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Risk factors associated with type 2 diabetes-related mortality

Risk factors associated with type 2 diabetes-related mortality

 


In a recent study published in PLoS Oneinvestigators are evaluating population-derived risk variables for cause-specific and all-cause mortality from type 2 diabetes.

Study: Age-specific population-attributable risk factors for all-cause and cause-specific mortality in type 2 diabetes: analysis of a 6-year prospective cohort study of over 360,000 people in Hong Kong. Image Credit: Montri Thipsorn / Shutterstock.com

study: Age-specific population-attributable risk factors for all-cause and cause-specific mortality in type 2 diabetes: analysis of a 6-year prospective cohort study of over 360,000 people in Hong Kong. Image credit: Montri Thipsorn / Shutterstock.com

Overview of type 2 diabetes

Type 2 diabetes has an increasing prevalence in both the young and the elderly and is associated with premature death.Controlling modifiable risk factors and managing comorbidities would reduce a significant number of premature deaths. type 2 diabetic can be prevented.

Because the robustness of the relationship between risk factor incidence and mortality changes with age, there may be significant age-related variation regarding the contribution of risk variables to the mortality burden of the population. Among patients with type 2 diabetes, the major risk factors associated with cause-specific and all-cause mortality in different age cohorts remain unknown.

About research

In this study, investigators will analyze the age-specific relationships and population attributable factors (PAFs) of risk variables for cause-specific and all-cause mortality in patients with type 2 diabetes.

The team conducted a prospective cohort study using information from the Hong Kong-wide Diabetes Complications Screening Program. All diabetic patients were considered eligible participants in the Diabetes Mellitus Risk Assessment and Management Program (RAMP-DM).

Patients with type 2 diabetes mellitus eligible for this study were RAMP-DM participants from January 1, 2000 to December 31, 2019 and were at least 18 years old at the time of evaluation. The survey was scheduled for September 2021 and the analysis was conducted from September 2021 to March 2022.

In assessing metabolism and screening for complications, the team collected data related to demographics, lifestyle, medical history, laboratory tests, anthropometric measurements, and drug use. Includes 3 common comorbidities of chronic kidney disease (CKD), cardiovascular disease (CVD), and all-site cancer, and 5 modifiable risk variables, including suboptimal HbA1c control and suboptimal blood pressure , a total of 8 risk factors were measured at baseline. Control, sub-optimal low-density lipoprotein cholesterol (LDL-C) control, current smoking habits, and sub-optimal body weight.

Investigation result

The study cohort included 360,202 people with type 2 diabetes. The mean age at baseline he was 61.4 years, and 188,872 participants were male. Approximately 17% of the study cohort reported his CVD, 14% had CKD, and 4.3% experienced cancer of all sites.

For LDL-C, HbA1c, and systolic blood pressure (SBP)/diastolic blood pressure (DBP), 54%, 50.2%, and 33.5% of individuals did not meet the recommended treatment goals, respectively. Participant current smoking rate he was 13.4%.

The distribution of risk variables varied by age group. For example, young adults reported fewer cases of her CKD, CVD, and cancer than older adults.

Younger people were more likely to be current smokers, had suboptimal control of LDL-C and HbA1c, and optimal control of SBP/DBP. Younger individuals also exhibited higher mean body mass index (BMI) values ​​and were more likely to be obese compared with older individuals. was not observed.

Absolute mortality risk increased with age at baseline. Crude all-cause mortality was 10 times higher for him over the age of 75 than between the ages of 18 and 54.

All risk variables were significantly associated with increased risk of death from all causes, except for a non-negligible correlation with suboptimal LDL-C control. In general, the higher risk of death associated with suboptimal weight was higher for those with a lower BMI than for those with a higher BMI. When disaggregated by age, the correlations between most risk variables and all-cause mortality were highest in the youngest age groups and weakened with increasing age.

Taken together, CVD, cancer and pneumonia account for more than 60% of all deaths. Suboptimal LDL-C management was associated with increased risk of CVD-related mortality and renal disease, and decreased mortality from pneumonia, cancer, and gastrointestinal disease.

Age-related gradients were also observed for associations between risk variables and several specific causes of death, with associations being more pronounced among younger than older individuals.

Conclusion

Although the absolute risk of death from type 2 diabetes is lower among younger people than among older people, modifiable risk variables and major comorbidities were associated with a higher comparative mortality risk among younger people.

The current study highlights the importance of early management of modifiable risk variables, especially blood pressure, to prevent premature death in young people with type 2 diabetes and to reduce the risk of CKD mortality from CKD in the elderly group. It has been.

Journal reference:

  • Wu, H., Lau, ESH, Yang, A., others(2023) Age-specific population-attributable risk factors for all-cause and cause-specific mortality in type 2 diabetes: analysis of a 6-year prospective cohort study of over 360,000 people in Hong Kong. PLOS Medicine 20(1). doi:10.1371/journal.pmed.1004173

Sources

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2/ https://www.news-medical.net/news/20230205/Risk-factors-associated-with-type-2-diabetes-related-mortality.aspx

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