Mortality in adults with and without diabetes in a national cohort of the US population, 1971-1993
Mortality in adults with and without diabetes in a national cohort of the US population, 1971-1993
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DOI：
10.2337/diacare.21.7.1138
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发表时间：
1998-07-01
期刊：
影响因子：
16.2
通讯作者：
Harris, MI
中科院分区：
文献类型：
--
作者：
Gu, K;Cowie, CC;Harris, MI
目的-检查22年死亡率（1971-1993），根据年龄、性别和种族，糖尿病和非糖尿病成年人的全国样本的死亡原因、预期寿命和存活率。在1971-1975年的第一次全国健康和营养检查调查（NHANES I）中确定了374名年龄在25-74岁之间的成年人。通过病史访谈确定糖尿病。队列随访死亡率至1992-1993年，96.2%（n = 13，830）的生命状态得到证实。死亡原因由死亡证明确定。结果-糖尿病受试者占队列的5.1%，占死亡人数的10.6%。糖尿病受试者的死亡率从基线时25-44岁受试者的12.4/1000人-年增加到65-74岁受试者的89.7/1000人-年。男性糖尿病患者的年龄调整死亡率比女性糖尿病患者高57%;非西班牙裔黑人糖尿病患者的死亡率比非西班牙裔白人糖尿病患者高27%。接受胰岛素治疗的受试者和糖尿病病程大于或等于15年的受试者的死亡率最高。糖尿病在死亡证明上被列为死亡的根本原因，只有7.7%的糖尿病男性和13.4%的糖尿病女性。考虑到死亡的多种原因，心脏病是最常见的，在糖尿病患者的死亡证明中占69.5%。在所有年龄、性别和种族组中，糖尿病患者的死亡率均高于非糖尿病患者。相对死亡风险（糖尿病受试者与非糖尿病受试者）随年龄增长而下降，从基线时25-44岁受试者的3.6降至65-74岁受试者的1.5。除恶性肿瘤外，糖尿病受试者所有主要死因的相对风险均升高。在所有年龄、性别和种族组中，糖尿病受试者的生存率均低于非糖尿病受试者。55-64岁的糖尿病成人的平均预期寿命低8年，65-74岁的糖尿病成人的平均预期寿命低4年。结论-在这个有代表性的全国成人样本中，糖尿病男性的死亡率高于糖尿病女性，糖尿病黑人的死亡率高于糖尿病。糖尿病患者的寿命比非糖尿病患者短。
OBJECTIVE - To examine 22-year mortality (1971-1993), causes of death, life expectancy, and survival in a national sample of diabetic and nondiabetic adults according to age, sex, and race.RESEARCH DESIGN AND METHODS - A representative national cohort of 14,374 adults aged 25-74 years was identified in 1971-1975 in the First National Health and Nutrition Examination Survey (NHANES I). Diabetes was ascertained by medical history interview The cohort was followed for mortality through 1992-1993, with verification of vital status for 96.2% (n = 13,830). Causes of death were determined from death certificates.RESULTS - Diabetic subjects comprised 5.1%;, of the cohort and accounted for 10.6% of the deaths. Mortality for diabetic subjects increased from 12.4 per 1,000 person-years for those aged 25-44 years at baseline to 89.7 per 1,000 person-years for those aged 65-74 years. The age-adjusted mortality rate was 57% higher for diabetic men than for diabetic women; the rate was 27% higher for diabetic non-Hispanic blacks than for diabetic non-Hispanic whites. Mortality rates were highest for insulin-treated subjects and for those with greater than or equal to 15 years' duration of diabetes. Diabetes was listed on the death certificate as the underlying cause of death for only 7.7% of diabetic men and 13.4% of diabetic women. Considering multiple causes of death, heart disease was listed the most frequently and was present on 69.5% of death certificates of people with diabetes. Death rates were higher for diabetic than for nondiabetic subjects in all age, sex, and race groups. The relative risk of death (diabetic versus nondiabetic subjects) declined with age from a value of 3.6 for those aged 25-44 years at baseline to 1.5 for those aged 65-74 years. The relative risk was elevated in diabetic subjects for all major causes of death except malignant neoplasms. Survival of diabetic subjects was lower than that of nondiabetic subjects in all age, sex, and race groups. Median life expectancy was 8 years lower for diabetic adults aged 55-64 years and 4 years lower for those aged 65-74 years.CONCLUSIONS - In this representative national sample of adults, mortality rates were higher for diabetic men than for diabetic women and for diabetic blacks than for diabetic The study confirms the substantially higher risk of death, lower survival, and lower life of diabetic adults compared with nondiabetic adults.