Cause-Specific Risk Factors of Death in Individuals with Diabetes: A Competing Risks Modeling.
CVA
CVD
Cancer
Competing Risks
Diabetes
Mortality
Journal
International journal of endocrinology and metabolism
ISSN: 1726-913X
Titre abrégé: Int J Endocrinol Metab
Pays: Netherlands
ID NLM: 101235597
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
15
04
2018
revised:
16
04
2019
accepted:
18
05
2019
entrez:
10
9
2019
pubmed:
10
9
2019
medline:
10
9
2019
Statut:
epublish
Résumé
Diabetes is on the rise worldwide. This study aimed to evaluate the risk factors of various causes of death in people with type 2 diabetes (T2D). In this cohort study on 2638 people with T2D, we applied cause-specific and sub-distribution hazards models to assess the impact of various factors on the risk of death. Moreover, we plotted a cumulative incidence curve to summarize cumulative failure rates over time. About 75% of individuals with T2D died from cardiovascular disease (CVD) and cerebrovascular accidents (CVA). Death from CVD was associated with the increased risk of hypertension (hazard ratio (HR) = 1.83, 95% CI: 1.37 - 2.46), hypercholesterolemia (HR = 1.58, 95% CI: 1.17 - 2.14), and diabetes duration. The risk of death from CVA was related to hypertension (HR = 2.76, 95% CI: 1.67 - 4.55) and hyperglycemia (HR = 4.34, 95% CI: 1.75 - 10.79). The CVA risk in patients with diabetes duration of 10 - 20 years was higher than the risk in patients with diabetes duration > 20 years (diabetes duration of ≤ 10 years as the reference category). Diabetes duration of longer than 20 years was associated with a higher risk of death from cancer (HR = 2.65, 95% CI: 1.05 - 6.68). The risk of death from foot infection and diabetic nephropathy increased in patients with longer diabetes duration after adjustment for sex, age, and body mass index. Regardless of the cause, death rates in people with T2D increase over time and risk factors have different impacts on death from each cause. This should be acknowledged in risk management in individuals with T2D.
Sections du résumé
BACKGROUND
BACKGROUND
Diabetes is on the rise worldwide.
OBJECTIVES
OBJECTIVE
This study aimed to evaluate the risk factors of various causes of death in people with type 2 diabetes (T2D).
METHODS
METHODS
In this cohort study on 2638 people with T2D, we applied cause-specific and sub-distribution hazards models to assess the impact of various factors on the risk of death. Moreover, we plotted a cumulative incidence curve to summarize cumulative failure rates over time.
RESULTS
RESULTS
About 75% of individuals with T2D died from cardiovascular disease (CVD) and cerebrovascular accidents (CVA). Death from CVD was associated with the increased risk of hypertension (hazard ratio (HR) = 1.83, 95% CI: 1.37 - 2.46), hypercholesterolemia (HR = 1.58, 95% CI: 1.17 - 2.14), and diabetes duration. The risk of death from CVA was related to hypertension (HR = 2.76, 95% CI: 1.67 - 4.55) and hyperglycemia (HR = 4.34, 95% CI: 1.75 - 10.79). The CVA risk in patients with diabetes duration of 10 - 20 years was higher than the risk in patients with diabetes duration > 20 years (diabetes duration of ≤ 10 years as the reference category). Diabetes duration of longer than 20 years was associated with a higher risk of death from cancer (HR = 2.65, 95% CI: 1.05 - 6.68). The risk of death from foot infection and diabetic nephropathy increased in patients with longer diabetes duration after adjustment for sex, age, and body mass index.
CONCLUSIONS
CONCLUSIONS
Regardless of the cause, death rates in people with T2D increase over time and risk factors have different impacts on death from each cause. This should be acknowledged in risk management in individuals with T2D.
Identifiants
pubmed: 31497037
doi: 10.5812/ijem.69419
pmc: PMC6678678
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e69419Déclaration de conflit d'intérêts
Conflicts of Interests: It is not declared by the authors.
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