Nilsson, Christopher LU ; Mansour-Aly, Dina LU ; Christensson, Anders LU ; Groop, Leif LU and Ahlqvist, Emma LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- ethnicity, GRS, macrovascular diabetic complications, microvascular diabetic complications, novel subgroups of diabetes, SIDD, SIRD, ANDIS, diabetes
- in
- Diabetes/Metabolism Research and Reviews
- volume
- 37
- issue
- 6
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- scopus:85096654550
- pmid:33119194
- ISSN
- 1520-7552
- DOI
- 10.1002/dmrr.3419
- project
- Aspects of ethnicity on blood pressure regulating mechanisms and kidney function
- The MEDIM project
- language
- English
- LU publication?
- yes
- id
- cfd17829-2b2f-4582-bd26-853ce643bb1d
- date added to LUP
- 2020-12-07 13:43:50
- date last changed
- 2024-06-27 02:43:20
@article{cfd17829-2b2f-4582-bd26-853ce643bb1d, abstract = {{<p>Background: Middle Eastern immigrants to Europe represent a high risk population for type 2 diabetes. We compared prevalence of novel subgroups and assessed risk of diabetic macro- and microvascular complications between diabetes patients of Middle Eastern and European origin. Methods: This study included newly diagnosed diabetes patients born in Sweden (N = 10641) or Iraq (N = 286), previously included in the All New Diabetes in Scania cohort. The study was conducted between January 2008 and August 2016. Patients were followed to April 2017. Incidence rates in diabetic macro- and microvascular complications were assessed using cox-regression adjusting for the confounding effect of age at onset, sex, anthropometrics, glomerular filtration rate (eGFR) and HbA1c. Findings: In Iraqi immigrants versus native Swedes, severe insulin-deficient diabetes was almost twice as common (27.9 vs. 16.2% p < 0.001) but severe insulin-resistant diabetes was less prevalent. Patients born in Iraq had higher risk of coronary events (hazard ratio [HR] 1.84, 95% CI 1.06–3.12) but considerably lower risk of chronic kidney disease (CKD) than Swedes (HR 0.19; 0.05–0.76). The lower risk in Iraqi immigrants was partially attributed to better eGFR. Genetic risk scores (GRS) showed more genetic variants associated with poor insulin secretion but lower risk of insulin resistance in the Iraqi than native Swedish group. Interpretation: People with diabetes, born in the Middle East present with a more insulin-deficient phenotype and genotype than native Swedes. They have a higher risk of coronary events but lower risk of CKD. Ethnic differences should be considered in the preventive work towards diabetes and its complications.</p>}}, author = {{Bennet, Louise and Nilsson, Christopher and Mansour-Aly, Dina and Christensson, Anders and Groop, Leif and Ahlqvist, Emma}}, issn = {{1520-7552}}, keywords = {{ethnicity; GRS; macrovascular diabetic complications; microvascular diabetic complications; novel subgroups of diabetes; SIDD; SIRD; ANDIS; diabetes}}, language = {{eng}}, number = {{6}}, publisher = {{John Wiley & Sons Inc.}}, series = {{Diabetes/Metabolism Research and Reviews}}, title = {{Adult-onset diabetes in Middle Eastern immigrants to Sweden : Novel subgroups and diabetic complications—The All New Diabetes in Scania cohort diabetic complications and ethnicity}}, url = {{http://dx.doi.org/10.1002/dmrr.3419}}, doi = {{10.1002/dmrr.3419}}, volume = {{37}}, year = {{2021}}, }