Röckl Susanne, Brinks Ralph, Baumert Jens, Paprott Rebecca, Du Yong, Heidemann Christin, Scheidt-Nave Christa
Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
Institute of Biometry and Epidemiology, German Diabetes Center, Düsseldorf, Germany.
BMJ Open Diabetes Res Care. 2017 Dec 16;5(1):e000451. doi: 10.1136/bmjdrc-2017-000451. eCollection 2017.
To estimate age-specific and sex-specific all-cause mortality among adults with and without type 2 diabetes (T2D) in Germany.
The German National Health Interview and Examination Survey 1998 (GNHIES98) included a mortality follow-up (median follow-up time 12.0 years) of its nationwide sample representative of the population aged 18-79 years. After exclusion of participants with type 1 diabetes, age- and sex-stratified mortality rates (MR) were calculated for 330 GNHIES98 participants with diagnosed T2D (self-reported diagnosis or antidiabetic medication), 245 with undiagnosed T2D (no diagnosed T2D, glycated hemoglobin A1c ≥6.5% (≥48 mmol/mol)), and 5975 without T2D. Mortality rate ratios (MRR) comparing MR of persons with and without T2D were estimated. Age-/sex-standardized MR and MRR were calculated including persons aged 45 years or older. MRR were used to estimate the number of years of life lost (YLL) due to diagnosed diabetes in 2010.
Over 75 994 person-years, 73 persons with undiagnosed T2D, 103 with diagnosed T2D, and 425 persons without T2D died. MRR were significantly higher in younger age groups, except for analyses limited to women or diagnosed T2D. Age- and sex-standardized MRR (95% CI) among persons aged 45 years or older were 1.96 (1.41 to 2.71) for undiagnosed, 1.68 (1.26 to 2.23) for diagnosed, and 1.82 (1.45 to 2.28) for total (undiagnosed or diagnosed) T2D. Sex-stratified analysis revealed similar age-standardized MRR for undiagnosed (1.56 (0.79 to 3.06)) and diagnosed T2D (1.56 (1.03 to 2.37)) among women, and a higher age-standardized MRR for undiagnosed (2.06 (1.43 to 2.97)) than diagnosed T2D (1.70 (1.10 to 2.63)) among men. YLL due to diagnosed diabetes in Germany in 2010 were 164 600 (35 000 to 279 300) among women and 169 900 (28 300 to 328 300) among men.
In Germany, age- and sex-standardized all-cause mortality is almost twice as high for adults with T2D as for adults without T2D. The T2D-associated excess risk of mortality appears to be most pronounced in younger adults and among men unaware of their T2D.
评估德国患有和未患有2型糖尿病（T2D）的成年人按年龄和性别划分的全因死亡率。
1998年德国国民健康访谈与检查调查（GNHIES98）对其具有全国代表性的18 - 79岁人群样本进行了死亡率随访（中位随访时间12.0年）。排除1型糖尿病患者后，为330名经诊断患有T2D（自我报告诊断或使用抗糖尿病药物）的GNHIES98参与者、245名未诊断出T2D（未诊断出T2D，糖化血红蛋白A1c≥6.5%（≥48 mmol/mol））的参与者以及5975名未患T2D的参与者计算了年龄和性别分层的死亡率（MR）。估计了患有和未患有T2D者的死亡率比（MRR）。计算了包括45岁及以上人群在内的年龄/性别标准化MR和MRR。MRR用于估计2010年因已诊断糖尿病导致的寿命损失年数（YLL）。
在超过75994人年的时间里，73名未诊断出T2D的人、103名已诊断出T2D的人以及425名未患T2D的人死亡。除了仅限于女性或已诊断出T2D的分析外，年轻年龄组的MRR显著更高。45岁及以上人群的年龄和性别标准化MRR（95%CI），未诊断出的为1.96（1.41至2.71），已诊断出的为1.68（1.26至2.23），总的（未诊断出或已诊断出）T2D为1.82（1.45至2.28）。性别分层分析显示，女性中未诊断出的（1.56（0.79至3.06））和已诊断出的T2D（1.56（1.03至2.37））的年龄标准化MRR相似，男性中未诊断出的（2.06（1.43至2.97））比已诊断出的T2D（1.70（1.10至2.63））的年龄标准化MRR更高。2010年德国因已诊断糖尿病导致的女性YLL为164600（35000至279300），男性为169900（28300至328300）。
在德国，患有T2D的成年人的年龄和性别标准化全因死亡率几乎是未患T2D成年人的两倍。与T2D相关的额外死亡风险在年轻成年人以及未意识到自己患有T2D的男性中似乎最为明显。
