Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis

Autor: Baena-Díez, Jose Miguel, Peñafiel, Judit, Subirana, Isaac, Ramos, Rafel, Elosua, Roberto, Marín-Ibañez, Alejandro, Guembe, María Jesús, Rigo, Fernando, Tormo-Díaz, María José, Moreno-Iribas, Conchi, Cabré, Joan Josep, Segura, Antonio, García-Lareo, Manel, Gómez de la Cámara, Agustín, Lapetra, José, Quesada, Miquel, Marrugat, Jaume, Medrano, Maria José, Berjón, Jesús, Frontera, Guiem, Gavrila, Diana, Barricarte, Aurelio, Basora, Josep, García, Jose María, Pavone, Natalia C, Lora-Pablos, David, Mayoral, Eduardo, Franch, Josep, Mata, Manel, Castell, Conxa, Frances, Albert, Grau, María, FRESCO Investigators
Přispěvatelé: [Miguel Baena-Diez, Jose] Hosp del Mar, Med Res Inst, REGICOR Study Grp Cardiovasc Epidemiol & Genet, Barcelona, Spain, [Penafiel, Judit] Hosp del Mar, Med Res Inst, REGICOR Study Grp Cardiovasc Epidemiol & Genet, Barcelona, Spain, [Subirana, Isaac] Hosp del Mar, Med Res Inst, REGICOR Study Grp Cardiovasc Epidemiol & Genet, Barcelona, Spain, [Elosua, Roberto] Hosp del Mar, Med Res Inst, REGICOR Study Grp Cardiovasc Epidemiol & Genet, Barcelona, Spain, [Marrugat, Jaume] Hosp del Mar, Med Res Inst, REGICOR Study Grp Cardiovasc Epidemiol & Genet, Barcelona, Spain, [Grau, Maria] Hosp del Mar, Med Res Inst, REGICOR Study Grp Cardiovasc Epidemiol & Genet, Barcelona, Spain, [Miguel Baena-Diez, Jose] Catalan Inst Hlth, Primary Care Ctr La Marina, Barcelona, Spain, [Garcia-Lareo, Manel] Catalan Inst Hlth, Primary Care Ctr La Marina, Barcelona, Spain, [Pavone, Natalia C.] Catalan Inst Hlth, Primary Care Ctr La Marina, Barcelona, Spain, [Miguel Baena-Diez, Jose] Catalan Inst Hlth, Primary Hlth Care Res Inst Jordi Gol, Barcelona, Spain, [Garcia-Lareo, Manel] Catalan Inst Hlth, Primary Hlth Care Res Inst Jordi Gol, Barcelona, Spain, [Pavone, Natalia C.] Catalan Inst Hlth, Primary Hlth Care Res Inst Jordi Gol, Barcelona, Spain, [Miguel Baena-Diez, Jose] Consortium Biomed Res Epidemiol & Publ Hlth, Madrid, Spain, [Subirana, Isaac] Consortium Biomed Res Epidemiol & Publ Hlth, Madrid, Spain, [Gomez de la Carnara, Agustin] Consortium Biomed Res Epidemiol & Publ Hlth, Madrid, Spain, [Gavrila, Diana] Consortium Biomed Res Epidemiol & Publ Hlth, Madrid, Spain, [Barricarte, Aurelio] Consortium Biomed Res Epidemiol & Publ Hlth, Madrid, Spain, [Lora-Pablos, David] Consortium Biomed Res Epidemiol & Publ Hlth, Madrid, Spain, [Ramos, Rafel] Catalan Inst Hlth, Family Med Res Unit, Girona, Spain, [Jose Tormo-Diaz, Maria] Catalan Inst Hlth, Family Med Res Unit, Girona, Spain, [Quesada, Miguel] Catalan Inst Hlth, Family Med Res Unit, Girona, Spain, [Ramos, Rafel] Catalan Inst Hlth, Primary Hlth Care Res Unit, Inst Jordi Gol, Girona, Spain, [Jose Tormo-Diaz, Maria] Catalan Inst Hlth, Primary Hlth Care Res Unit, Inst Jordi Gol, Girona, Spain, [Quesada, Miguel] Catalan Inst Hlth, Primary Hlth Care Res Unit, Inst Jordi Gol, Girona, Spain, [Ramos, Rafel] Univ Girona, Girona, Spain, [Marin-Ibanez, Alejandro] San Jose Norte Hlth Ctr, Zaragoza, Spain, [Jesus Guembe, Maria] Navarra Govt, Dept Hlth, Vasc Risk Navarra Res Grp, Pamplona, Spain, [Berjon, Jesus] Navarra Govt, Dept Hlth, Vasc Risk Navarra Res Grp, Pamplona, Spain, [Jesus Guembe, Maria] Navarra