Vascular disease in younger-onset diabetes: comparison of European, Asian and American Indian cohorts of the WHO multinational study of vascular disease in diabetes

Aims/hypothesis. 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. Conclusion/interpretation. This study confirms the high burden of large and small-vessel disease complications manifest in American Indian people with younger-onset diabetes.