RT Journal Article
T1 Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis
A1 Miguel Baena-Diez, Jose
A1 Penafiel, Judit
A1 Subirana, Isaac
A1 Ramos, Rafel
A1 Elosua, Roberto
A1 Marin-Ibanez, Alejandro
A1 Jesus Guembe, Maria
A1 Rigo, Fernando
A1 Jose Tormo-Diaz, Maria
A1 Moreno-Iribas, Conchi
A1 Josep Cabre, Joan
A1 Segura, Antonio
A1 Garcia-Lareo, Manel
A1 Gomez de la Carnara, Agustin
A1 Lapetra, Jose
A1 Quesada, Miguel
A1 Marrugat, Jaume
A1 Jose Medrano, Maria
A1 Berjon, Jesus
A1 Frontera, Guiem
A1 Gavrila, Diana
A1 Barricarte, Aurelio
A1 Basora, Josep
A1 Maria Garcia, Jose
A1 Pavone, Natalia C.
A1 Lora-Pablos, David
A1 Mayora, Eduardo
A1 Franch, Josep
A1 Mata, Manel
A1 Castell, Conxa
A1 Frances, Albert
A1 Grau, Maria
A1 FRESCO Investigators, 
K1 Coronary-heart-disease
K1 Cardiovascular risk
K1 Myocardial-infarction
K1 All-cause
K1 Mortality
K1 Mellitus
K1 Complications
K1 Metaanalysis
K1 Hazards
K1 Glucose
AB OBJECTIVEDiabetes is a common cause of shortened life expectancy. We aimed to assess the association between diabetes and cause-specific death.RESEARCH DESIGN AND METHODSWe 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.CONCLUSIONSDiabetes 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.
PB Amer diabetes assoc
SN 0149-5992
YR 2016
FD 2016-11-01
LK http://hdl.handle.net/10668/19201
UL http://hdl.handle.net/10668/19201
LA en
DS RISalud
RD Apr 12, 2025