6 research outputs found
Cardiovascular risk factors associated with venous thromboembolism
Importance It is uncertain to what extent established cardiovascular risk factors are associated with venous thromboembolism (VTE). Objective To estimate the associations of major cardiovascular risk factors with VTE, ie, deep vein thrombosis and pulmonary embolism. Design, Setting, and Participants This study included individual participant data mostly from essentially population-based cohort studies from the Emerging Risk Factors Collaboration (ERFC; 731 728 participants; 75 cohorts; years of baseline surveys, February 1960 to June 2008; latest date of follow-up, December 2015) and the UK Biobank (421 537 participants; years of baseline surveys, March 2006 to September 2010; latest date of follow-up, February 2016). Participants without cardiovascular disease at baseline were included. Data were analyzed from June 2017 to September 2018. Exposures A panel of several established cardiovascular risk factors. Main Outcomes and Measures Hazard ratios (HRs) per 1-SD higher usual risk factor levels (or presence/absence). Incident fatal outcomes in ERFC (VTE, 1041; coronary heart disease [CHD], 25 131) and incident fatal/nonfatal outcomes in UK Biobank (VTE, 2321; CHD, 3385). Hazard ratios were adjusted for age, sex, smoking status, diabetes, and body mass index (BMI). Results Of the 731 728 participants from the ERFC, 403 396 (55.1%) were female, and the mean (SD) age at the time of the survey was 51.9 (9.0) years; of the 421 537 participants from the UK Biobank, 233 699 (55.4%) were female, and the mean (SD) age at the time of the survey was 56.4 (8.1) years. Risk factors for VTE included older age (ERFC: HR per decade, 2.67; 95% CI, 2.45-2.91; UK Biobank: HR, 1.81; 95% CI, 1.71-1.92), current smoking (ERFC: HR, 1.38; 95% CI, 1.20-1.58; UK Biobank: HR, 1.23; 95% CI, 1.08-1.40), and BMI (ERFC: HR per 1-SD higher BMI, 1.43; 95% CI, 1.35-1.50; UK Biobank: HR, 1.37; 95% CI, 1.32-1.41). For these factors, there were similar HRs for pulmonary embolism and deep vein thrombosis in UK Biobank (except adiposity was more strongly associated with pulmonary embolism) and similar HRs for unprovoked vs provoked VTE. Apart from adiposity, these risk factors were less strongly associated with VTE than CHD. There were inconsistent associations of VTEs with diabetes and blood pressure across ERFC and UK Biobank, and there was limited ability to study lipid and inflammation markers. Conclusions and Relevance Older age, smoking, and adiposity were consistently associated with higher VTE risk.</p
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Life expectancy associated with different ages at diagnosis of type 2 diabetes in high-income countries: 23 million person-years of observation
Background The prevalence of type 2 diabetes is increasing rapidly, particularly among younger age groups. Estimates
suggest that people with diabetes die, on average, 6 years earlier than people without diabetes. We aimed to provide
reliable estimates of the associations between age at diagnosis of diabetes and all-cause mortality, cause-specific
mortality, and reductions in life expectancy.
Methods For this observational study, we conducted a combined analysis of individual-participant data from 19 highincome countries using two large-scale data sources: the Emerging Risk Factors Collaboration (96 cohorts, median
baseline years 1961–2007, median latest follow-up years 1980–2013) and the UK Biobank (median baseline year 2006,
median latest follow-up year 2020). We calculated age-adjusted and sex-adjusted hazard ratios (HRs) for all-cause
mortality according to age at diagnosis of diabetes using data from 1 515 718 participants, in whom deaths were
recorded during 23·1 million person-years of follow-up. We estimated cumulative survival by applying age-specific
HRs to age-specific death rates from 2015 for the USA and the EU.
Findings For participants with diabetes, we observed a linear dose–response association between earlier age at diagnosis
and higher risk of all-cause mortality compared with participants without diabetes. HRs were 2·69 (95% CI 2·43–2·97)
when diagnosed at 30–39 years, 2·26 (2·08–2·45) at 40–49 years, 1·84 (1·72–1·97) at 50–59 years, 1·57 (1·47–1·67) at
60–69 years, and 1·39 (1·29–1·51) at 70 years and older. HRs per decade of earlier diagnosis were similar for men and
women. Using death rates from the USA, a 50-year-old individual with diabetes died on average 14 years earlier when
diagnosed aged 30 years, 10 years earlier when diagnosed aged 40 years, or 6 years earlier when diagnosed aged 50 years
than an individual without diabetes. Using EU death rates, the corresponding estimates were 13, 9, or 5 years earlier.
Interpretation Every decade of earlier diagnosis of diabetes was associated with about 3–4 years of lower life expectancy,
highlighting the need to develop and implement interventions that prevent or delay the onset of diabetes and to
intensify the treatment of risk factors among young adults diagnosed with diabetes
Recommended from our members
Life expectancy associated with different ages at diagnosis of type 2 diabetes in high-income countries: 23 million person-years of observation
Background The prevalence of type 2 diabetes is increasing rapidly, particularly among younger age groups. Estimates
suggest that people with diabetes die, on average, 6 years earlier than people without diabetes. We aimed to provide
reliable estimates of the associations between age at diagnosis of diabetes and all-cause mortality, cause-specific
mortality, and reductions in life expectancy.
Methods For this observational study, we conducted a combined analysis of individual-participant data from 19 highincome countries using two large-scale data sources: the Emerging Risk Factors Collaboration (96 cohorts, median
baseline years 1961–2007, median latest follow-up years 1980–2013) and the UK Biobank (median baseline year 2006,
median latest follow-up year 2020). We calculated age-adjusted and sex-adjusted hazard ratios (HRs) for all-cause
mortality according to age at diagnosis of diabetes using data from 1 515 718 participants, in whom deaths were
recorded during 23·1 million person-years of follow-up. We estimated cumulative survival by applying age-specific
HRs to age-specific death rates from 2015 for the USA and the EU.
Findings For participants with diabetes, we observed a linear dose–response association between earlier age at diagnosis
and higher risk of all-cause mortality compared with participants without diabetes. HRs were 2·69 (95% CI 2·43–2·97)
when diagnosed at 30–39 years, 2·26 (2·08–2·45) at 40–49 years, 1·84 (1·72–1·97) at 50–59 years, 1·57 (1·47–1·67) at
60–69 years, and 1·39 (1·29–1·51) at 70 years and older. HRs per decade of earlier diagnosis were similar for men and
women. Using death rates from the USA, a 50-year-old individual with diabetes died on average 14 years earlier when
diagnosed aged 30 years, 10 years earlier when diagnosed aged 40 years, or 6 years earlier when diagnosed aged 50 years
than an individual without diabetes. Using EU death rates, the corresponding estimates were 13, 9, or 5 years earlier.
Interpretation Every decade of earlier diagnosis of diabetes was associated with about 3–4 years of lower life expectancy,
highlighting the need to develop and implement interventions that prevent or delay the onset of diabetes and to
intensify the treatment of risk factors among young adults diagnosed with diabetes