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Diabetes mellitus, fasting glucose, and risk of cause-specific death.
Tuesday,2012-11-06 12:25 America/Los_Angeles — eenright
| Title | Diabetes mellitus, fasting glucose, and risk of cause-specific death. |
| Publication Type | Journal Article |
| Year of Publication | 2011 |
| Authors | Seshasai, SRao Kondap, Kaptoge, S, Thompson, A, Di Angelantonio, E, Gao, P, Sarwar, N, Whincup, PH, Mukamal, KJ, Gillum, RF, Holme, I, Njølstad, I, Fletcher, A, Nilsson, P, Lewington, S, Collins, R, Gudnason, V, Thompson, SG, Sattar, N, Selvin, E, Hu, FB, Danesh, J |
| Corporate/Institutional Authors | Emerging Risk Factors Collaboration, |
| Journal | N Engl J Med |
| Volume | 364 |
| Issue | 9 |
| Pagination | 829-841 |
| Date Published | 2011 Mar 03 |
| ISSN | 1533-4406 |
| Keywords | Blood Glucose, Cause of Death, Diabetes Mellitus, Female, Humans, Hyperglycemia, Life Expectancy, Male, Middle Aged, Risk, Survival Analysis |
| Abstract | <p><b>BACKGROUND: </b>The extent to which diabetes mellitus or hyperglycemia is related to risk of death from cancer or other nonvascular conditions is uncertain.</p><p><b>METHODS: </b>We calculated hazard ratios for cause-specific death, according to baseline diabetes status or fasting glucose level, from individual-participant data on 123,205 deaths among 820,900 people in 97 prospective studies.</p><p><b>RESULTS: </b>After adjustment for age, sex, smoking status, and body-mass index, hazard ratios among persons with diabetes as compared with persons without diabetes were as follows: 1.80 (95% confidence interval [CI], 1.71 to 1.90) for death from any cause, 1.25 (95% CI, 1.19 to 1.31) for death from cancer, 2.32 (95% CI, 2.11 to 2.56) for death from vascular causes, and 1.73 (95% CI, 1.62 to 1.85) for death from other causes. Diabetes (vs. no diabetes) was moderately associated with death from cancers of the liver, pancreas, ovary, colorectum, lung, bladder, and breast. Aside from cancer and vascular disease, diabetes (vs. no diabetes) was also associated with death from renal disease, liver disease, pneumonia and other infectious diseases, mental disorders, nonhepatic digestive diseases, external causes, intentional self-harm, nervous-system disorders, and chronic obstructive pulmonary disease. Hazard ratios were appreciably reduced after further adjustment for glycemia measures, but not after adjustment for systolic blood pressure, lipid levels, inflammation or renal markers. Fasting glucose levels exceeding 100 mg per deciliter (5.6 mmol per liter), but not levels of 70 to 100 mg per deciliter (3.9 to 5.6 mmol per liter), were associated with death. A 50-year-old with diabetes died, on average, 6 years earlier than a counterpart without diabetes, with about 40% of the difference in survival attributable to excess nonvascular deaths.</p><p><b>CONCLUSIONS: </b>In addition to vascular disease, diabetes is associated with substantial premature death from several cancers, infectious diseases, external causes, intentional self-harm, and degenerative disorders, independent of several major risk factors. (Funded by the British Heart Foundation and others.).</p> |
| DOI | 10.1056/NEJMoa1008862 |
| Alternate Journal | N. Engl. J. Med. |
| PubMed ID | 21366474 |
| PubMed Central ID | PMC4109980 |
| Grant List | G0600705 / / Medical Research Council / United Kingdom G19/35 / / Medical Research Council / United Kingdom PG/09/002/26056 / / British Heart Foundation / United Kingdom U01 HL080295 / HL / NHLBI NIH HHS / United States G0100222 / / Medical Research Council / United Kingdom HHSN268200800007C / HL / NHLBI NIH HHS / United States G8802774 / / Medical Research Council / United Kingdom G1000143 / / Medical Research Council / United Kingdom RG/08/013/25942 / / British Heart Foundation / United Kingdom G0902037 / / Medical Research Council / United Kingdom RG/08/014/24067 / / British Heart Foundation / United Kingdom N01HC55222 / HL / NHLBI NIH HHS / United States MC_U137686857 / / Medical Research Council / United Kingdom N01HC85086 / HL / NHLBI NIH HHS / United States N01 HC085082 / HC / NHLBI NIH HHS / United States UL1 TR000062 / TR / NCATS NIH HHS / United States G0401527 / / Medical Research Council / United Kingdom UL1 RR025014 / RR / NCRR NIH HHS / United States / / Medical Research Council / United Kingdom N01HC85082 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States MC_U105260792 / / Medical Research Council / United Kingdom RG/08/014 / / British Heart Foundation / United Kingdom N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States RG/07/008/23674 / / British Heart Foundation / United Kingdom |