Chen Shen1, C Mary Schooling2, Wai Man Chan3, Siu Yin Lee3, Gabriel M Leung1, Tai Hing Lam1. 1. School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. 2. School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; City University of New York , School of Public Health and Hunter College, NY, USA. Electronic address: cms1@hkucc.hku.hk. 3. Department of Health, Government of Hong Kong SAR, Hong Kong, China.
Abstract
OBJECTIVE: In Western countries, diabetes mellitus is positively associated with death from all- and specific-causes including cancer, cardiovascular and respiratory diseases. In a Chinese setting with a different disease pattern: high diabetes rates in a relatively non-obese population with low ischemic heart disease (IHD) rates where diabetes is positively associated with IHD, we examined the association of self-reported diabetes with death among older people. METHODS: Multivariable Cox regression analysis was used in a population-based prospective cohort of 66,820 Chinese (65+ years) enrolled from July 1998 to December 2001 at Elderly Health Centers of the Hong Kong Government Department of Health, followed until May 31, 2012. RESULTS: During 10.9 years of follow-up, 19,845 deaths occurred. Self-reported diabetes was associated with death from all-causes (hazard ratio (HR)=1.56, 95% confidence interval (CI) 1.51, 1.62), cardiovascular disease (HR=1.84, 95% CI 1.72, 1.96), cancer (HR=1.11, 95% CI 1.03 to 1.20), liver cancer (HR=1.38, 95% CI 1.13 to 1.69) and stomach cancer (HR=1.38, 95% CI 1.03 to 1.85), adjusted for age, sex, socio-economic position, alcohol use, smoking, exercise and body mass index. CONCLUSION: Such a pattern of associations suggests that further investigation into the drivers of diabetes is required in this and similar populations.
OBJECTIVE: In Western countries, diabetes mellitus is positively associated with death from all- and specific-causes including cancer, cardiovascular and respiratory diseases. In a Chinese setting with a different disease pattern: high diabetes rates in a relatively non-obese population with low ischemic heart disease (IHD) rates where diabetes is positively associated with IHD, we examined the association of self-reported diabetes with death among older people. METHODS: Multivariable Cox regression analysis was used in a population-based prospective cohort of 66,820 Chinese (65+ years) enrolled from July 1998 to December 2001 at Elderly Health Centers of the Hong Kong Government Department of Health, followed until May 31, 2012. RESULTS: During 10.9 years of follow-up, 19,845 deaths occurred. Self-reported diabetes was associated with death from all-causes (hazard ratio (HR)=1.56, 95% confidence interval (CI) 1.51, 1.62), cardiovascular disease (HR=1.84, 95% CI 1.72, 1.96), cancer (HR=1.11, 95% CI 1.03 to 1.20), liver cancer (HR=1.38, 95% CI 1.13 to 1.69) and stomach cancer (HR=1.38, 95% CI 1.03 to 1.85), adjusted for age, sex, socio-economic position, alcohol use, smoking, exercise and body mass index. CONCLUSION: Such a pattern of associations suggests that further investigation into the drivers of diabetes is required in this and similar populations.
Authors: C M Schooling; W M Chan; S L Leung; T H Lam; S Y Lee; C Shen; J Y Leung; G M Leung Journal: Int J Epidemiol Date: 2014-12-05 Impact factor: 7.196