title: Cardiovascular disease risk profile and microvascular complications of diabetes: comparison of Indigenous cohorts with diabetes in Australia and Canada.
abstract: BACKGROUND
  Indigenous populations of Australia and Canada experience disproportionately high rates of chronic disease. Our goal was to compare cardiovascular (CVD) risk profile and diabetes complications from three recent comprehensive studies of diabetes complications in different Indigenous populations in Australia and Canada.
  
  
  METHODS
  We compared participants from three recent studies: remote Indigenous Australians (2002-2003, n = 37 known diabetes), urban Indigenous Australians (2003-2005, n = 99 known diabetes), and remote Aboriginal Canadians (2001-2002, n = 188 known diabetes).
  
  
  RESULTS
  The three groups were similar for HbA1c, systolic BP, diabetes duration. Although leaner by body-mass-index criteria, remote Indigenous Australians displayed a more adverse CVD risk profile with respect to: waist-hip-ratio (1.03, 0.99, 0.94, remote Indigenous Australians, urban Indigenous Australians, remote Canadians, p < 0.001); HDL-cholesterol (0.82, 0.96, 1.17 mmol/L, p < 0.001); urine albumin-creatinine-ratio (10.3, 2.4, 4.5 mg/mmol); and C-reactive protein. With respect to diabetes complications, microalbuminuria (50%, 25%, 41%, p = 0.001) was more common among both remote groups than urban Indigenous Australians, but there were no differences for peripheral neuropathy, retinopathy or peripheral vascular disease.
  
  
  CONCLUSIONS
  Although there are many similarities in diabetes phenotype in Indigenous populations, this comparison demonstrates that CVD risk profiles and diabetes complications may differ among groups. Irrespective, management and intervention strategies are required from a young age in Indigenous populations and need to be designed in consultation with communities and tailored to community and individual needs.
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia. louise.maple-brown@menzies.edu.au
authors.forename: Louise J
authors.initials: LJ
authors.lastname: Maple-Brown
authors.forename: Joan
authors.initials: J
authors.lastname: Cunningham
authors.forename: Bernard
authors.initials: B
authors.lastname: Zinman
authors.forename: Mary
authors.initials: M
authors.lastname: Mamakeesick
authors.forename: Stewart B
authors.initials: SB
authors.lastname: Harris
authors.forename: Philip W
authors.initials: PW
authors.lastname: Connelly
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shaw
authors.forename: Kerin
authors.initials: K
authors.lastname: O'Dea
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Hanley
mesh_terms: D000328:Adult; D001315:Australia; D002170:Canada; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000208:ethnology; D003925:Diabetic Angiopathies / Q000150:complications* / Q000208:ethnology; D003928:Diabetic Nephropathies / Q000150:complications / Q000208:ethnology; D003930:Diabetic Retinopathy / Q000150:complications / Q000208:ethnology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000208:ethnology; D044382:Population Groups / Q000208:ethnology*; D012189:Retrospective Studies; D012307:Risk Factors