Diabetes mellitus, fasting glucose, and risk of cause-specific death

Sreenivasa Rao Kondapally Seshasai; Stephen Kaptoge; Alexander Thompson; Emanuele Di Angelantonio; Pei Gao; Nadeem Sarwar; Peter H Whincup; Kenneth J Mukamal; Richard F Gillum; Ingar Holme; Inger Njølstad; Astrid Fletcher; Carl Martin Peter Nilsson; Sarah Lewington; Rory Collins; Vilmundur Gudnason; Simon G Thompson; Naveed Sattar; Elizabeth Selvin; Frank B Hu; John Danesh; Emerging Risk Factors Collaboration; Anne Tybjærg-Hansen; Ruth Frikke-Schmidt; Børge G. Nordestgaard; Marianne Benn; Marianne Benn

doi:10.1056/NEJMoa1008862

Diabetes mellitus, fasting glucose, and risk of cause-specific death

Sreenivasa Rao Kondapally Seshasai, Stephen Kaptoge, Alexander Thompson, Emanuele Di Angelantonio, Pei Gao, Nadeem Sarwar, Peter H Whincup, Kenneth J Mukamal, Richard F Gillum, Ingar Holme, Inger Njølstad, Astrid Fletcher, Carl Martin Peter Nilsson, Sarah Lewington, Rory Collins, Vilmundur Gudnason, Simon G Thompson, Naveed Sattar, Elizabeth Selvin, Frank B HuJohn Danesh, Emerging Risk Factors Collaboration, Anne Tybjærg-Hansen, Ruth Frikke-Schmidt, Børge G. Nordestgaard, Marianne Benn, Marianne Benn

1570 Citationer (Scopus)

Abstract

BACKGROUND: The extent to which diabetes mellitus or hyperglycemia is related to risk of death from cancer or other nonvascular conditions is uncertain. METHODS: We calculated hazard ratios for cause-specific death, according to baseline diabetes status or fasting glucose level, from individual-participant data on 123,205 deaths among 820,900 people in 97 prospective studies. RESULTS: After adjustment for age, sex, smoking status, and body-mass index, hazard ratios among persons with diabetes as compared with persons without diabetes were as follows: 1.80 (95% confidence interval [CI], 1.71 to 1.90) for death from any cause, 1.25 (95% CI, 1.19 to 1.31) for death from cancer, 2.32 (95% CI, 2.11 to 2.56) for death from vascular causes, and 1.73 (95% CI, 1.62 to 1.85) for death from other causes. Diabetes (vs. no diabetes) was moderately associated with death from cancers of the liver, pancreas, ovary, colorectum, lung, bladder, and breast. Aside from cancer and vascular disease, diabetes (vs. no diabetes) was also associated with death from renal disease, liver disease, pneumonia and other infectious diseases, mental disorders, nonhepatic digestive diseases, external causes, intentional self-harm, nervous-system disorders, and chronic obstructive pulmonary disease. Hazard ratios were appreciably reduced after further adjustment for glycemia measures, but not after adjustment for systolic blood pressure, lipid levels, inflammation or renal markers. Fasting glucose levels exceeding 100 mg per deciliter (5.6 mmol per liter), but not levels of 70 to 100 mg per deciliter (3.9 to 5.6 mmol per liter), were associated with death. A 50-year-old with diabetes died, on average, 6 years earlier than a counterpart without diabetes, with about 40% of the difference in survival attributable to excess nonvascular deaths. CONCLUSIONS: In addition to vascular disease, diabetes is associated with substantial premature death from several cancers, infectious diseases, external causes, intentional self-harm, and degenerative disorders, independent of several major risk factors. (Funded by the British Heart Foundation and others.)

Originalsprog	Engelsk
Tidsskrift	New England Journal of Medicine
Vol/bind	364
Udgave nummer	9
Sider (fra-til)	829-41
Antal sider	13
ISSN	0028-4793
DOI	https://doi.org/10.1056/NEJMoa1008862 https://doi.org/10.1056/NEJMoa1008862
Status	Udgivet - 3 mar. 2011

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Seshasai, S. R. K., Kaptoge, S., Thompson, A., Di Angelantonio, E., Gao, P., Sarwar, N., Whincup, P. H., Mukamal, K. J., Gillum, R. F., Holme, I., Njølstad, I., Fletcher, A., Nilsson, C. M. P., Lewington, S., Collins, R., Gudnason, V., Thompson, S. G., Sattar, N., Selvin, E., ... Benn, M. (2011). Diabetes mellitus, fasting glucose, and risk of cause-specific death. New England Journal of Medicine, 364(9), 829-41. https://doi.org/10.1056/NEJMoa1008862, https://doi.org/10.1056/NEJMoa1008862

