Risks and Population Burden of Cardiovascular Diseases Associated with Diabetes in China: A Prospective Study of 0.5 Million Adults
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Le résumé fourni par la source
BACKGROUND: In China, diabetes prevalence is rising rapidly, but little is known about the associated risks and population burden of cardiovascular diseases. We assess associations of diabetes with major cardiovascular diseases and the relevance of diabetes duration and other modifiable risk factors to these associations. METHODS AND FINDINGS: A nationwide prospective study recruited 512,891 men and women aged 30-79 y between 25 June 2004 and 15 July 2008 from ten diverse localities across China. During ~7 y of follow-up, 7,353 cardiovascular deaths and 25,451 non-fatal major cardiovascular events were recorded among 488,760 participants without prior cardiovascular disease at baseline. Cox regression yielded adjusted hazard ratios (HRs) comparing disease risks in individuals with diabetes to those without. Overall, 5.4% (n = 26,335) of participants had self-reported (2.7%) or screen-detected (2.7%) diabetes. Individuals with self-reported diabetes had an adjusted HR of 2.07 (95% CI 1.90-2.26) for cardiovascular mortality. There were significant excess risks of major coronary event (2.44, 95% CI 2.18-2.73), ischaemic stroke (1.68, 95% CI 1.60-1.77), and intracerebral haemorrhage (1.24, 95% CI 1.07-1.44). Screen-detected diabetes was also associated with significant, though more modest, excess cardiovascular risks, with corresponding HRs of 1.66 (95% CI 1.51-1.83), 1.62 (95% CI 1.40-1.86), 1.48 (95% CI 1.40-1.57), and 1.17 (95% CI 1.01-1.36), respectively. Misclassification of screen-detected diabetes may have caused these risk estimates to be underestimated, whilst lack of data on lipids may have resulted in residual confounding of diabetes-associated cardiovascular disease risks. Among individuals with diabetes, cardiovascular risk increased progressively with duration of diabetes and number of other presenting modifiable cardiovascular risk factors. Assuming a causal association, diabetes now accounts for ~0.5 million (489,676, 95% CI 335,777-681,202) cardiovascular deaths annually in China. CONCLUSIONS: Among Chinese adults, diabetes is associated with significantly increased risks of major cardiovascular diseases. The increasing prevalence and younger age of onset of diabetes foreshadow greater diabetes-attributable disease burden in China.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Risks and Population Burden of Cardiovascular Diseases Associated with Diabetes in China: A Prospective Study of 0.5 Million Adults
- Date Crossref
- 05/07/2016
- Éditeur
- Public Library of Science (PLoS)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Oxford Clinical Trial Service Unit and Epidemiological Studies Unit pays non établi dans la noticeUniversité ou école supérieure
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Chinese Academy of Medical Sciences & Peking Union Medical College pays non établi dans la noticeUniversité ou école supérieure
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Peking University pays non établi dans la noticeUniversité ou école supérieure
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China National Center for Food Safety Risk Assessment pays non établi dans la noticeOrganisme public
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Xian Center for Disease Control and Prevention pays non établi dans la noticeOrganisme public
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Gansu Provincial Center for Disease Control and Prevention pays non établi dans la noticeOrganisme public
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Liu Zhou Center for Disease Prevention and Control pays non établi dans la noticeOrganisme public
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Jiangsu Provincial Center for Disease Control and Prevention pays non établi dans la noticeOrganisme public
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School of Public Health Department of Epidemiology and Biostatistics pays non établi dans la noticeUniversité ou école supérieure
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Tongxiang Centre for Disease Control and Prevention pays non établi dans la noticeOrganisation à but non lucratif
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Gansu Centre for Disease Control and Prevention pays non établi dans la noticeInstitution
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Liuzhou Centre for Disease Control and Prevention pays non établi dans la noticeInstitution
Clinical Trial Service Unit and Epidemiological Studies Unit — University of Oxford, Chinese Academy of Medical Sciences & Peking Union Medical College et Peking University, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.