Trends in cause-specific mortality among adults with and without diagnosed diabetes in the USA: an epidemiological analysis of linked national survey and vital statistics data
Trends in cause-specific mortality among adults with and without diagnosed diabetes in the USA: an epidemiological analysis of linked national survey and vital statistics data
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DOI：
10.1016/s0140-6736(18)30314-3
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发表时间：
2018-06-16
期刊：
影响因子：
168.9
通讯作者：
Imperatore, Giuseppina
中科院分区：
文献类型：
--
作者：
Gregg, Edward W.;Cheng, Yiling J.;Imperatore, Giuseppina
背景：在美国，糖尿病并发症的大量减少改变了糖尿病相关的发病率。目前尚不清楚在死因方面是否也出现了类似的趋势。方法利用1985年至2015年国家健康访谈调查相关死亡率档案的数据，我们估计了美国成年人糖尿病状态下的年龄特异性死亡率和所有原因、血管原因、癌症和非血管、非癌症原因的比例死亡率。从1988-94年到2010-15年，美国成人糖尿病患者的全因死亡率每10年下降20%（从每1000人年23.1例[95% CI 20.1 -26.0]降至15.2例[14.6-15.8]），血管原因死亡率每10年下降32%（从每1000人年11.0例[9.2-12.2]降至5.2例[4.8-5.6]），癌症死亡率每10年下降16%（从每1000人年4.4例[3.2-5.5]降至3.0例[2.8-3.3]）。非癌症死亡人数每10年下降8%（从7.7[6.3-9.2]降至7.1[6.6-7.5]）。在没有诊断出糖尿病的人群中，所有四种主要死亡类别的死亡率也显著下降。然而，由于各种原因，糖尿病患者的死亡率下降明显更大（p（相互作用））
Background Large reductions in diabetes complications have altered diabetes-related morbidity in the USA. It is unclear whether similar trends have occurred in causes of death.Methods Using data from the National Health Interview Survey Linked Mortality files from 1985 to 2015, we estimated age-specific death rates and proportional mortality from all causes, vascular causes, cancers, and non-vascular, non-cancer causes among US adults by diabetes status.Findings From 1988-94, to 2010-15, all-cause death rates declined by 20% every 10 years among US adults with diabetes (from 23.1 [95% CI 20 .1-26.0] to 15.2 [14.6-15.8] per 1000 person-years), while death from vascular causes decreased 32% every 10 years (from 11.0 [9.2-12.2] to 5.2 [4.8-5.6] per 1000 person-years), deaths from cancers decreased 16% every 10 years (from 4.4 [3.2-5.5] to 3.0 [2.8-3.3] per 1000 person-years), and the rate of nonvascular, non-cancer deaths declined by 8% every 10 years (from 7.7 [6.3-9.2] to 7.1 [6.6-7.5]). Death rates also declined significantly among people without diagnosed diabetes for all four major mortality categories. However, the declines in death rates were significantly greater among people with diabetes for all-causes (p(interaction)