Seshasai, SRK, Kaptoge, S, Thompson, A, Di Angelantonio, E, Gao, P, Sarwar, N, Whincup, PH, Mukamal, KJ, Gillum, RF, Holme, I, Njølstad, I, Fletcher, A, Nilsson, CMP, Lewington, S, Collins, R, Gudnason, V, Thompson, SG, Sattar, N, Selvin, E, Hu, FB, Danesh, J, Emerging Risk Factors Collaboration, Tybjærg-Hansen, A, Frikke-Schmidt, R, Nordestgaard, BG, Benn, M & Benn, M 2011, 'Diabetes mellitus, fasting glucose, and risk of cause-specific death', New England Journal of Medicine, bind 364, nr. 9, s. 829-41. https://doi.org/10.1056/NEJMoa1008862, https://doi.org/10.1056/NEJMoa1008862

@article{4ec34ec464de4fb5a65f98edf08ab97f,

title = "Diabetes mellitus, fasting glucose, and risk of cause-specific death",

abstract = "BACKGROUND: The extent to which diabetes mellitus or hyperglycemia is related to risk of death from cancer or other nonvascular conditions is uncertain. METHODS: We calculated hazard ratios for cause-specific death, according to baseline diabetes status or fasting glucose level, from individual-participant data on 123,205 deaths among 820,900 people in 97 prospective studies. RESULTS: After adjustment for age, sex, smoking status, and body-mass index, hazard ratios among persons with diabetes as compared with persons without diabetes were as follows: 1.80 (95% confidence interval [CI], 1.71 to 1.90) for death from any cause, 1.25 (95% CI, 1.19 to 1.31) for death from cancer, 2.32 (95% CI, 2.11 to 2.56) for death from vascular causes, and 1.73 (95% CI, 1.62 to 1.85) for death from other causes. Diabetes (vs. no diabetes) was moderately associated with death from cancers of the liver, pancreas, ovary, colorectum, lung, bladder, and breast. Aside from cancer and vascular disease, diabetes (vs. no diabetes) was also associated with death from renal disease, liver disease, pneumonia and other infectious diseases, mental disorders, nonhepatic digestive diseases, external causes, intentional self-harm, nervous-system disorders, and chronic obstructive pulmonary disease. Hazard ratios were appreciably reduced after further adjustment for glycemia measures, but not after adjustment for systolic blood pressure, lipid levels, inflammation or renal markers. Fasting glucose levels exceeding 100 mg per deciliter (5.6 mmol per liter), but not levels of 70 to 100 mg per deciliter (3.9 to 5.6 mmol per liter), were associated with death. A 50-year-old with diabetes died, on average, 6 years earlier than a counterpart without diabetes, with about 40% of the difference in survival attributable to excess nonvascular deaths. CONCLUSIONS: In addition to vascular disease, diabetes is associated with substantial premature death from several cancers, infectious diseases, external causes, intentional self-harm, and degenerative disorders, independent of several major risk factors. (Funded by the British Heart Foundation and others.)",

keywords = "Blood Glucose, Cause of Death, Diabetes Mellitus, Female, Humans, Hyperglycemia, Life Expectancy, Male, Middle Aged, Risk, Survival Analysis",

author = "Seshasai, {Sreenivasa Rao Kondapally} and Stephen Kaptoge and Alexander Thompson and {Di Angelantonio}, Emanuele and Pei Gao and Nadeem Sarwar and Whincup, {Peter H} and Mukamal, {Kenneth J} and Gillum, {Richard F} and Ingar Holme and Inger Nj{\o}lstad and Astrid Fletcher and Nilsson, {Carl Martin Peter} and Sarah Lewington and Rory Collins and Vilmundur Gudnason and Thompson, {Simon G} and Naveed Sattar and Elizabeth Selvin and Hu, {Frank B} and John Danesh and Anne Tybj{\ae}rg-Hansen and Anne Tybj{\ae}rg-Hansen and Ruth Frikke-Schmidt and Nordestgaard, {B{\o}rge G.} and Marianne Benn and Marianne Benn",

year = "2011",

month = mar,

day = "3",

doi = "10.1056/NEJMoa1008862",

language = "English",

volume = "364",

pages = "829--41",

journal = "New England Journal of Medicine",

issn = "0028-4793",

publisher = "Massachusetts Medical Society",

number = "9",

}

TY - JOUR

T1 - Diabetes mellitus, fasting glucose, and risk of cause-specific death

AU - Seshasai, Sreenivasa Rao Kondapally

AU - Kaptoge, Stephen

AU - Thompson, Alexander

AU - Di Angelantonio, Emanuele

AU - Gao, Pei

AU - Sarwar, Nadeem

AU - Whincup, Peter H

AU - Mukamal, Kenneth J

AU - Gillum, Richard F

AU - Holme, Ingar

AU - Njølstad, Inger

AU - Fletcher, Astrid

AU - Nilsson, Carl Martin Peter

AU - Lewington, Sarah

AU - Collins, Rory

AU - Gudnason, Vilmundur

AU - Thompson, Simon G

AU - Sattar, Naveed

AU - Selvin, Elizabeth

AU - Hu, Frank B

AU - Danesh, John

AU - Emerging Risk Factors Collaboration

AU - Tybjærg-Hansen, Anne

AU - Frikke-Schmidt, Ruth

AU - Nordestgaard, Børge G.

