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Greater macrovascular and microvascular morbidity from type 2 diabetes in Northern compared with Southern China: a cross-sectional study.

INTRODUCTION: There are substantial differences in genes, diet, culture, and environment between the Northern and Southern Chinese populations, which may influence treatment strategy and screening policy. We studied the differences in type 2 diabetes (T2D) and diabetic complications between Northern and Southern China.

METHODS: We did a cross-sectional survey using data from the China Cardiometabolic Registries on blood pressure, blood lipids, and blood glucose in 25,398 Chinese T2D patients. Macrovascular, microvascular, and other complications were collected by self-report or medical records, and then divided into the Northern and Southern groups by the boundary of the Yangtze River.

RESULTS: Northern patients were younger and had heavier weight, greater body-mass index and waist circumference, higher blood pressure, higher total cholesterol, higher low-density lipoprotein cholesterol, and higher hemoglobin A1C. The prevalence of cardiovascular, cerebrovascular, and macrovascular complications were 1.76 times, 1.24 times, and 1.47 times more in Northern than that in Southern Chinese patients. In addition, the prevalence of diabetic nephropathy, retinopathy, neuropathy, and microvascular complications in Northern Chinese patients also increased. When stratified by age, the difference in both cardiovascular disease and ischemic stroke morbidity became significant even in the 35-44 age group.

CONCLUSIONS: More macrovascular and microvascular complications were found in Northern compared to Southern patients, and the largest difference also appeared in the younger age groups under 55, which may be meaningful to a screening and treatment strategy according to geographic differences.

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