title: Ethnicity and long-term vascular outcomes in Type 2 diabetes: a prospective observational study (UKPDS 83).
abstract: OBJECTIVE
  Evidence of ethnic differences in vascular complications of diabetes has been inconsistent. The aim of this study was to examine the relationship between ethnicity and long-term outcome in a large sample of individuals with newly diagnosed Type 2 diabetes.
  
  
  METHODS
  In a prospective observational study of 4273 UK Prospective Diabetes Study participants followed for a median of 18 years, 3543 (83%) were White Caucasian, 312 (7%) Afro-Caribbean and 418 (10%) Asian Indian. Relative risks for predefined outcomes were assessed comparing Afro-Caribbean and Asian Indian with White Caucasian using accelerated failure time models, with adjustment for cardiovascular risk factors and other potentially confounding variables.
  
  
  RESULTS
  During follow-up, 2468 (58%) participants had any diabetes-related end point, 1037 (24%) a myocardial infarction and 401 (9%) a stroke, and 1782 (42%) died. Asian Indian were at greater risk (relative risk, 95% confidence interval) for any diabetes-related end point (1.18, 1.07-1.29), but at lower risk of all-cause mortality (0.89, 0.80-0.97) and peripheral vascular disease (0.43, 0.23-0.82), vs. White Caucasian. Afro-Caribbean participants were at lower risk for all-cause mortality (0.84, 0.76-0.93), diabetes-related death (0.75, 0.64-0.88), myocardial infarction (0.55, 0.43-0.71) and peripheral vascular disease (0.55, 0.33-0.93) vs. White Caucasian. No ethnicity-related associations were found for stroke or microangiopathy.
  
  
  CONCLUSIONS
  Asian Indian ethnicity is associated with the greatest burden of disease, but not with an increased risk of major vascular complications or death. Afro-Caribbean ethnicity is associated with reduced risk of all-cause and diabetes-related death, myocardial infarction and peripheral vascular disease, suggesting an ethnicity-specific protective mechanism.
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, WA, Australia.
authors.forename: T M E
authors.initials: TM
authors.lastname: Davis
authors.forename: R L
authors.initials: RL
authors.lastname: Coleman
authors.forename: R R
authors.initials: RR
authors.lastname: Holman
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000208:ethnology*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007194:India / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006113:United Kingdom / Q000453:epidemiology; D014900:West Indies / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human