Risk of Cause-Specific Mortality across Glucose Spectrum in Elderly People: A Nationwide Population-Based Cohort Studyopen access
- Authors
- Lee, Joonyub; Kim, Hun-Sung; Song, Kee-Ho; Yoo, Soon Jib; Han, Kyungdo; Lee, Seung-Hwan
- Issue Date
- Oct-2023
- Publisher
- KOREAN ENDOCRINE SOC
- Keywords
- Diabetes mellitus; Aged; Glucose tolerance; Mortality
- Citation
- ENDOCRINOLOGY AND METABOLISM, v.38, no.5, pp 525 - 537
- Pages
- 13
- Journal Title
- ENDOCRINOLOGY AND METABOLISM
- Volume
- 38
- Number
- 5
- Start Page
- 525
- End Page
- 537
- URI
- https://scholarworks.bwise.kr/ssu/handle/2018.sw.ssu/49121
- DOI
- 10.3803/EnM.2023.1765
- ISSN
- 2093-596X
2093-5978
- Abstract
- Background: This study investigated the risk of cause-specific mortality according to glucose tolerance status in elderly South Koreans.Methods: A total of 1,292,264 individuals aged >= 65 years who received health examinations in 2009 were identified from the Na-tional Health Information Database. Participants were classified as normal glucose tolerance, impaired fasting glucose, newly-diag-nosed diabetes, early diabetes (oral hypoglycemic agents <= 2), or advanced diabetes (oral hypoglycemic agents >= 3 or insulin). The risk of system-specific and disease-specific deaths was estimated using multivariate Cox proportional hazards analysis.Results: During a median follow-up of 8.41 years, 257,356 deaths were recorded. Diabetes was associated with significantly higher risk of all-cause mortality (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.57 to 1.60); death due to circulatory (HR, 1.49; 95% CI, 1.46 to 1.52), respiratory (HR, 1.51; 95% CI, 1.47 to 1.55), and genitourinary systems (HR, 2.22; 95% CI, 2.10 to 2.35); and neoplasms (HR, 1.30; 95% CI, 1.28 to 1.32). Diabetes was also associated with a significantly higher risk of death due to ischemic heart disease (HR, 1.70; 95% CI, 1.63 to 1.76), cerebrovascular disease (HR, 1.46; 95% CI, 1.41 to 1.50), pneumonia (HR, 1.69; 95% CI, 1.63 to 1.76), and acute or chronic kidney disease (HR, 2.23; 95% CI, 2.09 to 2.38). There was a stepwise increase in the risk of death across the glucose spectrum (P for trend <0.0001). Stroke, heart failure, or chronic kidney disease increased the risk of all-cause mortality at every stage of glucose intolerance.Conclusion: A dose-dependent association between the risk of mortality from various causes and severity of glucose tolerance was noted in the elderly population.
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