American Journal of Epidemiology Vol. 128, No. 2: 389-401
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
MORTALITY AMONG DIABETICS IN A NATIONAL SAMPLE
1Division of Analysis, National Center for Health Statistics Federal Center Building no. 2, Room 2–27, 3700 East-West Highway, Hyattsville, MD 20782
2Clinical and Genetic Epidemiology Branch, Division of Epidemiology and Clinical Applications National Heart, Lung, and Blood Institute, Bethesda, MD
3National Diabetes Data Group, National Institute of Diabetes Digestive and Kidney Diseases, Bethesda, MD
4Biometry Office, Epidemiology, Demography, and Biometry Program, National Institute on Aging Bethesda, MD
Reprint requests to Dr. Joel C. Kleinman
The authors compare the mortality experience of a national sample of diabetic men and women with their nondiabetic counterparts. The study population consists of respondents from the First National Health and Nutrition Examination Survey (NHANES I), conducted in 1971–1975, who were traced in 1982–1984 through the NHANES I Epidemiologic Follow-up Study. Over the nine-year follow-up period, the age-adjusted death rates for diabetic men and women were twice the rates for nondiabetics. About 75% of the excess mortality among diabetic men and 57% among diabetic women was attributable to cardiovascular disease deaths. After adjustment for age, systolic blood pressure, serum cholesterol, body mass index, and smoking, the relative risk of death was 2.3 for diabetic men and 2.0 for diabetic women. The relative risk for diabetics was highest for ischemic heart disease mortality (2.8 for men and 2.5 for women) and lowest for noncardiovascular disease deaths (1.4 for men and 1.1 for women). When subjects who reported having had a heart attack prior to the baseline examination were excluded, the relative risks for ischemic heart disease mortality among diabetics remained substantial (2.4 for men and 2.6 for women). There was little evidence that the relative risk of death for diabetics compared with nondiabetics differed by age or sex, although 95% confidence intervals around these estimates were wide.
cardiovascular diseases; coronary disease; diabetes mellitus; follow-up studies; mortality
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