[Relationship between metabolic diseases and all-cause and cardiovascular disease death in elderly male diabetics during a 10-year follow-up].

OBJECTIVE

To explore the relationship between metabolic diseases and death from all causes and cardiovascular diseases (CVD) in elderly male diabetics.

METHODS

A total of 681 elderly male diabetics were recruited from June 1997 to June 1999 and followed up for 10 years. All underwent regular check-ups in PLA General Hospital each year. The Cox proportional hazards model was applied to the multivariate survival analysis for all-cause and CVD mortality. And the cumulative survival rates were calculated by Kaplan-Meier method and log-rank test was used to compare the survival rates.

RESULTS

During a 10-year follow-up, 208 subjects died, including 70 deaths from CVD. Multivariate Cox regression analysis showed that age [relative risk (RR) = 1.099, 95% confidence interval (CI)1.076-1.123], pulse pressure (RR = 1.009, 95%CI 1.001-1.017) , elevated postprandial glucose level (RR = 1.115, 95%CI 1.075-1.157) and lower triglyceride (RR = 0.683, 95%CI 0.539-0.865) and high-density lipoprotein cholesterol (RR = 0.444, 95%CI 0.257-0.766) increased the risks of all-cause mortality while age (RR = 1.112, 95%CI 1.070-1.155) , elevated postprandial glucose level (RR = 1.278, 95%CI 1.170-1.396) and systolic blood pressure (RR = 1.013, 95%CI 1.002-1.024) increased the risks of CVD mortality. The cumulative survival rates from CVD mortality in diabetics with metabolic syndrome were significantly lower compared with those with diabetes only (P < 0.01) .

CONCLUSION

CVD remains a main cause of death for Chinese elderly male diabetics. Advanced age and elevated postprandial glucose level are risk factors of all-cause and CVD mortality. Diabetes mellitus with concurrent hypertension or metabolic syndrome is associated with an increased risk of CVD death.