| Title: | Association of cardiovascular health with diabetic complications, all-cause mortality, and life expectancy among people with type 2 diabetes |
| Journal: | Diabetology & Metabolic Syndrome |
| Published: | 28 Oct 2022 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/36307875/ |
| DOI: | https://doi.org/10.1186/s13098-022-00934-6 |
| URL: | https://dmsjournal.biomedcentral.com/counter/pdf/10.1186/s13098-022-00934-6 |
| Citations: | 7 (7 in last 2 years) as of 8 Aug 2024 |
Publication 10627
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Abstract
BackgroundWe aimed to assess the impact of healthy cardiovascular health (CVH) on diabetic complications, mortality, and life expectancy among people with type 2 diabetes and to explore whether inflammation marker mediate these associations.MethodsThis prospective cohort study included 33,236 participants (aged 40-72) with type 2 diabetes from the UK Biobank with annual follow-up from 2006 to 2010 to 2020. Type 2 diabetes was ascertained from self-report, glycated hemoglobin ≥ 6.5%, hospital inpatient registry, or glucose-lowering medication use. Information on mortality was derived from the national death registry. Favorable CVH metrics consisted of non-smoker, regular physical activity, a healthy diet, non-overweight, untreated resting blood pressure < 120/<80 mm Hg, and untreated total cholesterol < 200 mg/dL. Participants were categorized into three groups according to the number of favorable CVH metrics: unfavorable (0 or 1); intermediate (any 2 or 3); and favorable (4 or more). Inflammation marker, as measured by C-reactive protein (CRP), was assessed at baseline and categorized as low (≤ 3 mg/L) and high (> 3 mg/L). Data were analyzed using Cox regression models, flexible parametric survival models, and mediation models.ResultsDuring the follow-up (median: 11.7 years), 3133 (9.4%) cases of diabetes complications and 4701 (14.1%) deaths occurred. Compared to unfavorable CVH, favorable CVH was associated with a reduced risk of diabetes complications (HR, 0.35; 95% CI, 0.26-0.47) and all-cause mortality (HR, 0.53; 95% CI, 0.43-0.65). In participants with unfavorable CVH, life expectancy at age 45 had a significantly reduction of 7.20 (95% CI, 5.48-8.92) years compared to those with a favorable CVH. Among people with type 2 diabetes, the proportions of diabetes complications and all-cause mortality that would be reduced by promoting the favorable CVH was 61.5% and 39.1%, respectively. CRP level mediated 14.3% and 29.7% of the associations between CVH and diabetic complication and all-cause mortality, respectively.ConclusionA favorable CVH was associated with lower risk of diabetes complications and mortality risk, and was associated with a longer life expectancy among people with type 2 diabetes. This association may be in part accounted for by inflammatory processes. Our findings highlight the importance of favorable CVH for the prevention of diabetic complications and all-cause mortality among people with type 2 diabetes, and underscores the need to monitor inflammation among people with unfavorable CVH.</p>
7 Authors
- Yuan Zhang
- Rongrong Yang
- Yabing Hou
- Yanchun Chen
- Shu Li
- Yaogang Wang
- Hongxi Yang
1 Application
| Application ID | Title |
|---|---|
| 45676 | The joint effects of genetic, lifestyle and environmental risk factors on common diseases and multimorbidity. |
Enabling scientific discoveries that improve human health