Time trends in mortality rates in type 1 diabetes from 2002 to 2011
Time trends in mortality rates in type 1 diabetes from 2002 to 2011
复制标题
DOI：
10.1007/s00125-013-3025-7
复制
发表时间：
2013-11-01
期刊：
影响因子：
8.2
通讯作者：
Carstensen, Bendix
中科院分区：
文献类型：
--
作者：
Jorgensen, Marit E.;Almdal, Thomas P.;Carstensen, Bendix
本研究的目的是评估Steno糖尿病中心1型糖尿病患者相对于丹麦一般背景人群的绝对和相对死亡率，对2002年1月1日至2011年1月1日的4，821例1型糖尿病患者进行随访，以任何原因的死亡为主要结局。Poisson回归被用于根据年龄、糖尿病病程和日历时间对死亡率进行建模，根据性别，在2002-2010年期间，在33，847年的1型糖尿病随访期间，研究人群中共发生673例死亡（402例男性，271例女性）。1型糖尿病患者死亡的主要原因是心血管疾病。发病年龄最小的人群，尤其是男性，死亡率最高。在此期间，男性和女性糖尿病人群的死亡率分别以每年6.6%和4.8%的速度下降;这大大高于背景人群死亡率的下降幅度。标准死亡率男性每年下降4.3%，女性每年下降2.6%。与背景人群相比，未发生肾病的患者的死亡率仅略有升高，尽管护理方面取得了进展，但在过去十年中，1型糖尿病患者的死亡率仍高于非糖尿病患者;然而，患者的死亡率在研究期间比背景人群下降得更快。肾病似乎是死亡率过高的主要原因。
The aim of this study was to estimate absolute and relative mortality rates in patients with type 1 diabetes at the Steno Diabetes Centre relative to the general Danish background population.Patients with type 1 diabetes (n = 4,821) were followed from 1 January 2002 until 1 January 2011, with death from any cause as the main outcome. Poisson regression was used to model mortality rates by age, diabetes duration and calendar time, according to sex.In the period 2002-2010, a total of 673 deaths (402 men, 271 women) occurred in the study population during 33,847 years of follow-up of type 1 diabetes. The predominant cause of death in patients with type 1 diabetes was cardiovascular disease. Mortality rates were highest among those with the lowest age at onset, particularly men. The mortality rate in the diabetic population decreased over that time period by 6.6% and 4.8% per year in men and women, respectively; this was substantially greater than the decrease in mortality rates in the background population. The decline in standard mortality rate was 4.3% per year in men and 2.6% per year in women. Patients who did not develop nephropathy had only slightly elevated mortality rates compared with the background population.Despite advances in care, mortality rates in the past decade continue to be greater in patients with type 1 diabetes than in those without diabetes; however, the mortality rate in patients decreased over the study period faster than that of the background population. Nephropathy seems to be the main driver of the excess mortality.