Bourdel-Marchasson I, Dubroca B, Decamps A, Richard-Harston S, Emeriau J P, Dartigues J F
Centre de Gériatrie du Centre Hospitalo, Universitaire de Bordeaux, Hôpital Xavier-Arnozan, Pessac, France.
Diabet Med. 1998 Oct;15(10):830-5. doi: 10.1002/(SICI)1096-9136(199810)15:10<830::AID-DIA683>3.0.CO;2-3.
We describe the 5-year mortality and its risk factors in a cohort of elderly people with and without known diabetes mellitus. The PAQUID cohort was representative of the population older than 65 living in Gironde, south-west France. Potential mortality risk factors were collected during a baseline evaluation, using a health questionnaire, from 68.9% of a randomly selected sample of over-65s in 1988. A total of 237 subjects (8.5%) had diabetes. Annual review occurred for 5 years and cause of any death was ascertained from family doctors. After 5 years, 623 people (22.3%) had died, of whom 576 were non-demented; 30.0% of the diabetic group versus 20.3% of the non-diabetic group had died. Survival of the known diabetic group was lower than that of the non-diabetic group (p < 0.001), although this excess mortality was significant only in the 65 to 75 age range (relative risk 1.8; 95% confidence interval 1.2 to 2.8, p = 0.04). Cardiovascular mortality rate did not differ between the diabetic and non-diabetic groups (RR 1.2 [0.8-2.0]). Death related to neoplasia was significantly higher in the known diabetic group (RR 2.2 [1.2-3.3], p = 0.01). In the final model, integrating diabetes as a mortality risk factor in the total cohort, known diabetes at the baseline examination was an independent risk factor for mortality (RR 1.4 [1.0-1.8], p = 0.01), in addition to tobacco use, hypertension and functional dependency. These results confirm suggestions that diabetes increases mortality in the over-65 age group, perhaps with an adverse interaction with other pathology.
我们描述了一组患有和未患有糖尿病的老年人的5年死亡率及其风险因素。PAQUID队列代表了居住在法国西南部吉伦特省65岁以上的人群。1988年，通过健康问卷从随机抽取的65岁以上样本中68.9%的人那里收集了潜在的死亡风险因素。共有237名受试者（8.5%）患有糖尿病。进行了为期5年的年度复查，并从家庭医生处确定了任何死亡原因。5年后，623人（22.3%）死亡，其中576人无痴呆症；糖尿病组的死亡率为30.0%，非糖尿病组为20.3%。已知糖尿病组的生存率低于非糖尿病组（p<0.001），尽管这种额外死亡率仅在65至75岁年龄范围内显著（相对风险1.8；95%置信区间1.2至2.8，p = 0.04）。糖尿病组和非糖尿病组的心血管死亡率没有差异（相对风险1.2 [0.8 - 2.0]）。已知糖尿病组中与肿瘤相关的死亡显著更高（相对风险2.2 [1.2 - 3.3]，p = 0.01）。在最终模型中，将糖尿病作为整个队列的死亡风险因素纳入，基线检查时已知的糖尿病除了吸烟、高血压和功能依赖外，还是死亡的独立风险因素（相对风险1.4 [1.0 - 1.8]，p = 0.01）。这些结果证实了糖尿病会增加65岁以上年龄组死亡率的观点，可能与其他病理情况存在不良相互作用。
