Age and the burden of death attributable to diabetes in the United States

被引:127
作者
Saydah, SH
Eberhardt, MS
Loria, CM
Brancati, FL
机构
[1] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
[2] Ctr Dis Control & Prevent, Off Anal Epidemiol & Hlth Promot, Natl Ctr Hlth Stat, Atlanta, GA USA
[3] NHLBI, Div Epidemiol & Clin Applicat, Bethesda, MD 20892 USA
[4] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA
关键词
diabetes mellitus; mortality;
D O I
10.1093/aje/kwf111
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Diabetes is a well-established cause of cardiovascular disease (CVD) and all-cause mortality. The burden of death attributable to diabetes in the United States is not well quantified, particularly with regard to age. The authors analyzed data from the Second National Health and Nutrition Examination Survey (NHANES 11) (19761980) and the NHANES II Mortality Study, in which a nationally representative cohort of 9,250 adults aged 3075 years was followed for 12-16 years, to determine all-cause and cause-specific mortality. Overall, between 1976 and 1980, the prevalence of diagnosed diabetes was 4.3%. By 1992, the relative hazard of all-cause mortality was 1.9 (95% confidence interval: 1.5, 2.3), and the population attributable risk (PAR) was 3.6%. The relative hazard of CVD mortality was 2.3 (95% confidence interval: 1.8, 2.8), and the PAR was 5.2%. Including participants with undiagnosed diabetes in the estimates increased the PAR for all-cause mortality to 5.1% and that for CVD mortality to 6.8%. Women had a higher prevalence of diagnosed diabetes than men and a greater relative hazard of death than nondiabetic women, leading to a higher PAR for women (3.8% for all causes and 7.3% for CVD) versus men (3.3% for all causes and 3.8% for CVD). These data suggest that diabetes accounts for at least 3.6% of all deaths and 5.2% of CVD deaths in US adults. Improvements in diabetes prevention and treatment should produce noticeable effects on US life expectancy.
引用
收藏
页码:714 / 719
页数:6
相关论文
共 29 条
[11]   Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in US adults - The Third National Health and Nutrition Examination Survey, 1988-1994 [J].
Harris, MI ;
Flegal, KM ;
Cowie, CC ;
Eberhardt, MS ;
Goldstein, DE ;
Little, RR ;
Wiedmeyer, HM ;
Byrd-Holt, DD .
DIABETES CARE, 1998, 21 (04) :518-524
[12]  
Kahn HA., 1989, STAT METHODS EPIDEMI
[13]   Global burden of diabetes, 1995-2025 - Prevalence, numerical estimates, and projections [J].
King, H ;
Aubert, RE ;
Herman, WH .
DIABETES CARE, 1998, 21 (09) :1414-1431
[14]   AN ANALYSIS OF EXCESS MORTALITY-RATES FOR PERSONS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS IN WESTERN AUSTRALIA USING THE COX PROPORTIONAL HAZARDS REGRESSION-MODEL [J].
KNUIMAN, MW ;
WELBORN, TA ;
WHITTALL, DE .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1992, 135 (06) :638-648
[15]  
LORIA C, 1999, VITAL HLTH STAT 1, V38
[16]  
*NAT CTR HLTH STAT, 2000, MULT CAUS DEATH INCL
[17]  
*NAT CTR HLTH STAT, 1987, VIT HLTH STAT 11, V237
[18]  
*NAT CTR HLTH STAT, 1981, VIT HLTH STAT 1, V15
[19]  
*NAT CTR HLTH STAT, 1986, NAT HLTH NUTR EX SUR
[20]  
*NAT CTR HLTH STAT, 1983, NAT HLTH NUTR EX SUR