| アブストラクト | OBJECTIVE: To examine the associations between age at type 2 diabetes diagnosis and the relative and absolute risk of all-cause and cause-specific mortality in England. RESEARCH DESIGN AND METHODS: In this cohort study using primary care data from the Clinical Practice Research Datalink, we identified 108,061 individuals with newly diagnosed type 2 diabetes (16-50 years of age), matched to 829,946 individuals without type 2 diabetes. We estimated all-cause and cause-specific mortality (cancer, cardiorenal, other [noncancer or cardiorenal]) by age at diagnosis, using competing-risk survival analyses adjusted for key confounders. RESULTS: Comparing individuals with versus without type 2 diabetes, the relative risk of death decreased with an older age at diagnosis: the hazard ratio for all-cause mortality was 4.32 (95% CI 3.35-5.58) in individuals diagnosed at ages 16-27 years compared with 1.53 (95% CI 1.46-1.60) at ages 48-50 years. Smaller relative risks by increasing age at diagnosis were also observed for cancer, cardiorenal, and noncancer or cardiorenal death. Irrespective of age at diagnosis, the 10-year absolute risk of all-cause and cause-specific mortality were higher in individuals with type 2 diabetes; yet, the absolute differences were small. CONCLUSIONS: Although the relative risk of death in individuals with versus without type 2 was higher at younger ages, the 10-year absolute risk of all investigated causes of death was small and similar in the two groups. Further multidecade studies could help estimate the long-term risk of complications and death in individuals with early-onset type 2 diabetes. |
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| 投稿者 | Barker, Mary M; Davies, Melanie J; Sargeant, Jack A; Chan, Juliana C N; Gregg, Edward W; Shabnam, Sharmin; Khunti, Kamlesh; Zaccardi, Francesco |
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| 組織名 | Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of;Leicester, Leicester, U.K.;Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska;Institutet, Solna, Sweden.;Diabetes Research Centre, University of Leicester, College of Life Sciences,;Leicester General Hospital, Leicester, U.K.;Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust,;Leicester, U.K.;National Institute for Health Research Leicester Biomedical Research Centre,;Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and;Obesity, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong;Kong, Prince of Wales Hospital, Shatin, Hong Kong.;School of Population Health, Royal College of Surgeons of Ireland, University of;Medicine and Health Sciences, Dublin, Ireland.;Department of Epidemiology and Biostatistics, School of Public Health, Imperial;College, London, U.K.;National Institute for Health Research Applied Research Collaboration East;Midlands, Leicester Diabetes Centre, University of Leicester, Leicester, U.K. |
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