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高山市自我报告的糖尿病与全因、心血管疾病和癌症死亡率的关系:日本一项基于人群的前瞻性队列研究

Self-reported diabetes mellitus and risk of mortality from all causes, cardiovascular disease, and cancer in Takayama: a population-based prospective cohort study in Japan.

作者信息

Oba Shino, Nagata Chisato, Nakamura Kozue, Takatsuka Naoyoshi, Shimizu Hiroyuki

机构信息

Department of Prevention for Lifestyle-related Diseases, Gifu University Graduate School of Medicine, Gifu, Japan.

出版信息

J Epidemiol. 2008;18(5):197-203. doi: 10.2188/jea.je2008004. Epub 2008 Aug 28.

Abstract

BACKGROUND

Diabetes mellitus has been reported to be a major risk factor for cardiovascular disease (CVD), and higher risk of CVD among women than that among men has been observed in many studies. Further, the association of diabetes with increasing risk of cancer has also been reported. Well-designed studies conducted among men and women in the general Japanese population remain scarce.

METHODS

Our cohort consisted of 13355 men and 15724 women residing in Takayama, Japan, in 1992. At the baseline, the subjects reported diabetes in a questionnaire. Any deaths occurring in the cohort until 1999 were noted by using data from the Office of the National Vital Statistics. The risk of mortality was separately assessed for men and women by using a Cox proportional hazard model after adjusting for age; smoking status; body mass index (BMI); physical activity; years of education; history of hypertension; and intake of total energy, vegetables, fat, and alcohol.

RESULTS

Diabetes significantly increased the risk of mortality from all causes [hazard ratio (HR): 1.35, 95% confidence interval (CI): 1.11-1.64] and from coronary heart disease (CHD) (HR: 2.96, 95% CI: 1.59-5.50) among men, and that from all causes (HR: 1.74, 95% CI: 1.34-2.26) and cancer (HR: 1.88, 95% CI: 1.16-3.05) among women. Diabetes was not significantly associated with mortality from CHD among women.

CONCLUSION

The findings suggest that diabetes increases the risk of mortality from CVD among men and that from cancer among women. The absence of increased risk of mortality from CHD among women may suggest a particular pattern in the Japanese population.

摘要

背景

据报道,糖尿病是心血管疾病(CVD)的主要危险因素,并且许多研究观察到女性患心血管疾病的风险高于男性。此外,也有报道称糖尿病与癌症风险增加有关。在日本普通人群的男性和女性中进行的精心设计的研究仍然很少。

方法

我们的队列由1992年居住在日本高山的13355名男性和15724名女性组成。在基线时,受试者在问卷中报告了糖尿病情况。利用国家生命统计办公室的数据记录了该队列直到1999年发生的所有死亡情况。在调整年龄、吸烟状况、体重指数(BMI)、身体活动、受教育年限、高血压病史以及总能量、蔬菜、脂肪和酒精摄入量后,使用Cox比例风险模型分别评估男性和女性的死亡风险。

结果

糖尿病显著增加了男性全因死亡风险[风险比(HR):1.35,95%置信区间(CI):1.11 - 1.64]和冠心病(CHD)死亡风险(HR:2.96,95%CI:1.59 - 5.50),以及女性全因死亡风险(HR:1.74,95%CI:1.34 - 2.26)和癌症死亡风险(HR:1.88,95%CI:1.16 - 3.05)。糖尿病与女性冠心病死亡风险无显著关联。

结论

研究结果表明,糖尿病增加了男性心血管疾病死亡风险和女性癌症死亡风险。女性冠心病死亡风险未增加可能表明日本人群存在特定模式。

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