Turin Tanvir Chowdhury, Okamura Tomonori, Rumana Nahid, Afzal Arfan Raheen, Watanabe Makoto, Higashiyama Aya, Nakao Yoko M, Nakai Michikazu, Takegami Misa, Nishimura Kunihiro, Kokubo Yoshihiro, Okayama Akira, Miyamoto Yoshihiro
Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan.
Prim Care Diabetes. 2017 Oct;11(5):461-466. doi: 10.1016/j.pcd.2017.04.007. Epub 2017 May 22.
Epidemiological estimate lifetime risk (LTR) is a measure that expresses the probability of disease in the remaining lifetime for individuals of a specific index age. These estimates can be useful for general audience targeted knowledge translation activities against diabetes. There are only a few reports on lifetime of impact of diabetes on coronary heart disease (CHD) events.
The Suita Study, a cohort study of cardiovascular diseases (CVD), was established in 1989. We included all participants who were CVD free at baseline. Age (in years) was used as the time scale. Age-specific incidence rates were calculated with person-year method within ten-year bands. We estimated the sex and index-age specific LTR of first-ever CHD with taking the competing risk of death into account.
We followed 5559 participants without CHD history during 1989-2007 for 71,745.4 person-years. At age 40 years the competing risk of death adjusted LTR for all CHD were 16.61% for men without diabetes and 21.06% for men with diabetes. Therefore the LTD for CHD was higher by 4.45% for men with diabetes compared to men without. The competing risk adjusted LTR of CHD at 40 years of aged women was 9.18% for without diabetes and 14.21% for with diabetes. This increased LTR of CHD for diabetic patients were observed among both men and women across all index ages.
In this urban community based population we observed that diabetes has significant effect on the residual LTR of CHD among both men and women of middle age. This easy understandable knowledge can be used as important indexes to assist public health education and planning.
流行病学估计终生风险（LTR）是一种衡量指标，用于表示特定指数年龄个体在剩余生命中患疾病的概率。这些估计对于针对糖尿病的面向普通人群的知识传播活动可能有用。关于糖尿病对冠心病（CHD）事件终生影响的报告很少。
吹田研究是一项关于心血管疾病（CVD）的队列研究，于1989年开展。我们纳入了所有在基线时无CVD的参与者。以年龄（岁）作为时间尺度。采用人年法计算十年年龄组内的年龄别发病率。我们在考虑死亡竞争风险的情况下，估计了首次发生冠心病的性别和指数年龄特异性LTR。
1989年至2007年期间，我们对5559名无冠心病病史的参与者进行了71745.4人年的随访。在40岁时，无糖尿病男性的所有冠心病死亡竞争风险调整LTR为16.61%，有糖尿病男性为21.06%。因此，有糖尿病男性的冠心病LTD比无糖尿病男性高4.45%。40岁无糖尿病女性的冠心病死亡竞争风险调整LTR为9.18%，有糖尿病女性为14.21%。在所有指数年龄的男性和女性中，糖尿病患者的冠心病LTR均有所增加。
在这个以城市社区为基础的人群中，我们观察到糖尿病对中年男性和女性冠心病的残余LTR有显著影响。这一易于理解的知识可作为协助公共卫生教育和规划的重要指标。
