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- Title
Are the Different Diabetes Subgroups Correlated With All-Cause, Cancer-Related, and Cardiovascular-Related Mortality?
- Authors
Peng-Fei Li; Wei-Liang Chen; Li, Peng-Fei; Chen, Wei-Liang
- Abstract
<bold>Context: </bold>Numerous studies have shown that cardiovascular disease (CVD) represents the most important cause of mortality among people with diabetes mellitus (DM). However, no studies have evaluated the risk of CVD-related mortality among different DM subgroups.<bold>Objective: </bold>We aimed to examine all-cause, CVD-related, and cancer-related mortality for different DM subgroups.<bold>Design, Setting, Patients, and Interventions: </bold>We included participants (age ≥ 20 years) from the National Health and Nutrition Examination Survey III (NHANES III) data set. We evaluated the risks of all-cause and cause-specific (CVD and cancer) mortality among 5 previously defined diabetes subgroups: severe autoimmune diabetes (SAID), severe insulin-deficient diabetes (SIDD), severe insulin-resistant diabetes (SIRD), mild obesity-related diabetes (MOD), and mild age-related diabetes (MARD).<bold>Primary Outcome Measure: </bold>The hazard ratios (HRs) for all-cause and cause-specific (CVD and cancer) mortality were measured for each of the 5 DM subgroups. We also evaluated the odds ratios (ORs) for retinopathy and nephropathy in each subgroup.<bold>Results: </bold>A total of 712 adults were enrolled and the median follow-up time was 12.71 years (range, 0.25-18.08 years). The number of deaths in the 5 subgroups (SAID, SIDD, SIRD, MOD, and MARD) were 50, 75, 64, 7, and 18, respectively, and the number of CVD-related deaths in the 5 subgroups was 29, 30, 26, 2, and 11, respectively. Compared to the MOD subgroup, the adjusted HRs and 95% CIs of CVD-related mortality for the SAID, SIDD, SIRD, and MARD subgroups were 3.23 (95% CI, 0.77-13.61), 2.87 (95% CI, 0.68-12.06), 2.23 (95% CI, 0.53-9.50), and 4.75 (95% CI, 1.05-21.59), respectively (the HR for the MARD subgroup had a P value of .04). In addition, compared to the MARD subgroup, the adjusted ORs and 95% CIs for retinopathy in the SAID and SIDD groups were 2.38 (95% CI, 1.13-5.01, P = .02) and 3.34 (95% CI, 1.17-6.88, P = .001), respectively. The ORs for nephropathy were nonsignificant.<bold>Conclusions: </bold>Our study of patients from the NHANES III data set indicated that among the different DM subgroups, the MARD subgroup tended to have a higher CVD-related mortality than the MOD subgroup. The all-cause and cancer-related mortality rates were similar across the different diabetes subgroups. In addition, compared to the MARD subgroup, the SAID and SIDD subgroups had a higher retinopathy risk, but there was no difference in nephropathy among the subgroups.
- Subjects
UNITED States; CARDIOVASCULAR diseases risk factors; MEDICAL personnel; TYPE 2 diabetes; AUTOANTIBODIES; DIABETES; DIABETES complications; OBESITY complications; CARDIOVASCULAR disease related mortality; CAUSES of death; OBESITY; CARDIOVASCULAR diseases; TYPE 1 diabetes; SEVERITY of illness index; SURVEYS; QUESTIONNAIRES; TUMORS; LONGITUDINAL method; DISEASE complications
- Publication
Journal of Clinical Endocrinology & Metabolism, 2020, Vol 105, Issue 12, p1
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgaa628