title: Development of macrovascular diseases in NIDDM patients in northern Taiwan. A 4-yr follow-up study.
abstract: OBJECTIVE
  To assess the development of macrovascular diseases and explore major associative factors in NIDDM.
  
  
  METHODS
  A total of 479 NIDDM patients > or = 40 yr of age were recruited from four community primary care health centers of northern Taiwan in July 1986 for a cohort study with a 4-yr follow-up. No patient required insulin therapy within 1 yr of diagnosis nor had a history of diabetic ketoacidosis. All were able to participate independently in the activities of daily living. BP and ECG were measured, and a structured questionnaire was asked of each patient. Venous blood after overnight fasting was collected every year to measure cholesterol, HDL cholesterol, plasma glucose, and HbA1c.
  
  
  RESULTS
  The duration of diabetes was associated with the development of stroke with a relative risk of 1.063 for every 1-yr increment (P = 0.07). As for HVDs, the significant risk factors were serum cholesterol and HbA1c. For every 1-mg/dl increase in mean total cholesterol level, the relative risk of developing HVD increased 1.016-fold (P = 0.04). For every 1% increase in HbA1c, the relative risk of developing HVD increased 1.170-fold (P = 0.01). With regard to leg VDs, sex and cigarette smoking were significant risk factors. Women diabetic subjects had a higher relative risk than men. Cigarette smoking was significantly associated with leg VD with a relative risk of 6.9 for smokers compared with nonsmokers. The most significant risk factor for LVD was the total cholesterol level. For every 1-mg/dl increase in mean serum cholesterol level, the relative risk of LVD increased 1.013-fold.
  
  
  CONCLUSIONS
  In the prevention of macrovascular diseases, effective intervention of the nondiabetic cardiovascular risk factors may be as important as or even more important than the good control of diabetes.
authors.affiliation: Department of Family Medicine, Provincial Tao-Yuan Hospital, Taiwan, Republic of China.
authors.forename: C C
authors.initials: CC
authors.lastname: Fu
authors.forename: C J
authors.initials: CJ
authors.lastname: Chang
authors.forename: C H
authors.initials: CH
authors.lastname: Tseng
authors.forename: M S
authors.initials: MS
authors.lastname: Chen
authors.forename: C S
authors.initials: CS
authors.lastname: Kao
authors.forename: T J
authors.initials: TJ
authors.lastname: Wu
authors.forename: H P
authors.initials: HP
authors.lastname: Wu
authors.forename: L M
authors.initials: LM
authors.lastname: Chuang
authors.forename: C J
authors.initials: CJ
authors.lastname: Chen
authors.forename: T Y
authors.initials: TY
authors.lastname: Tai
mesh_terms: D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012907:Smoking; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D014652:Vascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology
chemical_list: D002784:Cholesterol; D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin