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

Diabetes care, 2016-11, Vol.39 (11), p.1987-1995 [Peer Reviewed Journal]

2016 by the American Diabetes Association. ;Copyright American Diabetes Association Nov 1, 2016 ;ISSN: 0149-5992 ;EISSN: 1935-5548 ;DOI: 10.2337/dc16-0614 ;PMID: 27493134 ;CODEN: DICAD2

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Title:
Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis
Author: 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
Subjects: Adult ; Aged ; Blood Glucose - metabolism ; Cardiovascular disease ; Cardiovascular Diseases - complications ; Cardiovascular Diseases - mortality ; Cause of Death ; Cohort Studies ; Data analysis ; Diabetes ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 1 - mortality ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - mortality ; Female ; Follow-Up Studies ; Humans ; Life Expectancy ; Male ; Middle Aged ; Mortality ; Multivariate Analysis ; Neoplasms - complications ; Neoplasms - mortality ; Risk Assessment ; Risk Factors
Is Part Of: Diabetes care, 2016-11, Vol.39 (11), p.1987-1995
Description: Diabetes is a common cause of shortened life expectancy. We aimed to assess the association between diabetes and cause-specific death. 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. 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. 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.
Publisher: United States: American Diabetes Association
Language: English
Identifier: ISSN: 0149-5992
EISSN: 1935-5548
DOI: 10.2337/dc16-0614
PMID: 27493134
CODEN: DICAD2
Source: Geneva Foundation Free Medical Journals
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Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis

2016 by the American Diabetes Association. ;Copyright American Diabetes Association Nov 1, 2016 ;ISSN: 0149-5992 ;EISSN: 1935-5548 ;DOI: 10.2337/dc16-0614 ;PMID: 27493134 ;CODEN: DICAD2

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