HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) All Versions of this Article: dc08-0107v1 31/7/1360    most recent Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Soedamah-Muthu, S. S. Search for Related Content PubMed PubMed Citation Articles by Soedamah-Muthu, S. S. Social Bookmarking                What's this?

The relationship between risk factors and mortality in type 1 diabetic patients in Europe, the EURODIAB Prospective Complications Study (PCS)

¹Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
²Epidemiology and Public-Health, Royal Free and University College London Medical School, London, UK
³National Heart and Lung Institute, Imperial College, London, UK
⁴Medicine, University of Turin, Torino, Italy

s.s.soedamah-muthu{at}umcutrecht.nl

ABSTRACT

Objective: To examine risk factors for mortality in patients with type 1 diabetes.

Research design and methods: Baseline risk factors were measured in the EURODIAB Prospective cohort study with 2,787 type 1 diabetic patients (51% men, 49% women), recruited from 16 European countries. Mortality data were collected during a 7-year follow-up.

Results: There was an annual mortality rate of 5 per 1,000 person-years in patients with type 1 diabetes (mean age at baseline 33 years, range 15-61 years), 102 subjects died of the total 2,787. The final multivariable model contained age at baseline (sHR=1.68, 1.36-2.08), glycosylated haemoglobin (sHR=1.17, 0.94-1.44), WHR (sHR=1.32, 1.14-1.53), pulse pressure (sHR=1.27, 1.06-1.52), non-HDL cholesterol (sHR=1.25, 1.04-1.49) and antihypertensive medication (sHR=0.39, 0.25-0.62) as risk factors for all-cause mortality. Macroalbuminuria (sHR 2.22, 95%CI: 1.06-4.65), peripheral (sHR=1.92, 95%CI: 1.08-3.41) and autonomic neuropathy (sHR 2.34, 95%CI: 1.29-4.26) were the most important risk markers for mortality. Similar risk factors were found for all-cause, non-CVD, unknown cause and CVD mortality.

Conclusions: Important risk factors of the increased total and non-CVD mortality risk in type 1 patients are age, WHR, pulse pressure and non-HDL cholesterol. The use of antihypertensive medication lowers the risk of mortality in type 1 diabetes. Microvascular complications from macroalbuminuria, peripheral and autonomic neuropathy are strong risk markers for future mortality, exceeding the effect of the traditional risk factors.

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?