Cardiovascular Risk Among Patients with Controlled and Uncontrolled Type 2 Diabetes: A Sub-Cohort Analysis from the Heart Health Promotion (HHP) Study

Figures & data

Table 1 Sociodemographic Profile of the Studied Sample

	Normal	Controlled DM	Uncontrolled DM	P-value
	N = 1997	N = 149	N = 286
	(82.1%)	(6.1%)	(11.8%)
Gender
Male	785 (82.1)	54 (5.6)	117 (12.2)	0.64^¶
Females	1212 (82.1)	95 (6.4)	169 (11.8)
Nationality
Saudi	1419 (81.8)	105 (6.1)	210 (12.1)	<0.01^¶
Arab Non-Saudi	487 (85.7)	30 (5.3)	51 (9.0)
Asian	79 (69.3)	13 (11.4)	22 (19.3)
Others	12 (75.0)	1 (6.3)	3 (18.8)
Age (years)
18–29	836 (98.1)	4 (0.5)	12 (1.14)	<0.01^#
30–39	599 (91.2)	24 (3.7)	34 (5.2)
40–49	331 (75.6)	38 (8.7)	69 (15.8)
50–59	182 (55.0)	45 (13.6)	104 (31.4)
>60	49 (55.0)	38 (24.7)	67 (43.5)
Marital Status
Married	1360 (77.1)	137 (7.8)	266 (15.1)	<0.01^#
Single	588 (97.0)	7 (1.2)	11 (1.8)
Widow or divorced	49 (77.8)	5 (7.9)	9 (14.3)
Education
College and above	1386 (84.7)	92 (5.6)	158 (9.7)	<0.01^¶
Essential Education	588 (82.4)	36 (5.0)	90 (12.6)
Illiterate	23 (28.0)	21 (25.6)	38 (46.3)
Smoking
Current smoker	164 (87.7)	6 (3.2)	17 (9.1)	0.02^#
None-smoker	1783 (82.0)	137 (6.3)	254 (11.7)
Ex-smoker	50 (70.4)	6 (8.5)	15 (21.1)
Family history of premature death	151 (69.6%)	20 (9.2%)	46 (21.2)	<0.01

Notes: Variables are presented as frequency (N) and percentages (%). ^¶Chi-square test was used, ^#Fisher’s Exact test was used.

Abbreviation: DM, diabetes mellitus.

Table 2 Cardiovascular Risk Profile and Vitamin D Level Among the Studied Sample

	Normal	Controlled DM	Uncontrolled DM	P-value
	N = 1997	N = 149	N = 286
	(82.1%)	(6.1%)	(11.8%)
Obesity
Underweight	66 (3.3)	1 (0.7)	0 (0.0)	<0.01
Normal	697 (34.9)	7 (4.7)	26 (9.1)
Overweight	693 (34.7)	38 (25.5)	99 (34.6)
Obese	353 (17.7)	64 (43.0)	89 (34.6)
Morbid obesity	188 (9.4)	39 (26.2)	72 (25.2)
Diabetes treatment
Insulin	-	15 (10.1)	69 (24.2)	<0.01
Antihyperglycemic drugs	-	77 (51.7)	200 (69.9)	<0.01
Controlled diet regimen	18 (0.9)	66 (44.3)	162 (56.6)	<0.01
Lifestyle
Healthy diet	11 (0.55)	3 (2.0)	0 (0.0)	0.04^#
Physical inactivity	1475 (73.9)	126 (84.6)	216 (75.5)	0.01
Vitamin D and Calcium
Deficiency (<30 nmol/L)	610 (30.6)	26 (17.4)	71 (25.0)	<0.01
Inadequacy (30–49 nmol/L)	602 (30.2)	35 (23.5)	84 (29.6)
Sufficiency (50–125 nmol/L)	733 (36.8)	84 (56.4)	121 (42.7)
Harmful (>125 nmol/L)	49 (2.5)	4 (2.7)	8 (2.8)
Calcium	2.3±2.3	2.5±2.1	2.7±6.0	0.28
Blood Pressure
SBP	114.7±13.2	125.6±12.7	128.3±16.0	<0.01
DBP	69.3±11.2	72.8±8.8	74.7±10.5	<0.01
Hypertension	213 (10.7)	74 (49.7)	156 (54.4)
Kidney Function
Serum creatinine	69.5±16.0	71.6±15.7	72.3±33.7	0.05
Uric Acid	282.5±78.9	307.9±85.7	280.5±79.6	<0.01
Chronic Kidney Disease	6 (0.3)	2 (1.4)	6 (2.1)	<0.01^#
Lipid Profile
Cholesterol (mmol/l)	4.7±0.8	4.9±1.0	4.9±3.7	<0.01
TG	1.09±0.8	1.6±1.3	1.8±1.2	<0.01
LDL-C	2.9±0.8	3.0±0.9	3.0±0.8	0.98
HDL	1.3±0.4	1.2±0.4	1.2±0.3	<0.01
TC/HDL Ratio	0.18±0.4	0.3±0.4	0.3±0.5	<0.01
Dyslipidemia
High triglycerides	271 (13.6)	103 (69.1)	129 (45.1)	<0.01
High total Cholesterol	637 (31.9)	58 (38.9)	108 (37.8)	0.04
High LDL	587 (29.4)	55 (36.9)	103 (36.0)	0.02
Low HDL	511 (25.6)	59 (39.6)	113 (39.5)	<0.01
TC/HDL Ratio ≥ 5	366 (18.3)	41 (27.5)	93 (32.5)	<0.01
Glycemic indices
Fasting Blood Glucose	4.4±0.7	6.4±1.8	9.4±3.7	<0.01
HbA1c	5.2±0.3	6.7±0.2	8.7±1.4	<0.01
Framingham cardiovascular risk score
Low risk <10%	1905 (95.4)	75 (50.3)	105 (36.7)	<0.01
Intermediate risk 10–20%	68 (3.4)	49 (32.9)	89 (31.1)
High risk >20%	24 (1.2)	25 (16.8)	92 (32.2)

Notes: Chi-square test was used in all comparisons with only one case where. ^#Fisher’s Exact test was used.

Abbreviations: DM, diabetes mellitus; SBP, systolic blood pressure; DBP, diastolic blood pressure; TG, triglycerides; TC, total cholesterol; LDL-C, density lipoprotein; HDL, high-density lipoprotein.

Table 3 Multivariate Logistic Regression Modeling of Intermediate/High Cardiac Risk

	Adjusted Odds Ratio (95% CI)
Diabetes Mellitus
Normal	Ref
Diabetes	3.02 (1.41–7.24)*
Uncontrolled Diabetes	13.57 (6.99–26.36)*
Gender
Males	Ref
Females	0.09 (0.05–0.17)*
Body Mass Index (BMI) (continuous variable)	1.04 (0.99–1.09)
Age (continuous variable)	1.26 (1.21–1.32)*

Notes: Multivariate logistic regression model to define the independent effect of diabetes control on developing a moderate or high cardiac risk-adjusted for age, gender, and body mass index. *P<0.05.

Data Sharing Statement

Most of the data needed is included in the published article. However, more data is available from the King Saud University Ethics Committee for researchers who meet the criteria for access to confidential data. The ethics committee contact details for data requests are: as.ude.usk@bri. This contact point is completely independent of all researchers.