Impact of Socioeconomic Status on Cardiovascular Disease and Mortality in 24,947 Individuals With Type 1 Diabetes
Impact of Socioeconomic Status on Cardiovascular Disease and Mortality in 24,947 Individuals With Type 1 Diabetes
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DOI：
10.2337/dc15-0145
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发表时间：
2015-08-01
期刊：
影响因子：
16.2
通讯作者：
Gudbjornsdottir, Soffia
中科院分区：
文献类型：
--
作者：
Rawshani, Araz;Svensson, Ann-Marie;Gudbjornsdottir, Soffia
目的社会经济地位(SES)是心血管疾病(CVD)和死亡的有力预测因子。我们研究了一大批1型糖尿病患者的相关性。研究设计和方法将瑞典国家糖尿病登记处的临床数据与国家登记处联系起来，从而获得关于收入、教育、婚姻状况、出生国、合并症和事件的信息。对患者进行跟踪，直到首次发生事件、死亡或随访结束。通过严格的协变量调整，用COX回归对社会经济变量和预后之间的关系进行了建模。平均年龄39.1岁(13.9岁)，平均随访6.0岁(1.0岁)。死亡和致命性/非致命性心血管疾病分别发生在926和1378人中。与单身相比，已婚患者的死亡风险、心血管疾病死亡和糖尿病相关死亡风险降低了50%。收入最低的两个五分之一的人患致命/非致命心血管疾病、冠心病和中风的风险是收入最高的五分之一的人的两倍，死亡、糖尿病相关死亡和心血管死亡的风险大约是收入最高的五分之一的人的三倍。与拥有
OBJECTIVESocioeconomic status (SES) is a powerful predictor of cardiovascular disease (CVD) and death. We examined the association in a large cohort of patients with type 1 diabetes.RESEARCH DESIGN AND METHODSClinical data from the Swedish National Diabetes Register were linked to national registers, whereby information on income, education, marital status, country of birth, comorbidities, and events was obtained. Patients were followed until a first incident event, death, or end of follow-up. The association between socioeconomic variables and the outcomes was modeled using Cox regression, with rigorous covariate adjustment.RESULTSWe included 24,947 patients. Mean (SD) age and follow-up was 39.1 (13.9) and 6.0 (1.0) years. Death and fatal/nonfatal CVD occurred in 926 and 1378 individuals. Compared with being single, being married was associated with 50% lower risk of death, cardiovascular (CV) death, and diabetes-related death. Individuals in the two lowest quintiles had twice as great a risk of fatal/nonfatal CVD, coronary heart disease, and stroke and roughly three times as great a risk of death, diabetes-related death, and CV death as individuals in the highest income quintile. Compared with having