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Associations of mortality and cardiovascular disease risks with diabetes and albuminuria in urban Indigenous Australians: the DRUID follow‐up study
Author(s) -
Barr E. L. M.,
Cunningham J.,
Tatipata S.,
Dunbar T.,
Kangaharan N.,
Guthridge S.,
Li S. Q.,
Condon J. R.,
Shaw J. E.,
O'Dea K.,
MapleBrown L. J.
Publication year - 2017
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13360
Subject(s) - medicine , albuminuria , diabetes mellitus , hazard ratio , population , disease , endocrinology , environmental health , confidence interval
Aim To assess the relationships of diabetes and albuminuria with all‐cause mortality and cardiovascular disease outcomes in a population without prior cardiovascular disease using data from the Darwin Region Urban Indigenous Diabetes (DRUID) study. Methods We conducted a prospective cohort study of 706 participants (aged 15–81 years, 68% women) without prior cardiovascular disease who underwent a 75‐g oral glucose tolerance test. Deaths and fatal or non‐fatal cardiovascular disease were determined over 7 years, and hazard ratios with 95% CIs and population attributable risks were estimated for baseline glycaemia and albuminuria. Results Compared with normoglycaemia and after adjustment for age, sex, hypertension, dyslipidaemia and smoking, known diabetes was associated with an adjusted hazard ratio of 4.8 (95% CI 1.5–14.7) for all‐cause mortality and 5.6 (95% CI 2.1–15.2) for cardiovascular disease. Compared with normoalbuminuria, the respective adjusted risks for macroalbuminuria were 10.9 (95% CI 3.7–32.1) and 3.9 (95% CI 1.4–10.8). The Adjusted all‐cause mortality and cardiovascular disease estimated population attributable risks for diabetes were 27% and 32%, and for albuminuria they were 32% and 21%, respectively. Conclusions In our study population, the burden of mortality and cardiovascular disease was largely driven by diabetes and albuminuria. This finding on the influence of diabetes and albuminuria is consistent with reports in other high‐risk Indigenous populations and should be better reflected in risk scores and intervention programmes.