Degree of joint risk factor control and hazard of mortality in diabetes patients: a matched cohort study in UK Biobank
Abstract Background Diabetes patients are at higher risk for mortality than the general population; however, little is known about whether the excess mortality risk associated with diabetes could be mitigated or nullified via controlling for risk factors. Methods We included 18,535 diabetes patients...
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BMC
2024-03-01
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| Series: | BMC Medicine |
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| Online Access: | https://doi.org/10.1186/s12916-024-03288-0 |
| _version_ | 1797266803960840192 |
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| author | Jian Zhou Xuan Wang Rui Tang Minghao Kou Hao Ma Xiang Li Yoriko Heianza Vivian Fonseca Lu Qi |
| author_facet | Jian Zhou Xuan Wang Rui Tang Minghao Kou Hao Ma Xiang Li Yoriko Heianza Vivian Fonseca Lu Qi |
| author_sort | Jian Zhou |
| collection | DOAJ |
| description | Abstract Background Diabetes patients are at higher risk for mortality than the general population; however, little is known about whether the excess mortality risk associated with diabetes could be mitigated or nullified via controlling for risk factors. Methods We included 18,535 diabetes patients and 91,745 matched individuals without diabetes without baseline cancer or cardiovascular disease (CVD), followed up from 2006 to 2021. The main exposure was the number of optimized risk factors including glycated hemoglobin < 53 mmol/mole, systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg, no albuminuria, non-current smoking and low-density lipoprotein cholesterol (LDL-C) < 2.5 mmol/L. We used Cox proportional hazards models to explore the association of the degree of risk factor control with all-cause mortality, cancer mortality, CVD mortality and other mortality. Results Each additional risk factor control was associated with a 16, 10, 21 and 15% lower risk of all-cause mortality, cancer mortality, CVD mortality and other mortality, respectively. Optimal risk factors control (controlling 5 risk factors) was associated with a 50% (HR 0.50, 95% CI 0.41–0.62), 74% (HR 0.26, 95% CI 0.16–0.43) and 38% (HR 0.62, 95% CI 0.44–0.87) lower risk of all-cause mortality, CVD mortality and other mortality, respectively. Diabetes patients with 4, 3 and 5 or more controlled risk factors, respectively, showed no excess risk of all-cause mortality, cancer mortality and CVD mortality compared to matched non-diabetes patients. Conclusions The results from this study indicate that optimal risk factor control may eliminate diabetes-related excess risk of all-cause mortality, CVD mortality and other mortality. |
| first_indexed | 2024-04-25T01:06:30Z |
| format | Article |
| id | doaj.art-dda88242c3444f54879e08aa2c1b0d46 |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-04-25T01:06:30Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-dda88242c3444f54879e08aa2c1b0d462024-03-10T12:14:34ZengBMCBMC Medicine1741-70152024-03-0122111110.1186/s12916-024-03288-0Degree of joint risk factor control and hazard of mortality in diabetes patients: a matched cohort study in UK BiobankJian Zhou0Xuan Wang1Rui Tang2Minghao Kou3Hao Ma4Xiang Li5Yoriko Heianza6Vivian Fonseca7Lu Qi8Department of Epidemiology, Tulane University School of Public Health and Tropical MedicineDepartment of Epidemiology, Tulane University School of Public Health and Tropical MedicineDepartment of Epidemiology, Tulane University School of Public Health and Tropical MedicineDepartment of Epidemiology, Tulane University School of Public Health and Tropical MedicineDepartment of Epidemiology, Tulane University School of Public Health and Tropical MedicineDepartment of Epidemiology, Tulane University School of Public Health and Tropical MedicineDepartment of Epidemiology, Tulane University School of Public Health and Tropical MedicineSection of Endocrinology and Metabolism, Tulane University School of MedicineDepartment of Epidemiology, Tulane University School of Public Health and Tropical MedicineAbstract Background Diabetes patients are at higher risk for mortality than the general population; however, little is known about whether the excess mortality risk associated with diabetes could be mitigated or nullified via controlling for risk factors. Methods We included 18,535 diabetes patients and 91,745 matched individuals without diabetes without baseline cancer or cardiovascular disease (CVD), followed up from 2006 to 2021. The main exposure was the number of optimized risk factors including glycated hemoglobin < 53 mmol/mole, systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg, no albuminuria, non-current smoking and low-density lipoprotein cholesterol (LDL-C) < 2.5 mmol/L. We used Cox proportional hazards models to explore the association of the degree of risk factor control with all-cause mortality, cancer mortality, CVD mortality and other mortality. Results Each additional risk factor control was associated with a 16, 10, 21 and 15% lower risk of all-cause mortality, cancer mortality, CVD mortality and other mortality, respectively. Optimal risk factors control (controlling 5 risk factors) was associated with a 50% (HR 0.50, 95% CI 0.41–0.62), 74% (HR 0.26, 95% CI 0.16–0.43) and 38% (HR 0.62, 95% CI 0.44–0.87) lower risk of all-cause mortality, CVD mortality and other mortality, respectively. Diabetes patients with 4, 3 and 5 or more controlled risk factors, respectively, showed no excess risk of all-cause mortality, cancer mortality and CVD mortality compared to matched non-diabetes patients. Conclusions The results from this study indicate that optimal risk factor control may eliminate diabetes-related excess risk of all-cause mortality, CVD mortality and other mortality.https://doi.org/10.1186/s12916-024-03288-0Risk factor controlMortalityRelative importanceUK Biobank |
| spellingShingle | Jian Zhou Xuan Wang Rui Tang Minghao Kou Hao Ma Xiang Li Yoriko Heianza Vivian Fonseca Lu Qi Degree of joint risk factor control and hazard of mortality in diabetes patients: a matched cohort study in UK Biobank BMC Medicine Risk factor control Mortality Relative importance UK Biobank |
| title | Degree of joint risk factor control and hazard of mortality in diabetes patients: a matched cohort study in UK Biobank |
| title_full | Degree of joint risk factor control and hazard of mortality in diabetes patients: a matched cohort study in UK Biobank |
| title_fullStr | Degree of joint risk factor control and hazard of mortality in diabetes patients: a matched cohort study in UK Biobank |
| title_full_unstemmed | Degree of joint risk factor control and hazard of mortality in diabetes patients: a matched cohort study in UK Biobank |
| title_short | Degree of joint risk factor control and hazard of mortality in diabetes patients: a matched cohort study in UK Biobank |
| title_sort | degree of joint risk factor control and hazard of mortality in diabetes patients a matched cohort study in uk biobank |
| topic | Risk factor control Mortality Relative importance UK Biobank |
| url | https://doi.org/10.1186/s12916-024-03288-0 |
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