Epidemiology of the diabetes-cardio-renal spectrum: a cross-sectional report of 1.4 million adults
Abstract Background Type-2 diabetes (T2D), chronic kidney disease, and heart failure (HF) share epidemiological and pathophysiological features. Although their prevalence was described, there is limited contemporary, high-resolution, epidemiological data regarding the overlap among them. We aimed to...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-022-01521-9 |
| _version_ | 1818211678926405632 |
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| author | Meir Schechter Cheli Melzer Cohen Ilan Yanuv Aliza Rozenberg Gabriel Chodick Johan Bodegård Lawrence A. Leiter Subodh Verma Hiddo J. Lambers Heerspink Avraham Karasik Ofri Mosenzon |
| author_facet | Meir Schechter Cheli Melzer Cohen Ilan Yanuv Aliza Rozenberg Gabriel Chodick Johan Bodegård Lawrence A. Leiter Subodh Verma Hiddo J. Lambers Heerspink Avraham Karasik Ofri Mosenzon |
| author_sort | Meir Schechter |
| collection | DOAJ |
| description | Abstract Background Type-2 diabetes (T2D), chronic kidney disease, and heart failure (HF) share epidemiological and pathophysiological features. Although their prevalence was described, there is limited contemporary, high-resolution, epidemiological data regarding the overlap among them. We aimed to describe the epidemiological intersections between T2D, HF, and kidney dysfunction in an entire database, overall and by age and sex. Methods This is a cross-sectional analysis of adults ≥ 25 years, registered in 2019 at Maccabi Healthcare Services, a large healthcare maintenance organization in Israel. Collected data included sex, age, presence of T2D or HF, and last estimated glomerular filtration rate (eGFR) in the past two years. Subjects with T2D, HF, or eGFR < 60 mL/min/1.73 m2 were defined as within the diabetes-cardio-renal (DCR) spectrum. Results Overall, 1,389,604 subjects (52.2% females) were included; 445,477 (32.1%) were 25– < 40 years, 468,273 (33.7%) were 40– < 55 years, and 475,854 (34.2%) were ≥ 55 years old. eGFR measurements were available in 74.7% of the participants and in over 97% of those with T2D or HF. eGFR availability increased in older age groups. There were 140,636 (10.1%) patients with T2D, 54,187 (3.9%) with eGFR < 60 mL/min/1.73m2, and 11,605 (0.84%) with HF. Overall, 12.6% had at least one condition within the DCR spectrum, 2.0% had at least two, and 0.23% had all three. Cardiorenal syndrome (both HF and eGFR < 60 mL/min/1.73m2) was prevalent in 0.40% of the entire population and in 2.3% of those with T2D. In patients with both HF and T2D, 55.2% had eGFR < 60 mL/min/1.73m2 and 15.8% had eGFR < 30 mL/min/1.73m2. Amongst those within the DCR spectrum, T2D was prominent in younger participants, but was gradually replaced by HF and eGFR < 60 mL/min/1.73m2 with increasing age. The congruence between all three conditions increased with age. Conclusions This large, broad-based study provides a contemporary, high-resolution prevalence of the DCR spectrum and its components. The results highlight differences in dominance and degree of congruence between T2D, HF, and kidney dysfunction across ages. |
| first_indexed | 2024-12-12T05:36:19Z |
| format | Article |
| id | doaj.art-f4e41b35e48048809e9286d06c138961 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-12-12T05:36:19Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-f4e41b35e48048809e9286d06c1389612022-12-22T00:36:07ZengBMCCardiovascular Diabetology1475-28402022-06-012111910.1186/s12933-022-01521-9Epidemiology of the diabetes-cardio-renal spectrum: a cross-sectional report of 1.4 million adultsMeir Schechter0Cheli Melzer Cohen1Ilan Yanuv2Aliza Rozenberg3Gabriel Chodick4Johan Bodegård5Lawrence A. Leiter6Subodh Verma7Hiddo J. Lambers Heerspink8Avraham Karasik9Ofri Mosenzon10Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical CenterMaccabi Institute for Research and Innovation, Maccabi Healthcare ServicesDiabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical CenterDiabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical CenterMaccabi Institute for Research and Innovation, Maccabi Healthcare