Macrovascular and renal microvascular complications in West Africans with intermediate hyperglycemia living in West Africa and Europe: The RODAM study

Emmanuel Bannerman-Williams; Charles F Hayfron-Benjamin; Yacoba Atiase; Silver Bahendeka; Karlijn Meeks; Kerstin Klipstein-Grobusch; Juliet Addo; Frank Mockenhaupt; Matthias B Schulze; Erik Beune; Bert-Jan van den Born; Charles Agyemang

doi:10.1016/j.heliyon.2023.e19334

Macrovascular and renal microvascular complications in West Africans with intermediate hyperglycemia living in West Africa and Europe: The RODAM study

Heliyon. 2023 Aug 20;9(8):e19334. doi: 10.1016/j.heliyon.2023.e19334. eCollection 2023 Aug.

Authors

Emmanuel Bannerman-Williams^{1

2

3}, Charles F Hayfron-Benjamin^{1

2

4

5}, Yacoba Atiase⁶, Silver Bahendeka⁷, Karlijn Meeks^{1

8}, Kerstin Klipstein-Grobusch^{9

10}, Juliet Addo¹¹, Frank Mockenhaupt¹², Matthias B Schulze^{13

14

15}, Erik Beune¹, Bert-Jan van den Born^{1

2}, Charles Agyemang^{1

16}

Affiliations

¹ Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
² Department of Internal and Vascular Medicine, Amsterdam UMC, University of Amsterdam, Cardiovascular Sciences, Amsterdam, the Netherlands.
³ Department of Surgery, University of Ghana Medical School, Ghana.
⁴ Department of Physiology, University of Ghana Medical School, Ghana.
⁵ Department of Anaesthesia and Critical Care, University of Ghana Medical School, Ghana.
⁶ Department of Medicine and Therapeutics, University of Ghana Medical School, Ghana.
⁷ MKPGMS-Uganda Martyrs University, Kampala, Uganda.
⁸ Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
⁹ Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands.
¹⁰ Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹¹ Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
¹² Institute of Tropical Medicine and International Health, Charité Universitätsmedizin Berlin, Berlin, Germany.
¹³ Department of Molecular Epidemiology, German Institute for Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
¹⁴ German Center for Diabetes Research (DZD), Neuherberg, Germany.
¹⁵ Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany.
¹⁶ Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Abstract

Background: Metabolic conditions, including intermediate hyperglycemia (IH), affect migrants to a greater extent than the populations of origin. Evidence suggests that IH increases the risk of vascular complications, but it is unclear whether the differences in IH between the non-migrant and migrant populations translate to differences in vascular complications between the two populations. We compared the prevalence of macrovascular and renal microvascular complications among West Africans with IH living in West Africa and their migrant compatriots in Europe.

Methods: Data from the multicenter Research on Obesity and Diabetes among African Migrants(RODAM) study were analyzed. Ghanaians with IH(524 non-migrant and 1439 migrants) were included. Logistic regression analyses were used to determine the associations between migrant status and macrovascular [coronary artery disease(CAD) and peripheral artery disease(PAD)] and renal microvascular[nephropathy] complications with adjustment for age, sex, socioeconomic status, smoking, systolic blood pressure, BMI, total cholesterol, HbA1c, C-reactive protein, and serum uric acid.

Findings: The prevalence of microvascular/macrovascular complications was higher in non-migrants than in migrants(nephropathy 15.3vs.9.7%; PAD 3.1%vs.1.3%; and CAD 15.8% vs. 5.0%). The differences persisted in the fully adjusted model: nephropathy [odds ratio, 2.12; 95% CI(1.46-3.08); PAD, 4.44(1.87-10.51); CAD 2.35(1.64-3.37)]. Non-migrant females had higher odds of nephropathy[2.14(1.34-3.43)], PAD[7.47(2.38-23.40)] and CAD [2.10(1.34-3.27)] compared to migrant females. Non-migrant males had higher odds of nephropathy[2.54(1.30-4.97)] and CAD[2.85(1.48-5.50)], but not PAD[1.81(0.32-10.29)],than their migrant peers.

Interpretation: Macrovascular and renal microvascular complications were more prevalent in non-migrants than in migrant West Africans with IH. Further studies are needed to identify factors that increase the risk to aid preventive/treatment strategies.

Keywords: Diabetes complications; Intermediate hyperglycemia; Macrovascular complications; Microvascular complications; Prediabetes; RODAM study; Sub-saharan africa.