Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/20315
Title
Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis
Author(s)
Baena-Diez, Jose Miguel | Penafiel, Judit | Subirana, Isaac | Ramos-Asensio, Rafael | Elosua, Roberto | Marin-Ibanez, Alejandro | Guembe, Maria Jesus | Reigada Mendez, Rebeca | Tormo-Diaz, Maria Jose | Moreno-Iribas, Conchi | Cabre, Joan Josep | Segura, Antonio | Garcia-Lareo, Manel | Gomez de la Carnara, Agustin | Lapetra, Jose | Quesada, Miguel | Marrugat, Jaume | Medrano, Maria Jose ISCIII | Berjon, Jesus | Frontera-Juan, Guillem | Gavrila, Diana | Barricarte, Aurelio | Basora, Josep | Garcia, Jose Maria | Pavone, Natalia C | Lora-Pablos, David | Mayora, Eduardo | Franch, Josep | Mata, Manel | Castell, Conxa | Frances, Albert | Grau, Maria | FRESCO Investigators
Date issued
2016-11
Citation
Miguel Baena-Diez Jose, Penafiel Judit, Subirana Isaac, Ramos Rafel, Elosua Roberto, Marin-Ibanez Alejandro, et al. Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis. Diabetes Care. 2016 Nov;39(11):1987-1995. Epub 2016 Aug 4.
Language
Inglés
Document type
research article
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. 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 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.
MESH
Cardiovascular Diseases | Diabetes Mellitus, Type 2 | Aged | Blood Glucose | Adult | Diabetes Mellitus, Type 1 | Risk Assessment | Follow-Up Studies | Humans | Cause of Death | Life Expectancy | Middle Aged | Neoplasms | Male | Multivariate Analysis | Female | Risk Factors | Cohort Studies
DECS
Estudios de Cohortes | Femenino | Análisis Multivariante | Masculino | Estudios de Seguimiento | Factores de Riesgo | Humanos | Esperanza de Vida | Persona de Mediana Edad | Neoplasias | Glucemia | Causas de Muerte | Anciano | Medición de Riesgo | Diabetes Mellitus Tipo 2 | Enfermedades Cardiovasculares | Diabetes Mellitus Tipo 1 | Adulto
Online version
DOI
Collections
- Investigación > IIS > IdisBa - Instituto de Investigación Sanitaria Illes Balears (Baleares)
- Investigación > IIS > IMIM - Hospital del Mar Research Institute-Barcelona (Cataluña)
- Investigación > ISCIII > Centro Nacional de Epidemiología (CNE)
- Investigación > IIS > i+12 - Instituto de Investigación Hospital 12 de Octubre (Madrid)
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