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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, Miguel
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
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.
It is part of: Diabetes Care, 2016, vol. 39, num. 11, p. 1987-1995
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ISSN: 0149-5992
Appears in Collections:Articles publicats en revistes (Medicina)

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