AU - Benn, Marianne

PY - 2011/3/3

Y1 - 2011/3/3

N2 - BACKGROUND: The extent to which diabetes mellitus or hyperglycemia is related to risk of death from cancer or other nonvascular conditions is uncertain. METHODS: We calculated hazard ratios for cause-specific death, according to baseline diabetes status or fasting glucose level, from individual-participant data on 123,205 deaths among 820,900 people in 97 prospective studies. RESULTS: After adjustment for age, sex, smoking status, and body-mass index, hazard ratios among persons with diabetes as compared with persons without diabetes were as follows: 1.80 (95% confidence interval [CI], 1.71 to 1.90) for death from any cause, 1.25 (95% CI, 1.19 to 1.31) for death from cancer, 2.32 (95% CI, 2.11 to 2.56) for death from vascular causes, and 1.73 (95% CI, 1.62 to 1.85) for death from other causes. Diabetes (vs. no diabetes) was moderately associated with death from cancers of the liver, pancreas, ovary, colorectum, lung, bladder, and breast. Aside from cancer and vascular disease, diabetes (vs. no diabetes) was also associated with death from renal disease, liver disease, pneumonia and other infectious diseases, mental disorders, nonhepatic digestive diseases, external causes, intentional self-harm, nervous-system disorders, and chronic obstructive pulmonary disease. Hazard ratios were appreciably reduced after further adjustment for glycemia measures, but not after adjustment for systolic blood pressure, lipid levels, inflammation or renal markers. Fasting glucose levels exceeding 100 mg per deciliter (5.6 mmol per liter), but not levels of 70 to 100 mg per deciliter (3.9 to 5.6 mmol per liter), were associated with death. A 50-year-old with diabetes died, on average, 6 years earlier than a counterpart without diabetes, with about 40% of the difference in survival attributable to excess nonvascular deaths. CONCLUSIONS: In addition to vascular disease, diabetes is associated with substantial premature death from several cancers, infectious diseases, external causes, intentional self-harm, and degenerative disorders, independent of several major risk factors. (Funded by the British Heart Foundation and others.)

AB - BACKGROUND: The extent to which diabetes mellitus or hyperglycemia is related to risk of death from cancer or other nonvascular conditions is uncertain. METHODS: We calculated hazard ratios for cause-specific death, according to baseline diabetes status or fasting glucose level, from individual-participant data on 123,205 deaths among 820,900 people in 97 prospective studies. RESULTS: After adjustment for age, sex, smoking status, and body-mass index, hazard ratios among persons with diabetes as compared with persons without diabetes were as follows: 1.80 (95% confidence interval [CI], 1.71 to 1.90) for death from any cause, 1.25 (95% CI, 1.19 to 1.31) for death from cancer, 2.32 (95% CI, 2.11 to 2.56) for death from vascular causes, and 1.73 (95% CI, 1.62 to 1.85) for death from other causes. Diabetes (vs. no diabetes) was moderately associated with death from cancers of the liver, pancreas, ovary, colorectum, lung, bladder, and breast. Aside from cancer and vascular disease, diabetes (vs. no diabetes) was also associated with death from renal disease, liver disease, pneumonia and other infectious diseases, mental disorders, nonhepatic digestive diseases, external causes, intentional self-harm, nervous-system disorders, and chronic obstructive pulmonary disease. Hazard ratios were appreciably reduced after further adjustment for glycemia measures, but not after adjustment for systolic blood pressure, lipid levels, inflammation or renal markers. Fasting glucose levels exceeding 100 mg per deciliter (5.6 mmol per liter), but not levels of 70 to 100 mg per deciliter (3.9 to 5.6 mmol per liter), were associated with death. A 50-year-old with diabetes died, on average, 6 years earlier than a counterpart without diabetes, with about 40% of the difference in survival attributable to excess nonvascular deaths. CONCLUSIONS: In addition to vascular disease, diabetes is associated with substantial premature death from several cancers, infectious diseases, external causes, intentional self-harm, and degenerative disorders, independent of several major risk factors. (Funded by the British Heart Foundation and others.)

KW - Blood Glucose

KW - Cause of Death

KW - Diabetes Mellitus

KW - Female

KW - Humans

KW - Hyperglycemia

KW - Life Expectancy

KW - Male

KW - Middle Aged

KW - Risk

KW - Survival Analysis

U2 - 10.1056/NEJMoa1008862

DO - 10.1056/NEJMoa1008862

M3 - Journal article

C2 - 21366474

SN - 0028-4793

VL - 364

SP - 829

EP - 841

JO - New England Journal of Medicine

JF - New England Journal of Medicine

IS - 9

ER -

Diabetes mellitus, fasting glucose, and risk of cause-specific death

Abstract

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