Baseline glycemic status and mortality in 241,499 Korean metropolitan subjects: A Kangbuk Samsung Health Study

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• 作者：Eun-Jung Rhee<sup>asup> ; Se Eun Park<sup>asup> ; Yoosoo Chang<sup>bsup> ; Seungho Ryu<sup>bsup><sup> ; sup><sup>1sup><sup> ; sup><sup>sh703.yoo@samsung.com" class="auth_mail" title="E-mail the corresponding authorsup> ; Won-Young Lee<sup>asup><sup> ; sup><sup>1sup><sup> ; sup><sup>drlwy@hanmail.net" class="auth_mail" title="E-mail the corresponding authorsup>
• 关键词：Glycemia ; Mortality ; Cancer ; Diabetes
• 刊名：Metabolism
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：65
• 期：2
• 页码：68-77
• 全文大小：472 K

文摘

Diabetes and prediabetes subjects have increased risk for mortality. We analyzed the mortality risk due to all causes, cardiovascular disease (CVD) and cancer in Korean subjects participating in a health-screening program according to baseline glycemic status and HbA1c levels.

sSec_2">Materials/methods

sp0010">Among 241,499 participants of a health-screening program between 2005 and 2012, the risk of death from all causes, CVD, and cancer was calculated based on the baseline glycemic status (normoglycemia, prediabetes, and diabetes) and HbA1c levels. Uncontrolled diabetes was defined as HbA1c ≥ 7.0%. Vital status and confirmation of the cause of death were based on the analysis of death certificate records from the National Death Index.

sSec_3">Results

sp0015">During 923,343.1 person-years of follow-up, 877 participants died. The multivariable-adjusted hazard ratios (HR) of subjects with controlled and uncontrolled diabetes to normoglycemic subjects for all-cause mortality were 1.58 (95% CI 1.24&ndash;2.03) and 2.26 (95% CI 1.78&ndash;2.86), respectively. The HRs of subjects with controlled and uncontrolled diabetes to normoglycemic subjects for mortality due to cancer were 1.75 (95% CI 1.23&ndash;2.48) and 1.67 (95% CI 1.13&ndash;2.45). However, glycemic status was not significantly associated with the risk of mortality due to CVD. The subjects with HbA1c higher than 6.5% showed more than 2-fold increased risk for all-cause mortality and the subjects with HbA1c lower than 5.2% showed increased HR (1.45, 95% CI 1.06&ndash;1.97) compared with those with HbA1c of 5.5% in subjects not taking anti-diabetic medications.

sSec_4">Conclusions

sp0020">Mortality risk from all causes and cancer significantly increased in diabetes subjects regardless of the glucose control status. In subjects not taking anti-diabetic medications, both high and low HbA1c resulted in increased risk for all-cause mortality.