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J Epidemiol. 2017 Mar;27(3S):S98-S106. doi: 10.1016/j.je.2016.12.012. Epub 2017 Feb 10.

Survival of macrovascular disease, chronic kidney disease, chronic respiratory disease, cancer and smoking in patients with type 2 diabetes: BioBank Japan cohort.

Author information

1
Department of Health Sciences, University of Yamanashi, Yamanashi, Japan. Electronic address: hyokomichi@yamanashi.ac.jp.
2
Department of Public Policy, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
3
Laboratory of Genome Technology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
4
Hisayama Research Institute for Lifestyle Diseases, Fukuoka, Japan.
5
Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
6
Laboratory of Molecular Medicine, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
7
Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.
8
Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
9
RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.
10
Department of Health Sciences, University of Yamanashi, Yamanashi, Japan.
11
Tokushukai Hospitals, Japan.
12
Nippon Medical School, Japan.
13
Juntendo University, Japan.
14
Nihon University, Japan.
15
Iwate Medical University, Japan.
16
Tokyo Metropolitan Institute of Gerontology, Japan.
17
The Cancer Institute Hospital of JFCR, Japan.
18
Aso Iizuka Hospital, Japan.
19
Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.
20
Shiga University of Medical Science, Japan.
21
National Hospital Organization, Osaka National Hospital, Japan.
22
Fukujuji Hospital, Japan.

Abstract

BACKGROUND:

The number of patients with diabetes is increasing worldwide. Macrovascular disease, chronic kidney disease, chronic respiratory disease, cancer and smoking frequently accompany type 2 diabetes. Few data are available related to mortality of Asians with diabetes associated with these serious comorbidities. The present study aimed to quantify the excess mortality risks of type 2 diabetic patients with comorbidities.

METHODS:

We analysed the available records of 30,834 Japanese patients with type 2 diabetes from the BioBank Japan Project between 2003 and 2007. Men and women were followed up for median 8.03 and 8.30 years, respectively. We applied Cox proportional hazard model and Kaplan-Meier estimates for survival curves to evaluate mortality in diabetic patients with or without macrovascular disease, chronic respiratory disease, chronic kidney disease, cancer and smoking.

RESULTS:

Adjusted hazard ratios (HRs) for mortality were 1.39 (95% CI, 1.09-1.78) for male sex, 2.01 (95% CI, 1.78-2.26) per 10-year increment of age. Adjusted HRs of primary interest were 1.77 (95% CI, 1.42-2.22), macrovascular disease; 1.58 (95% CI, 1.08-2.31), chronic respiratory disease; 2.03 (95% CI, 1.67-2.47), chronic kidney disease; 1.16 (95% CI, 0.86-1.56), cancer; and 1.74 (95% CI, 1.30-2.31), current smoking.

CONCLUSIONS:

Diabetic patients with a past or current history of chronic kidney, macrovascular or respiratory diseases or smoking habit have exhibited the highest risk of mortality. Data were limited to those of survivors of comorbidities but we propose the need to improve comorbidities and terminate cigarette smoking for better prognosis in patients with diabetes.

KEYWORDS:

Cancer; Cardiovascular diseases; Diabetes; Diabetes complications; Survival analysis

PMID:
28209242
PMCID:
PMC5350597
DOI:
10.1016/j.je.2016.12.012
[Indexed for MEDLINE]
Free PMC Article

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