Govt, Dept Hlth, Knowledge Planning Evaluat & Management, Navarra, Spain, [Rigo, Fernando] Cardiovasc Grp Balear Isl, Palma De Mallorca, Spain, [Frontera, Guiem] Cardiovasc Grp Balear Isl, Palma De Mallorca, Spain, [Jose Tormo-Diaz, Maria] Murcian Hlth Dept, Murcia, Spain, [Jose Tormo-Diaz, Maria] Univ Murcia, Murcia, Spain, [Jose Tormo-Diaz, Maria] Murcian Inst Biomed Res, Murcia, Spain, [Moreno-Iribas, Conchi] Navarre Publ Hlth Inst, Pamplona, Spain, [Barricarte, Aurelio] Navarre Publ Hlth Inst, Pamplona, Spain, [Moreno-Iribas, Conchi] Res Network Hlth Serv Chron Dis, Pamplona, Spain, [Moreno-Iribas, Conchi] Navarra Hlth Res Inst, Pamplona, Spain, [Berjon, Jesus] Navarra Hlth Res Inst, Pamplona, Spain, [Barricarte, Aurelio] Navarra Hlth Res Inst, Pamplona, Spain, [Josep Cabre, Joan] Catalan Inst Hlth, Primary Care Ctr Sant Pere Ctr, Reus, Spain, [Josep Cabre, Joan] Catalan Inst Hlth, Primary Hlth Care Res Unit, Inst Jordi Gol, Reus, Spain, [Segura, Antonio] Castille La Mancha Government, Dept Hlth & Social Affairs, Hlth Sci Inst, Talavera De La Reina, Spain, [Maria Garcia, Jose] Castille La Mancha Government, Dept Hlth & Social Affairs, Hlth Sci Inst, Talavera De La Reina, Spain, [Gomez de la Carnara, Agustin] Hosp 12 Octubre Res Inst, Clin Res Dept, Madrid, Spain, [Lora-Pablos, David] Hosp 12 Octubre Res Inst, Clin Res Dept, Madrid, Spain, [Lapetra, Jose] Consortium Biomed Res Obes & Nutr, Madrid, Spain, [Mayora, Eduardo] Consortium Biomed Res Obes & Nutr, Madrid, Spain, [Lapetra, Jose] Primary Care Ctr San Pablo, Dept Family Med, Primary Care Div, Seville, Spain, [Jose Medrano, Maria] Carlos III Hlth Inst, Madrid, Spain, [Gavrila, Diana] Murcia Govt, Hlth & Consumers Dept, Murcia, Spain, [Basora, Josep] Catalan Inst Hlth, Primary Hlth Care Res Unit, Inst Jordi Gol, Reus, Spain, [Mayora, Eduardo] Andalusia Hlth Serv, Diabet Strategy, Seville, Spain, [Franch, Josep] Catalan Inst Hlth, Primary Care Ctr Raval Sud, Barcelona, Spain, [Franch, Josep] Catalan Inst Hlth, Primary Hlth Care Res Unit, Inst Jordi Gol, Barcelona, Spain, [Franch, Josep] Consortium Biomed Res Diabet & Associated Metab D, Madrid, Spain, [Mata, Manel] Primary Care Ctr La Mina, Barcelona, Spain, [Mata, Manel] Catalan Inst Hlth, Inst Jordi Gol, Primary Hlth Care Res Unit, Barcelona, Spain, [Castell, Conxa] Govt Catalonia, Publ Hlth Agcy, Barcelona, Spain, [Frances, Albert] Hosp del Mar, Dept Urol, Barcelona, Spain, [Grau, Maria] Univ Barcelona, Barcelona, Spain, MARATO TV3, Institute de Salud Carlos III-Fondo Europeo de Desarrollo Regional-European Regions Development Funds, Agency for Management of University and Research Grants, Consortium for Biomedical Research in Epidemiology and Public Health, Consortium for Biomedical Research in Obesity and Nutrition, Instituto de Salud Carlos III-Fondo Europeo de Desarrollo Regional-European Regions Development Fund FEDER
Rok vydání: 2016
Předmět:
Blood Glucose
Male
Complications
Endocrinology
Diabetes and Metabolism
Disease
030204 cardiovascular system & hematology
Cohort Studies
0302 clinical medicine
Risk Factors
Cause of Death
Neoplasms
Cause of death
education.field_of_study
Diabetis
Hazard ratio
Diabetes
Metaanalysis
Middle Aged
Cardiovascular Diseases
Female
Risk assessment
