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Risk factors for cardiovascular disease do not fully explain differences in carotid intima-media thickness between Indigenous and European Australians without diabetes

Maple-Brown, Louise, Hodge, Allison, Cunningham, Joan, Celermajer, David and O'Dea, Kerin (2009). Risk factors for cardiovascular disease do not fully explain differences in carotid intima-media thickness between Indigenous and European Australians without diabetes. Clinical Endocrinology,71(2):189-194.

Document type: Journal Article

IRMA ID 10426xPUB8
Title Risk factors for cardiovascular disease do not fully explain differences in carotid intima-media thickness between Indigenous and European Australians without diabetes
Author Maple-Brown, Louise
Hodge, Allison
Cunningham, Joan
Celermajer, David
O'Dea, Kerin
Journal Name Clinical Endocrinology
Publication Date 2009
Volume Number 71
Issue Number 2
ISSN 1365-2265   (check CDU catalogue open catalogue search in new window)
Start Page 189
End Page 194
Total Pages 6
Place of Publication UK
Publisher Wiley-Blackwell Publishing
HERDC Category C1 - Journal Article (DEST)
Abstract Objective 
To investigate whether cardiovascular risk factors can explain the higher carotid intima–media thickness (CIMT) in Indigenous compared with European Australians.

Design

Cross-sectional study in three subgroups.

Patients
Non-diabetic urban European (n = 86), urban Indigenous (n = 69), and remote Indigenous (n = 60) Australians aged 25–64 years.

Measurements
CIMT, age, sex, anthropometry, blood pressure, smoking status, fasting glucose and insulin, haemoglobin (Hb)A1c, homocysteine, C-reactive protein (CRP), lipids, urinary albumin and creatinine.

Results
CIMT and levels of risk factors, except fasting glucose and total cholesterol, worsened across the three groups. Logn fasting insulin [β = 0·022, 95% confidence interval (CI) 0–0·0439], age (β = 0·006, 95% CI 0·004–0·007), gender (female β = –0·005 vs. male, 95% CI –0·084 to –0·026), mean arterial pressure (MAP) (β = 0·001, 95% CI 0·001–0·002) and ethnicity/location [urban Indigenous (β = 0·027, 95% CI –0·010 to 0·064 vs. European); remote Indigenous (β = 0·083, 95% CI 0·042–0·123 vs. European)] explained 41% of variance in CIMT. Significant interactions were seen for ethnicity/location with age (P = 0·014) and MAP (P = 0·018). Age was consistently associated with CIMT across the three populations, and was associated with larger increments in CIMT for the Indigenous subgroups (β = 0·007, 95% CI 0·005–0·009 urban; β = 0·007, 95% CI 0·004–0·010 remote) compared with Europeans (β = 0·003, 95% CI 0·002–0·006) in models including age, sex and MAP. MAP was only associated with CIMT in the remote Indigenous subgroup.

Conclusion
After adjusting for selected risk factors, CIMT in remote Indigenous participants was still higher than in Europeans. The slope of the association between age and CIMT steepened from urban Europeans to remote Indigenous.
Keywords risk factor
cardiovascular disease
differences
carotid intima-media thickness
Indigenous Australians
European Australians
diabetes
DOI http://dx.doi.org/10.1111/j.1365-2265.2008.03445.x   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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