Premium
Risk factors for cardiovascular disease and mortality events in adults with type 2 diabetes — a 10‐year follow‐up: Tehran Lipid and Glucose Study
Author(s) -
Afsharian Sheila,
Akbarpour Samaneh,
Abdi Hengameh,
Sheikholeslami Farhad,
Moeini Ali Siamak,
Khalili Davood,
Momenan Amir Abbas,
Azizi Fereidoun,
Hadaegh Farzad
Publication year - 2016
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2776
Subject(s) - medicine , hazard ratio , type 2 diabetes , diabetes mellitus , population , overweight , proportional hazards model , attributable risk , obesity , endocrinology , epidemiology , confidence interval , environmental health
Background To identify risk factors for cardiovascular disease (CVD) and mortality events in patients with type 2 diabetes and to calculate their population attributable fraction among a representative Iranian population. Methods A total of 1198 patients with type 2 diabetes (504 men and 694 women), aged ≥30 years, without prevalent CVD, with a median follow‐up of 10 years were included in current study. To examine the association between risk factors and their outcomes, multivariate sex‐adjusted Cox proportional hazard regression models were used. Results During the study, 281 and 172 participants experienced CVD and all‐cause mortality events, respectively. Regarding CVD events, fasting plasma glucose (FPG) level of 7.22–<10 mmol/L [hazard ratio (HR): 1.46, 95% CI 1.12–1.96], FPG level ≥10 mmol/L (HR 2.04, 1.53–2.72), hypertension (HR 1.65, 1.28–2.13), hypercholesterolaemia (HR 1.96, 1.40–2.75) and high waist to hip ratio (HR 1.30, 0.99–1.70; p = 0.051) were significant predictors, and corresponding population attributable fractions were 9.76, 17.84, 23.26, 41.63 and 14.76%, respectively. Considering all‐cause mortality events, hypertension (HR 1.70, 1.23–2.36), FPG level ≥10 mmol/L (HR 2.31, 1.55–3.20) and smoking (HR 1.45, 1.03–2.04) were significant predictors, and corresponding population attributable fractions were 25.81, 20.88 and 11.18%, respectively. Meanwhile, being overweight or obese was associated with lower all‐cause and CVD mortality events. Conclusions Among modifiable risk factors in patients with type 2 diabetes, hypercholesterolaemia and central adiposity for CVD, smoking for mortality events and hypertension and poor glycaemic control for both outcomes need to be paid most attention by healthcare professionals. Copyright © 2016 John Wiley & Sons, Ltd.