Cardiovascular risk profile, diabetes specific factors, and prevalent microvascular eye complications in sub-Saharan Africans with type 2 diabetes

  • Andre P. KengneEmail author
  • Patricia Gouking
  • Edvine Wawo
  • Godefroy Koki
  • Eric Balti
  • Herbert Hakapoka
  • Mesmin Y. Dehayem
  • Eugene Sobngwi
  • Jean-Claude Mbanya
Original Article


The aim of this study is to examine the association between cardiovascular risk profile, diabetes-specific factors, and prevalent retinopathy in sub-Saharan Africans with type 2 diabetes. We enrolled 213 (41 % women) diabetic adults from the Cameroon National Obesity Center in 2008. Prevalent retinopathy was based on history and digital mydriatic retinal photography. Cardiovascular risk profile was assessed, and global absolute coronary risk was estimated with the UK Prospective Diabetes Study (UKPDS) and Framingham coronary risk equations. Logistic regressions were used to relate risk factors to prevalent retinopathy and discrimination and calibration assessed. Fifty-four patients (25.4 %) had prevalent of retinopathy. Patients with retinopathy had more often hypertension (88 vs 43 %, p = 0.003), and age at diagnosis, known duration of diabetes, blood glucose, and systolic blood pressure were associated with retinopathy. Estimated 10-year coronary risks by the Framingham and UKPDS had low discrimination for retinopathy, with C-statistic (95 % confidence interval) of 0.593 (0.504–0.682) and 0.603 (0.518–0.688), respectively. New equations developed from this sample had better discrimination and calibration, with a maximum C-statistic of 0.881 (0.828–0.933). Cardiovascular risk profile was poorly correlated with prevalent retinopathy in this population. Strategies based upon routinely assessed diabetes-related factors can improve the selection of patients at high risk of retinopathy for costly confirmatory investigations.


Risk factors Diabetes retinopathy Diabetes type 2 Risk prediction models Sub-Saharan Africa Cameroon 


Conflict of interest

None for all authors

Funding support


Financial disclosure



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Copyright information

© Research Society for Study of Diabetes in India 2015

Authors and Affiliations

  • Andre P. Kengne
    • 1
    Email author
  • Patricia Gouking
    • 2
  • Edvine Wawo
    • 3
  • Godefroy Koki
    • 4
  • Eric Balti
    • 2
  • Herbert Hakapoka
    • 2
  • Mesmin Y. Dehayem
    • 2
  • Eugene Sobngwi
    • 2
  • Jean-Claude Mbanya
    • 2
  1. 1.South African Medical Research Council and University of Cape TownCape TownSouth Africa
  2. 2.Diabetes and Endocrine serviceYaounde Central HospitalYaoundeCameroon
  3. 3.Department of MedicineYaounde University Teaching HospitalYaoundeCameroon
  4. 4.Faculty of Medicine and Biomedical SciencesUniversity of Yaounde 1YaoundeCameroon

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