Mortality from heart disease in a cohort of 23,000 patients with insulin-treated diabetes
Mortality from heart disease in a cohort of 23,000 patients with insulin-treated diabetes
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DOI：
10.1007/s00125-003-1116-6
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发表时间：
2003-06-01
期刊：
影响因子：
8.2
通讯作者：
Patterson, CC
中科院分区：
文献类型：
--
作者：
Laing, SP;Swerdlow, AJ;Patterson, CC
目标/假设。尽管缺血性心脏病是老年糖尿病患者死亡的主要原因，但 1 型糖尿病患者的年龄特异性死亡率尚未公布。英国糖尿病协会队列主要是 1 型糖尿病患者之一，现在有足够的随访报告所有心脏病，特别是缺血性心脏病，按年龄划分的死亡率。方法。 1972 年至 1993 年期间，对来自英国各地的 23,751 名接受胰岛素治疗的糖尿病患者进行了诊断，年龄在 30 岁以下，并对其死亡率进行了跟踪调查，直至 2000 年 12 月。计算了年龄和性别特异性心脏病死亡率和标准化死亡率。结果。随访期间共有 1437 人死亡，其中 536 人死于心血管疾病，其中 369 人死于缺血性心脏病。在所有年龄段，队列中的缺血性心脏病死亡率均高于一般人群。 40 岁以下男性和女性的死亡率相似。所有年龄段女性的标准化死亡率均高于男性，20-29 岁女性的标准化死亡率为 44.8 (95% CI 20.5-85.0)，30-39 岁的女性为 41.6 (26.7-61.9)。结论/解释。患有 1 型糖尿病的年轻女性因缺血性心脏病死亡的风险特别高，其死亡率与 40 岁以下的 1 型糖尿病男性相似。这些观察结果强调需要识别和治疗这些年轻患者的冠状动脉危险因素。
Aims/hypothesis. Although ischaemic heart disease is the predominant cause of mortality in older people with diabetes, age-specific mortality rates have not been published for patients with Type 1 diabetes. The Diabetes UK cohort, essentially one of patients with Type 1 diabetes, now has sufficient follow-up to report all heart disease, and specifically ischaemic heart disease, mortality rates by age.Methods. A cohort of 23,751 patients with insulin-treated diabetes, diagnosed under the age of 30 years and from throughout the United Kingdom, was identified during the period 1972 to 1993 and followed for mortality until December 2000. Age- and sex-specific heart disease mortality rates and standardised mortality ratios were calculated.Results. There were 1437 deaths during the follow-up, 536 from cardiovascular disease, and of those, 369 from ischaemic heart disease. At all ages the ischaemic heart disease mortality rates in the cohort were higher than in the general population. Mortality rates within the cohort were similar for men and women under the age of 40. The standardised mortality ratios were higher in women than men at all ages, and in women were 44.8 (95%CI 20.5-85.0) at ages 20-29 and 41.6 (26.7-61.9) at ages 30-39.Conclusions/interpretation. The risk of mortality from ischaemic heart disease is exceptionally high in young adult women with Type 1 diabetes, with rates similar to those in men with Type 1 diabetes under the age of 40. These observations emphasise the need to identify and treat coronary risk factors in these young patients.