ServicesCardiovascular, Renal and Metabolism, Medical Department, BioPharmaceuticals, AstraZenecaLi Ka Shing Knowledge Institute, St. Michael’s Hospital, University of TorontoDivision of Cardiac Surgery, St. Michael’s Hospital, University of TorontoDepartment of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of GroningenMaccabi Institute for Research and Innovation, Maccabi Healthcare ServicesDiabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical CenterAbstract Background Type-2 diabetes (T2D), chronic kidney disease, and heart failure (HF) share epidemiological and pathophysiological features. Although their prevalence was described, there is limited contemporary, high-resolution, epidemiological data regarding the overlap among them. We aimed to describe the epidemiological intersections between T2D, HF, and kidney dysfunction in an entire database, overall and by age and sex. Methods This is a cross-sectional analysis of adults ≥ 25 years, registered in 2019 at Maccabi Healthcare Services, a large healthcare maintenance organization in Israel. Collected data included sex, age, presence of T2D or HF, and last estimated glomerular filtration rate (eGFR) in the past two years. Subjects with T2D, HF, or eGFR < 60 mL/min/1.73 m2 were defined as within the diabetes-cardio-renal (DCR) spectrum. Results Overall, 1,389,604 subjects (52.2% females) were included; 445,477 (32.1%) were 25– < 40 years, 468,273 (33.7%) were 40– < 55 years, and 475,854 (34.2%) were ≥ 55 years old. eGFR measurements were available in 74.7% of the participants and in over 97% of those with T2D or HF. eGFR availability increased in older age groups. There were 140,636 (10.1%) patients with T2D, 54,187 (3.9%) with eGFR < 60 mL/min/1.73m2, and 11,605 (0.84%) with HF. Overall, 12.6% had at least one condition within the DCR spectrum, 2.0% had at least two, and 0.23% had all three. Cardiorenal syndrome (both HF and eGFR < 60 mL/min/1.73m2) was prevalent in 0.40% of the entire population and in 2.3% of those with T2D. In patients with both HF and T2D, 55.2% had eGFR < 60 mL/min/1.73m2 and 15.8% had eGFR < 30 mL/min/1.73m2. Amongst those within the DCR spectrum, T2D was prominent in younger participants, but was gradually replaced by HF and eGFR < 60 mL/min/1.73m2 with increasing age. The congruence between all three conditions increased with age. Conclusions This large, broad-based study provides a contemporary, high-resolution prevalence of the DCR spectrum and its components. The results highlight differences in dominance and degree of congruence between T2D, HF, and kidney dysfunction across ages.https://doi.org/10.1186/s12933-022-01521-9Type-2 DiabetesHeart FailureChronic Kidney DiseaseCross-sectional StudyEpidemiologyDiabetes-cardio-renal Spectrum |
| spellingShingle | Meir Schechter Cheli Melzer Cohen Ilan Yanuv Aliza Rozenberg Gabriel Chodick Johan Bodegård Lawrence A. Leiter Subodh Verma Hiddo J. Lambers Heerspink Avraham Karasik Ofri Mosenzon Epidemiology of the diabetes-cardio-renal spectrum: a cross-sectional report of 1.4 million adults Cardiovascular Diabetology Type-2 Diabetes Heart Failure Chronic Kidney Disease Cross-sectional Study Epidemiology Diabetes-cardio-renal Spectrum |
| title | Epidemiology of the diabetes-cardio-renal spectrum: a cross-sectional report of 1.4 million adults |
| title_full | Epidemiology of the diabetes-cardio-renal spectrum: a cross-sectional report of 1.4 million adults |
| title_fullStr | Epidemiology of the diabetes-cardio-renal spectrum: a cross-sectional report of 1.4 million adults |
| title_full_unstemmed | Epidemiology of the diabetes-cardio-renal spectrum: a cross-sectional report of 1.4 million adults |
| title_short | Epidemiology of the diabetes-cardio-renal spectrum: a cross-sectional report of 1.4 million adults |
| title_sort | epidemiology of the diabetes cardio renal spectrum a cross sectional report of 1 4 million adults |
| topic | Type-2 Diabetes Heart Failure Chronic Kidney Disease Cross-sectional Study Epidemiology Diabetes-cardio-renal Spectrum |
| url | https://doi.org/10.1186/s12933-022-01521-9 |
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