American Journal of Epidemiology Vol. 135, No. 12: 1321-1330
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health
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Prevalence of Coronary Heart Disease in Subjects with Normal and Impaired Glucose Tolerance and Non-insulin-dependent Diabetes Mellitus in a Biethnic Colorado Population
The San Luis Valley Diabetes Study
1Department of Preventive Medicine and Bio-metncs, University of Colorado School of Medicine Denver, CO.
Reprint requests to Dr. Marlan Rewers, Department of Preventive Medicine and Bio-metrics, University of Colorado, Box C245, 4200 E. Ninth Avenue, Denver, CO 80262
The prevalence of coronary heart disease was studied in 1984–1988 in 1, 092 individuals with normal glucose tolerance, 173 individuals with impaired glucose tolerance, and 429 individuals with non-insulin-dependent diabetes mellitus, who were age 25–74 years and were from a biethnic community in the San Luis Valley, Colorado. Glucose tolerance was classified using the World Health Organization criteria, and coronary heart disease prevalence was assessed using the Rose Questionnaire and a resting electrocardiogram. Compared with normal glucose tolerance, coronary heart disease was significantly more prevalent in diabetic non-Hispanic white women (odds ratio (OR) for all end points combined = 3.2, 95% confidence interval (Cl) 1.8–5.5) and men (OR = 1.9, 95% Cl 1.1–3.3) and in diabetic Hispanic women (OR = 1.7, 95% Cl 1.1–2.5), but not men (OR = 1.0, 95% Cl 0.6–1.7). Among diabetic men, the prevalence of possible myocardial infarction was lower in Hispanics than in non-Hispanic whites (OR = 0.4, 95% Cl 0.2–0.7). Similar patterns of coronary heart disease were observed in individuals with impaired glucose tolerance. The paradoxically low prevalence of coronary heart disease in Hispanics with non-insulin-dependent diabetes mellitus, especially men, may be due to unknown protective factors, increased case fatality, or competing mortality in this group. Am J Epidemiol 1992; 135: 1321–30
coronary disease; diabetes mellitus; ethnic groups; glucose tolerance test; Hispanic Americans
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