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Increased Mortality Burden in Young Asian Subjects with Dysglycemia and Comorbidities.

ABSTRACT: BACKGROUND:High blood glucose level has a linear relationship with all-cause mortality. However, the influence of glycemic abnormality on mortality differs by age group. We aimed to analyze all-cause mortality according to glycemic status, age groups, and comorbidities using a national health database. METHODS:The 6,330,369 participants who underwent Korean National Health Screening in 2009 were followed up until 2016, with a median follow-up of 7.3 years. All-cause mortality rates were analyzed according to glycemic status (normoglycemia, impaired fasting glucose [IFG], newly diagnosed diabetes, diabetes duration <5 years, diabetes duration ?5 years), age groups (20-39, 40-65, and ?65 years), and comorbidities using the Korean National Health Insurance System database. RESULTS:At baseline, 712,901 (11.3%) subjects had diabetes. Compared with subjects without diabetes, those with diabetes at baseline showed increased mortality risk after adjustment for multiple risk factors (hazard ratio [HR] 1.613; 95% confidence interval [CI] 1.598,1.629), and those with IFG showed a significantly increased mortality risk compared with normoglycemic subjects (HR 1.053; 95% CI 1.042,1.064). Mortality risk associated with glycemic status decreased gradually from younger to older age groups and was consistently higher in those with diabetes with coronary heart disease, ischemic stroke or decreased renal function than those without comorbidities. CONCLUSION:Compared with normoglycemic subjects, subjects with diabetes and IFG had an increased mortality risk and the mortality risk was higher in the younger age group than in the older age group. The presence of diabetes and comorbid diseases synergistically increased mortality risk.

SUBMITTER: Rhee EJ

PROVIDER: S-EPMC7230603 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Increased Mortality Burden in Young Asian Subjects with Dysglycemia and Comorbidities.

Rhee Eun-Jung EJ Jung Inha I Kwon Hyemi H Park Se Eun SE Kim Yang-Hyun YH Han Kyung-Do KD Park Yong-Gyu YG Lee Won-Young WY

Journal of clinical medicine 20200407 4

<h4>Background</h4>High blood glucose level has a linear relationship with all-cause mortality. However, the influence of glycemic abnormality on mortality differs by age group. We aimed to analyze all-cause mortality according to glycemic status, age groups, and comorbidities using a national health database.<h4>Methods</h4>The 6,330,369 participants who underwent Korean National Health Screening in 2009 were followed up until 2016, with a median follow-up of 7.3 years. All-cause mortality rate ...[more]

PMID: 32272722

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Project description:BACKGROUND:African Americans with systemic lupus erythematosus (SLE) have increased renal disease compared to Caucasians, but differences in other comorbidities have not been well-described. We used an electronic health record (EHR) technique to test for differences in comorbidities in African Americans compared to Caucasians with SLE. METHODS:We used a de-identified EHR with 2.8 million subjects to identify SLE cases using a validated algorithm. We performed phenome-wide association studies (PheWAS) comparing African American to Caucasian SLE cases and African American SLE cases to matched non-SLE controls. Controls were age, sex, and race matched to SLE cases. For multiple testing, a false discovery rate (FDR) p value of 0.05 was used. RESULTS:We identified 270 African Americans and 715 Caucasians with SLE and 1425 matched African American controls. Compared to Caucasians with SLE adjusting for age and sex, African Americans with SLE had more comorbidities in every organ system. The most striking included hypertension odds ratio (OR) = 4.25, FDR p = 5.49 × 10- 15; renal dialysis OR = 10.90, FDR p = 8.75 × 10- 14; and pneumonia OR = 3.57, FDR p = 2.32 × 10- 8. Compared to the African American matched controls without SLE, African Americans with SLE were more likely to have comorbidities in every organ system. The most significant codes were renal and cardiac, and included renal failure (OR = 9.55, FDR p = 2.26 × 10- 40) and hypertensive heart and renal disease (OR = 8.08, FDR p = 1.78 × 10- 22). Adjusting for race, age, and sex in a model including both African American and Caucasian SLE cases and controls, SLE was independently associated with renal, cardiovascular, and infectious diseases (all p <?0.01). CONCLUSIONS:African Americans with SLE have an increased comorbidity burden compared to Caucasians with SLE and matched controls. This increase in comorbidities in African Americans with SLE highlights the need to monitor for cardiovascular and infectious complications.

Dataset Information

Increased Mortality Burden in Young Asian Subjects with Dysglycemia and Comorbidities.

Publications

Increased Mortality Burden in Young Asian Subjects with Dysglycemia and Comorbidities.

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