Gimeno S G, Ferreira S R, Franco L J, Iunes M, Osiro K
Departamento de Medicina Preventiva, Universidade Federal de São Paulo (UNIFESP-EPM), Brasil.
Rev Saude Publica. 1998 Apr;32(2):118-24. doi: 10.1590/s0034-89101998000200003.
As part of a study involving Japanese migrants, living in a developed city in the state of S. Paulo, Southeastern Brazil, a four-year experience of mortality among diabetic and non-diabetic subjects is described and their respective death rates are compared. In 1993, a cohort of 530 Japanese-Brazilians (236 issei or 1st generation and 294 nisei or 2nd generation) of both sexes, aged 40 from to 79 years old, were identified.
At that time, 91 (17%) were classified as non-insulin-dependent diabetic subjects (NIDDM), 90 (17%) with impaired glucose tolerance (IGT) and 349 (66%) as normal, according to WHO criteria. In 1996, families were questioned with a view detecting the deaths which had occurred among the subjects previously studied. This information, in addition to that from death certificates was used to record the date and the causes of death. Mortality rates for all causes and for specific causes (circulatory and renal diseases) were obtained for the three groups of subjects, by glucose tolerance status. Proportional hazard regression models were used to compare the mortality rates, adjusted for several covariables (gender, age, generation, hypertension, dyslipidemia, obesity and serum creatinine).
Crude mortality rate ratios for all causes and specific causes, for NIDDM, and normal subjects were 2.95 (95% CI: 1.10-7.62) and 4.57 (95% CI: 1.31-16.48), respectively. No difference was observed between the crude mortality rate ratio for IGT and normal subjects. After simultaneous adjustments for the covariates, higher mortality rates for specific causes were observed among NIDDM than in the normal subjects (mortality rates ratio: 3.86; 95% CI: 1.11-13.38). These results in Japanese-Brazilians are consistent with previous reports of increased mortality in other diabetic subjects, thus confirming the adverse effect of this metabolic disturbance on mortality among diabetic subjects.
作为一项针对居住在巴西东南部圣保罗州一个发达城市的日本移民的研究的一部分，本文描述了糖尿病患者和非糖尿病患者四年的死亡率情况，并比较了他们各自的死亡率。1993年，确定了一个由530名日裔巴西人组成的队列（236名一世移民或第一代移民，294名二世移民或第二代移民），年龄在40至79岁之间，男女皆有。
当时，根据世界卫生组织的标准，91人（17%）被归类为非胰岛素依赖型糖尿病患者（NIDDM），90人（17%）糖耐量受损（IGT），349人（66%）为正常。1996年，对这些家庭进行询问，以查明之前研究对象中发生的死亡情况。除了死亡证明上的信息外，这些信息还被用于记录死亡日期和死因。根据糖耐量状况，得出了三组研究对象的全因死亡率和特定原因（循环系统和肾脏疾病）死亡率。使用比例风险回归模型比较死亡率，并对几个协变量（性别、年龄、代际、高血压、血脂异常、肥胖和血清肌酐）进行了调整。
NIDDM患者和正常受试者的全因和特定原因的粗死亡率比值分别为2.95（95%可信区间：1.10 - 7.62）和4.57（95%可信区间：1.31 - 16.48）。IGT患者和正常受试者的粗死亡率比值未观察到差异。在对协变量进行同时调整后，NIDDM患者特定原因的死亡率高于正常受试者（死亡率比值：3.86；95%可信区间：1.11 - 13.38）。这些日裔巴西人的结果与之前其他糖尿病患者死亡率增加的报告一致，从而证实了这种代谢紊乱对糖尿病患者死亡率的不利影响。
