Dybjer Elin, Dahl Aslan Anna K, Engström Gunnar, Nilsson Erik D, Nägga Katarina, Nilsson Peter M, Hassing Linda B
Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
School of Health Sciences, University of Skövde, Skövde, Sweden.
Diabet Med. 2022 Aug;39(8):e14806. doi: 10.1111/dme.14806. Epub 2022 Feb 13.
There are few cohorts of type 1 diabetes that follow individuals over more than half a century in terms of health outcomes. The aim of this study was to examine associations between type 1 diabetes, diagnosed before age 18, and long-term morbidity and mortality, and to investigate whether cognitive ability plays a role in long-term morbidity and mortality risk.
In a Swedish cohort, 120 men with type 1 diabetes and 469 without type 1 diabetes were followed between 18 and 77 years of age as regards morbidity and mortality outcomes, and impact of cognitive ability at military conscription for the outcomes. In Cox regression analyses and Kaplan-Meier analyses with log-rank tests, associations between diabetes and cognitive ability respectively, and outcomes (mortality, cardiovascular morbidity and diabetes complications) were investigated.
Men with type 1 diabetes suffered from dramatically higher mortality (HR 4.62, 95% CI: 3.56-5.60), cardiovascular mortality (HR 5.60, 95% CI: 3.27-9.57), and cardiovascular events (HR 3.97, 95% CI: 2.79-5.64) compared to men without diabetes. Higher cognitive ability at military conscription was associated with lower mortality in men without diabetes, but was not associated with any outcome in men with diabetes.
In this historical cohort study with 60 years of follow-up time and a less effective treatment of diabetes than today, mortality rates and cardiovascular outcomes were high for men with type 1 diabetes. Morbidity or mortality did not differ between those that had low to normal or high cognitive ability among men with type 1 diabetes.
很少有1型糖尿病队列对个体进行长达半个多世纪的健康状况跟踪。本研究的目的是探讨18岁前诊断出的1型糖尿病与长期发病率和死亡率之间的关联，并调查认知能力是否在长期发病和死亡风险中起作用。
在一个瑞典队列中，对120名患有1型糖尿病的男性和469名未患1型糖尿病的男性进行了跟踪，随访年龄在18至77岁之间，观察发病和死亡结果，以及征兵时认知能力对这些结果的影响。在Cox回归分析和采用对数秩检验的Kaplan-Meier分析中，分别研究了糖尿病和认知能力与结果（死亡率、心血管发病率和糖尿病并发症）之间的关联。
与未患糖尿病的男性相比，患有1型糖尿病的男性死亡率（风险比4.62，95%置信区间：3.56 - 5.60）、心血管死亡率（风险比5.60，95%置信区间：3.27 - 9.57）和心血管事件（风险比3.97，95%置信区间：2.79 - 5.64）显著更高。征兵时较高的认知能力与未患糖尿病男性的较低死亡率相关，但与患有糖尿病男性的任何结果均无关联。
在这项有60年随访时间且糖尿病治疗效果不如现在的历史性队列研究中，1型糖尿病男性的死亡率和心血管结局较高。1型糖尿病男性中认知能力低至正常或高的人群在发病率或死亡率上没有差异。
