Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study
Abstract Background Both type 1 and type 2 diabetes are well-established risk factors for cardiovascular disease and early mortality. However, few studies have directly compared the hazards of cardiovascular outcomes and premature death among people with type 1 diabetes to those among people with ty...
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12933-019-0953-7 |
| _version_ | 1818437002290266112 |
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| author | You-Bin Lee Kyungdo Han Bongsung Kim Seung-Eun Lee Ji Eun Jun Jiyeon Ahn Gyuri Kim Sang-Man Jin Jae Hyeon Kim |
| author_facet | You-Bin Lee Kyungdo Han Bongsung Kim Seung-Eun Lee Ji Eun Jun Jiyeon Ahn Gyuri Kim Sang-Man Jin Jae Hyeon Kim |
| author_sort | You-Bin Lee |
| collection | DOAJ |
| description | Abstract Background Both type 1 and type 2 diabetes are well-established risk factors for cardiovascular disease and early mortality. However, few studies have directly compared the hazards of cardiovascular outcomes and premature death among people with type 1 diabetes to those among people with type 2 diabetes and subjects without diabetes. Furthermore, information about the hazard of cardiovascular disease and early mortality among Asians with type 1 diabetes is sparse, although the clinical and epidemiological characteristics of Asians with type 1 diabetes are unlike those of Europeans. We estimated the hazard of myocardial infarction (MI), hospitalization for heart failure (HF), atrial fibrillation (AF), and mortality during follow-up in Korean adults with type 1 diabetes compared with those without diabetes and those with type 2 diabetes. Methods We used Korean National Health Insurance Service datasets of preventive health check-ups from 2009 to 2016 in this retrospective longitudinal study. The hazard ratios of MI, HF, AF, and mortality during follow-up were analyzed using the Cox regression analyses according to the presence and type of diabetes in ≥ 20-year-old individuals without baseline cardiovascular disease (N = 20,423,051). The presence and type of diabetes was determined based on the presence of type 1 or type 2 diabetes at baseline. Results During more than 93,300,000 person-years of follow-up, there were 116,649 MIs, 135,532 AF cases, 125,997 hospitalizations for HF, and 344,516 deaths. The fully-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident MI, hospitalized HF, AF, and all-cause death within the mean follow-up of 4.6 years were higher in the type 1 diabetes group than the type 2 diabetes [HR (95% CI) 1.679 (1.490–1.893) for MI; 2.105 (1.901–2.330) for HF; 1.608 (1.411–1.833) for AF; 1.884 (1.762–2.013) for death] and non-diabetes groups [HR (95% CI) 2.411 (2.138–2.718) for MI; 3.024 (2.730–3.350) for HF; 1.748 (1.534–1.993) for AF; 2.874 (2.689–3.073) for death]. Conclusions In Korea, the presence of diabetes was associated with a higher hazard of cardiovascular disease and all-cause death. Specifically, people with type 1 diabetes had a higher hazard of cardiovascular disease and all-cause mortality compared to people with type 2 diabetes. |
| first_indexed | 2024-12-14T17:17:45Z |
| format | Article |
| id | doaj.art-26d96576a76e45bbb5f9006bf5cf1d39 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-12-14T17:17:45Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-26d96576a76e45bbb5f9006bf5cf1d392022-12-21T22:53:24ZengBMCCardiovascular Diabetology1475-28402019-11-0118111710.1186/s12933-019-0953-7Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide studyYou-Bin Lee0Kyungdo Han1Bongsung Kim2Seung-Eun Lee3Ji Eun Jun4Jiyeon Ahn5Gyuri Kim6Sang-Man Jin7Jae Hyeon Kim8Division of Endocrinology and Metabolism, Department of Medicine, Korea University Guro Hospital, Korea University College of MedicineDepartment of Biostatistics, The Catholic University of KoreaDepartment of Statistics and Actuarial Science, Soongsil UniversityDivision of Endocrinology and Metabolism, Department of Medicine, Konkuk University Medical CenterDivision of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at GangdongDivision of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract Background Both type 1 and type 2 diabetes are well-established risk factors for cardiovascular disease and early mortality. However, few studies have directly compared the hazards of cardiovascular outcomes and premature death among people with type 1 diabetes to those among people with type 2 diabetes and subjects without diabetes. Furthermore, information about the hazard of cardiovascular disease and early mortality among Asians with type 1 diabetes is sparse, although the clinical and epidemiological characteristics of Asians with type 1 diabetes are unlike those of Europeans. We estimated the hazard of myocardial infarction (MI), hospitalization for heart failure (HF), atrial fibrillation (AF), and mortality during follow-up in Korean adults with type 1 diabetes compared with those without diabetes and those with type 2 diabetes. Methods We used Korean National Health Insurance Service datasets of preventive health check-ups from 2009 to 2016 in this retrospective longitudinal study. The hazard ratios of MI, HF, AF, and mortality during follow-up were analyzed using the Cox regression analyses according to the presence and type of diabetes in ≥ 20-year-old individuals without baseline cardiovascular disease (N = 20,423,051). The presence and type of diabetes was determined based on the presence of type 1 or type 2 diabetes at baseline. Results During more than 93,300,000 person-years of follow-up, there were 116,649 MIs, 135,532 AF cases, 125,997 hospitalizations for HF, and 344,516 deaths. The fully-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident MI, hospitalized HF, AF, and all-cause death within the mean follow-up of 4.6 years were higher in the type 1 diabetes group than the type 2 diabetes [HR (95% CI) 1.679 (1.490–1.893) for MI; 2.105 (1.901–2.330) for HF; 1.608 (1.411–1.833) for AF; 1.884 (1.762–2.013) for death] and non-diabetes groups [HR (95% CI) 2.411 (2.138–2.718) for MI; 3.024 (2.730–3.350) for HF; 1.748 (1.534–1.993) for AF; 2.874 (2.689–3.073) for death]. Conclusions In Korea, the presence of diabetes was associated with a higher hazard of cardiovascular disease and all-cause death. Specifically, people with type 1 diabetes had a higher hazard of cardiovascular disease and all-cause mortality compared to people with type 2 diabetes.http://link.springer.com/article/10.1186/s12933-019-0953-7Atrial fibrillationHeart failureMoralityMyocardial infarctionType 1 diabetes mellitus |
| spellingShingle | You-Bin Lee Kyungdo Han Bongsung Kim Seung-Eun Lee Ji Eun Jun Jiyeon Ahn Gyuri Kim Sang-Man Jin Jae Hyeon Kim Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study Cardiovascular Diabetology Atrial fibrillation Heart failure Morality Myocardial infarction Type 1 diabetes mellitus |
| title | Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study |
| title_full | Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study |
| title_fullStr | Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study |
| title_full_unstemmed | Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study |
| title_short | Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study |
| title_sort | risk of early mortality and cardiovascular disease in type 1 diabetes a comparison with type 2 diabetes a nationwide study |
| topic | Atrial fibrillation Heart failure Morality Myocardial infarction Type 1 diabetes mellitus |
| url | http://link.springer.com/article/10.1186/s12933-019-0953-7 |
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