Cohort study
Adult
medicine.medical_specialty
Coronary-heart-disease
Population
030209 endocrinology & metabolism
Sistema cardiovascular -- Malalties -- Mortalitat
Risk Assessment
Càncer -- Mortalitat
03 medical and health sciences
Life Expectancy
Internal medicine
Diabetes mellitus
Internal Medicine
medicine
Humans
Mortality
education
Aged
Advanced and Specialized Nursing
business.industry
Mellitus
Hazards
All-cause
Cardiovascular risk
medicine.disease
Myocardial-infarction
Glucose
Diabetes Mellitus
Type 1
Diabetes Mellitus
Type 2
Multivariate Analysis
Life expectancy
business
Follow-Up Studies
Zdroj: Dipòsit Digital de la UB
Universidad de Barcelona
ISSN: 1935-5548
Popis: OBJECTIVE: Diabetes is a common cause of shortened life expectancy. We aimed to assess the association between diabetes and cause-specific death. RESEARCH DESIGN AND METHODS: We used the pooled analysis of individual data from 12 Spanish population cohorts with 10-year follow-up. Participants had no previous history of cardiovascular diseases and were 35-79 years old. Diabetes status was self-reported or defined as glycemia >125 mg/dL at baseline. Vital status and causes of death were ascertained by medical records review and linkage with the official death registry. The hazard ratios and cumulative mortality function were assessed with two approaches, with and without competing risks: proportional subdistribution hazard (PSH) and cause-specific hazard (CSH), respectively. Multivariate analyses were fitted for cardiovascular, cancer, and noncardiovascular noncancer deaths. RESULTS: We included 55,292 individuals (15.6% with diabetes and overall mortality of 9.1%). The adjusted hazard ratios showed that diabetes increased mortality risk: 1) cardiovascular death, CSH = 2.03 (95% CI 1.63-2.52) and PSH = 1.99 (1.60-2.49) in men; and CSH = 2.28 (1.75-2.97) and PSH = 2.23 (1.70-2.91) in women; 2) cancer death, CSH = 1.37 (1.13-1.67) and PSH = 1.35 (1.10-1.65) in men; and CSH = 1.68 (1.29-2.20) and PSH = 1.66 (1.25-2.19) in women; and 3) noncardiovascular noncancer death, CSH = 1.53 (1.23-1.91) and PSH = 1.50 (1.20-1.89) in men; and CSH = 1.89 (1.43-2.48) and PSH = 1.84 (1.39-2.45) in women. In all instances, the cumulative mortality function was significantly higher in individuals with diabetes. CONCLUSIONS: Diabetes is associated with premature death from cardiovascular disease, cancer, and noncardiovascular noncancer causes. The use of CSH and PSH provides a comprehensive view of mortality dynamics in a population with diabetes. This work was supported by MARATO TV3 (081630), Instituto de Salud Carlos III–Fondo Europeo de Desarrollo Regional–European Regions Development Funds (Red de Investigación Cardiovascular RD12/0042 [Programa HERACLES], Red RedIAPP RD12/0005, RD06/0018, PI081327, and PI1101801), Agency for Management of University and Research Grants (2014 SGR 240), Consortium for Biomedical Research in Epidemiology and Public Health, and Consortium for Biomedical Research in Obesity and Nutrition. M.G. was supported by the Instituto de Salud Carlos III– Fondo Europeo de Desarrollo Regional–European Regions Development Fund FEDER (FIS CP12/ 03287).
Databáze: OpenAIRE
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