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独居的糖尿病患者的全因和特定原因死亡率风险:一项大规模基于人群的队列研究。

All-cause and cause-specific mortality risks in individuals with diabetes living alone: A large-scale population-based cohort study.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.

出版信息

Diabetes Res Clin Pract. 2024 Nov;217:111876. doi: 10.1016/j.diabres.2024.111876. Epub 2024 Sep 27.

Abstract

AIMS

The rise in one-person households is a global trend. We aimed to investigate mortality risk in individuals with diabetes living alone (IDLA) using a large-scale population-based database.

METHODS

A total of 2,447,557 adults with type 2 diabetes were identified from the Korean National Health Information Database. One-person households were defined based on the number of registered family members. The risks of all-cause and cause-specific mortalities were estimated using a multivariable Cox proportional hazards regression model.

RESULTS

During a median follow-up period of 6.0 years, 191,084 deaths (7.8 %) occurred. IDLA had a higher risk of mortality compared to those not living alone after adjusting for potential confounders (HR 1.20, 95 % CI: 1.18-1.22). This association was more prominent in younger individuals, men, and those with low income, and it was dependent on the duration of living alone. The risks of cause-specific mortality were all significantly higher in the IDLA group compared with the non-IDLA group. Adherence to favorable lifestyle behaviors was associated with a significant reduction in all-cause mortality, particularly in IDLA.

CONCLUSIONS

The elevated risk of mortality in IDLA highlights the need for tailored medical interventions and social assistance, particularly for those with unhealthy lifestyles or low income.

摘要

目的

一人家庭的增加是一个全球趋势。我们旨在使用大规模的基于人群的数据库研究独居的糖尿病患者(IDLA)的死亡风险。

方法

从韩国国家健康信息数据库中确定了 2447557 名 2 型糖尿病成年人。根据登记的家庭成员人数定义一人家庭。使用多变量 Cox 比例风险回归模型估计全因和特定原因死亡率的风险。

结果

在中位随访 6.0 年期间,发生了 191084 例死亡(7.8%)。调整潜在混杂因素后,IDLA 的死亡风险高于非独居者(HR 1.20,95%CI:1.18-1.22)。这种关联在年轻个体、男性和低收入个体中更为明显,并且取决于独居的持续时间。与非 IDLA 组相比,IDLA 组的特定原因死亡率风险均显著更高。良好生活方式行为的依从性与全因死亡率的显著降低相关,特别是在 IDLA 组中。

结论

IDLA 死亡风险升高突出表明需要针对特定人群进行医疗干预和社会援助,特别是对于那些生活方式不健康或收入较低的人群。

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