Gulliford Martin C, Charlton Judith
Department of Public Health Sciences, Division of Health and Social Care Research, King's College London, Capital House, 42 Weston Street, London SE1 3QD, United Kingdom.
Am J Epidemiol. 2009 Feb 15;169(4):455-61. doi: 10.1093/aje/kwn342. Epub 2008 Nov 26.
There is concern that the increasing prevalence of type 2 diabetes may diminish improving trends in life expectancy. This study aimed to determine whether the mortality of type 2 diabetes, relative to mortality in the general population, is remaining constant. The study included a cohort of 48,556 subjects with type 2 diabetes first diagnosed between 1996 and 2006, drawn from 197 family practices in the United Kingdom General Practice Research Database. There were 6,630 deaths observed. Expected mortality was estimated from United Kingdom life tables. Relative mortality was modeled using Poisson regression. In men with diabetes, from 1996 to 2006, the age-standardized all-cause mortality rate decreased by 0.82/1,000 per year (95% confidence interval (CI): 0.36, 1.27) and by 0.49 (95% CI: 0.29, 0.68) in women with diabetes. After adjustment for age, sex, and diabetes duration, there was a consistent decrease in relative mortality during the period of study. Relative mortality for subjects diagnosed in 1996 was 13% (95% CI: 2, 25) higher than that in 2001; for subjects diagnosed in 2006, relative mortality was 26% (95% CI: 8, 40) lower than that in 2001. Relative mortality of type 2 diabetes appears to be decreasing in men and women in the United Kingdom.
人们担心2型糖尿病患病率的上升可能会削弱预期寿命的改善趋势。本研究旨在确定2型糖尿病的死亡率相对于普通人群的死亡率是否保持不变。该研究纳入了48556名于1996年至2006年间首次诊断为2型糖尿病的受试者队列,这些受试者来自英国全科医学研究数据库中的197个家庭诊所。共观察到6630例死亡。预期死亡率根据英国生命表估算。使用泊松回归对相对死亡率进行建模。在患有糖尿病的男性中,1996年至2006年期间,年龄标准化全因死亡率每年下降0.82/1000(95%置信区间(CI):0.36,1.27);在患有糖尿病的女性中,每年下降0.49(95%CI:0.29,0.68)。在对年龄、性别和糖尿病病程进行调整后,研究期间相对死亡率持续下降。1996年诊断的受试者的相对死亡率比2001年高13%(95%CI:2,25);2006年诊断的受试者的相对死亡率比2001年低26%(95%CI:8,40)。在英国,2型糖尿病的相对死亡率在男性和女性中似乎都在下降。