All-cause and cause-specific mortality risk and loss in life expectancy associated with incident type 2 diabetes onset age and duration.

Autor: Zhang Y; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA., Song M; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.; Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA., Wang M; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA., Hertzmark E; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA., Wu K; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA., Eliassen AH; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA., Mucci LA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA., Sun Q; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA., Stampfer MJ; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA., Willett WC; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA., Hu FB; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA., Giovannucci EL; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Jazyk: angličtina
Zdroj: Journal of internal medicine [J Intern Med] 2024 Sep; Vol. 296 (3), pp. 260-279. Date of Electronic Publication: 2024 Jul 18.
DOI: 10.1111/joim.13817
Abstrakt: Background: Evidence on type 2 diabetes onset age and duration on mortality risk has been limited by short follow-up, inadequate control for confounding, missing repeated measurements, and inability to cover the full range of onset age, duration, and major causes of death. Moreover, scarce data dissect how type 2 diabetes onset age and duration shape life expectancy.
Methods: We evaluate prospectively these topics based on 270,075 eligible participants in the Nurses' Health Studies and Health Professionals Follow-up Study, leveraging repeated measurements throughout up to 40 years of follow-up. Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
Results: In fully adjusted analyses, incident early onset type 2 diabetes (diagnosed <40 years of age) was associated with significantly higher mortality from all-causes (HR, 95% CI was 3.16, 2.64-3.79; vs. individuals without type 2 diabetes), cardiovascular disease (6.56, 4.27-10.1), respiratory disease (3.43, 1.38-8.51), neurodegenerative disease (5.13, 2.09-12.6), and kidney disease (8.55, 1.98-36.9). The relative risk elevations declined dramatically with each higher decade of age at diagnosis for deaths from most of these causes, though the absolute risk difference increased continuously. A substantially higher cumulative incidence of mortality and a greater loss in life expectancy were associated with younger age at type 2 diabetes diagnosis. Longer disease duration was associated with generally higher relative and absolute risk of mortality.
Conclusion: Early onset of type 2 diabetes and longer disease duration are associated with substantially increased risk of all-cause and cause-specific mortality and greater loss in life expectancy.
(© 2024 The Association for the Publication of the Journal of Internal Medicine.)
Databáze: MEDLINE
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