title: Vascular disease in younger-onset diabetes: comparison of European, Asian and American Indian cohorts of the WHO Multinational Study of Vascular Disease in Diabetes.
abstract: OBJECTIVE
  This study compared the incidence of vascular disease in subjects with younger-onset diabetes from different ethnic groups.
  
  
  METHODS
  The incidence of vascular disease endpoints has been studied in a sub-group (n = 994) of participants of the World Health Organization Multinational Study of Vascular Disease in Diabetes (WHO MSVDD) who had younger-onset diabetes (diagnosed before the age of 30 years). The study participants have been divided into European (n = 631), Asian (n = 84) and American Indian (n = 91) cohorts.
  
  
  RESULTS
  For Type I (insulin-dependent) and Type II (non-insulin-dependent) diabetes mellitus, American Indian men had a higher incidence of lower-extremity amputation and renal failure than the other cohorts, whereas European women had a higher incidence of angina than other cohorts. American Indians also had a higher incidence of any retinopathy, clinical proteinuria and albuminuria than the European and Asian cohorts.
  
  
  CONCLUSIONS
  This study confirms the high burden of large and small-vessel disease complications manifest in American Indian people with younger-onset diabetes.
authors.affiliation: Centre for American Indian Health Research and Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Centre, Oklahoma City 73190, USA.
authors.forename: E T
authors.initials: ET
authors.lastname: Lee
authors.forename: M
authors.initials: M
authors.lastname: Lu
authors.forename: P H
authors.initials: PH
authors.lastname: Bennett
authors.forename: H
authors.initials: H
authors.lastname: Keen
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D000787:Angina Pectoris / Q000453:epidemiology; D001208:Asia / Q000453:epidemiology; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000453:epidemiology*; D003928:Diabetic Nephropathies / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007198:Indians, North American; D007391:International Cooperation; D007866:Leg / Q000601:surgery; D008297:Male; D051437:Renal Insufficiency / Q000453:epidemiology; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D014944:World Health Organization