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http://hdl.handle.net/2445/178363
Title: | Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis |
Author: | Baena Díez, José Miguel Peñafiel, Judith Subirana, Isaac Ramos, Rafel Elosua, Roberto Marín Ibánez, Alejandro Jesús Guembe, María Rigo, Fernando José Tormo Díaz, Maria Moreno Iribas, Conchi Josep Cabré, Joan Segura, Antonio García Lareo, Manel Gomez de la Carnara, Agustin Lapetra, José Quesada, Miquel Marrugat, Jaume, 1954- Jose Medrano, Maria Berjón, Jesus Frontera, Guillem Gavrila, Diana Barricarte, Aurelio Basora, Josep María García, Jose Pavone, Natalia C. Lora Pablos, David Mayoral, Eduardo Franch Nadal, Josep Mata Cases, Manel Castell, Conxa Frances, Albert Grau, Maria |
Keywords: | Diabetis Diabetes |
Issue Date: | 1-Nov-2016 |
Publisher: | American Diabetes Association |
Abstract: | 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.RESULTSWe 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 non cancer 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. |
Note: | https://doi.org/10.2337/dc16-0614 |
It is part of: | Diabetes Care, 2016, vol. 39, num. 11, p. 1987-1995 |
URI: | http://hdl.handle.net/2445/178363 |
Related resource: | https://doi.org/10.2337/dc16-0614 |
ISSN: | 0149-5992 |
Appears in Collections: | Articles publicats en revistes (Medicina) |
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