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Chronic Inflammatory Disorders and Risk of Type 2 Diabetes Mellitus, Coronary Heart Disease, and Stroke: A Population-Based Cohort Study

Circulation (New York, N.Y.), 2014-09, Vol.130 (10), p.837-844 [Peer Reviewed Journal]

2014 by the American College of Cardiology Foundation and the American Heart Association, Inc. ;2015 INIST-CNRS ;2014 American Heart Association, Inc. ;ISSN: 0009-7322 ;EISSN: 1524-4539 ;DOI: 10.1161/CIRCULATIONAHA.114.009990 ;PMID: 24970784 ;CODEN: CIRCAZ

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Title:
Chronic Inflammatory Disorders and Risk of Type 2 Diabetes Mellitus, Coronary Heart Disease, and Stroke: A Population-Based Cohort Study
Author: Dregan, Alex ; Charlton, Judith ; Chowienczyk, Phil ; Gulliford, Martin C
Subjects: Adult ; Aged ; Aged, 80 and over ; Autoimmune Diseases - blood ; Autoimmune Diseases - complications ; Biological and medical sciences ; Biomarkers - blood ; Blood and lymphatic vessels ; C-Reactive Protein - metabolism ; Cardiology. Vascular system ; Case-Control Studies ; Chronic Disease ; Cohort Studies ; Coronary Disease - epidemiology ; Coronary heart disease ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes. Impaired glucose tolerance ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Heart ; Humans ; Inflammation - blood ; Inflammation - complications ; Inflammatory Bowel Diseases - blood ; Inflammatory Bowel Diseases - complications ; Male ; Medical sciences ; Middle Aged ; Neurology ; Psoriasis - blood ; Psoriasis - complications ; Rheumatic Diseases - blood ; Rheumatic Diseases - complications ; Risk Factors ; Stroke - epidemiology ; United Kingdom ; Vascular diseases and vascular malformations of the nervous system
Is Part Of: Circulation (New York, N.Y.), 2014-09, Vol.130 (10), p.837-844
Description: BACKGROUND—This study sought to evaluate whether risks of diabetes mellitus and cardiovascular disease are elevated across a range of organ-specific and multisystem chronic inflammatory disorders. METHODS AND RESULTS—A matched cohort study was implemented in the UK Clinical Practice Research Datalink including participants with severe psoriasis (5648), mild psoriasis (85 232), bullous skin diseases (4284), ulcerative colitis (12 203), Crohn’s disease (7628), inflammatory arthritis (27 358), systemic autoimmune disorders (7472), and systemic vasculitis (6283) and in 373 851 matched controls. The main outcome measures were new diagnoses of type 2 diabetes mellitus, stroke, or coronary heart disease. The outcomes were evaluated for each condition in a multiple outcomes model, with adjustment for conventional cardiovascular risk factors. Estimates for different inflammatory conditions were pooled in a random-effects meta-analysis. There were 4695 new diagnoses of type 2 diabetes mellitus, 3266 of coronary heart disease, and 1715 of stroke. The hazard ratio for pooled multiple failure estimate was 1.20 (95% confidence interval [CI], 1.15–1.26). The highest relative hazards were observed in systemic autoimmune disorders (1.32; 95% CI, 1.16–1.50) and systemic vasculitis (1.29; 95% CI, 1.16–1.44). Hazards were increased in organ-specific disorders, including severe psoriasis (1.29; 95% CI, 1.12–1.47) and ulcerative colitis (1.26; 95% CI, 1.14–1.40). Participants in the highest tertile of C-reactive protein had greater risk of multiple outcomes (1.52; 95% CI, 1.37–1.68). CONCLUSIONS—The risk of cardiovascular diseases and type 2 diabetes mellitus is increased across a range of organ-specific and multisystem chronic inflammatory disorders with evidence that risk is associated with severity of inflammation. Clinical management of patients with chronic inflammatory disorders should seek to reduce cardiovascular risk.
Publisher: Hagerstown, MD: by the American College of Cardiology Foundation and the American Heart Association, Inc
Language: English
Identifier: ISSN: 0009-7322
EISSN: 1524-4539
DOI: 10.1161/CIRCULATIONAHA.114.009990
PMID: 24970784
CODEN: CIRCAZ
Source: Geneva Foundation Free Medical Journals at publisher websites
MEDLINE

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Chronic Inflammatory Disorders and Risk of Type 2 Diabetes Mellitus, Coronary Heart Disease, and Stroke: A Population-Based Cohort Study

2014 by the American College of Cardiology Foundation and the American Heart Association, Inc. ;2015 INIST-CNRS ;2014 American Heart Association, Inc. ;ISSN: 0009-7322 ;EISSN: 1524-4539 ;DOI: 10.1161/CIRCULATIONAHA.114.009990 ;PMID: 24970784 ;CODEN: CIRCAZ

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