Racial/Ethnic Differences in Subclinical Atherosclerosis Among Adults With Diabetes

Abstract

Recent findings from the Multi-ethnic Study of Atherosclerosis (MESA) (1) are consistent with previous reports that non-Hispanic white (white) adults have a greater presence and quantity of coronary artery calcium (CAC) than non-Hispanic black (black), Hispanic, and Chinese-American (Chinese) adults (2,3,4,5). It is not known whether previously reported racial/ethnic differences in atherosclerosis persist in the presence of type 1 or type 2 diabetes, an established risk factor for cardiovascular disease (CVD). Further, it is not known whether previously reported racial/ethnic differences in markers of atherosclerosis in the carotid and peripheral arteries (6,7) are also present among persons with diabetes. We assessed whether racial/ethnic differences in CAC, common and internal carotid intimal medial thickness (IMT), and the ankle brachial index (ABI) were evident in persons with diabetes in the MESA cohort and whether these differences persisted following adjustment for measured cardiovascular disease risk factors. MESA is a multicenter study of 6,814 men and women aged 45–84 who were free from clinical CVD in 2000–2002 (8). From the cohort of 6,814 participants, we excluded 25 participants without glucose measurements and 5,761 without diabetes. Our final analysis sample included 204 whites, 387 blacks, 311 Hispanics, and 126 Chinese with diabetes. The prevalence of diabetes in the cohort by race/ethnicity is comparable to …