Dataset Information

HbA1c and the risks for all-cause and cardiovascular mortality in the general Japanese population: NIPPON DATA90.

ABSTRACT: OBJECTIVE: Associations between HbA1c and cardiovascular diseases (CVD) have been reported mainly in Western countries. It is not clear whether HbA1c measurements are useful for assessing CVD mortality risk in East Asian populations. RESEARCH DESIGN AND METHODS: The risk for cardiovascular death was evaluated in a large cohort of participants selected randomly from the overall Japanese population. A total of 7,120 participants (2,962 men and 4,158 women; mean age 52.3 years) free of previous CVD were followed for 15 years. Adjusted hazard ratios (HRs) and 95% CIs among categories of HbA1c (<5.0%, 5.0-5.4%, 5.5-5.9%, 6.0-6.4%, and ?6.5%) for participants without treatment for diabetes and HRs for participants with diabetes were calculated using a Cox proportional hazards model. RESULTS: During the study, there were 1,104 deaths, including 304 from CVD, 61 from coronary heart disease, and 127 from stroke (78 from cerebral infarction, 25 from cerebral hemorrhage, and 24 from unclassified stroke). Relations to HbA1c with all-cause mortality and CVD death were graded and continuous, and multivariate-adjusted HRs for CVD death in participants with HbA1c 6.0-6.4% and ?6.5% were 2.18 (95% CI 1.22-3.87) and 2.75 (1.43-5.28), respectively, compared with participants with HbA1c <5.0%. Similar associations were observed between HbA1c and death from coronary heart disease and death from cerebral infarction. CONCLUSIONS: High HbA1c levels were associated with increased risk for all-cause mortality and death from CVD, coronary heart disease, and cerebral infarction in general East Asian populations, as in Western populations.

SUBMITTER: Sakurai M

PROVIDER: S-EPMC3816883 | biostudies-other | 2013 Nov

REPOSITORIES: biostudies-other

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HbA1c and the risks for all-cause and cardiovascular mortality in the general Japanese population: NIPPON DATA90.

Sakurai Masaru M Saitoh Shigeyuki S Miura Katsuyuki K Nakagawa Hideaki H Ohnishi Hirofumi H Akasaka Hiroshi H Kadota Aya A Kita Yoshikuni Y Hayakawa Takehito T Ohkubo Takayoshi T Okayama Akira A Okamura Tomonori T Ueshima Hirotsugu H

Diabetes care 20130722 11

<h4>Objective</h4>Associations between HbA1c and cardiovascular diseases (CVD) have been reported mainly in Western countries. It is not clear whether HbA1c measurements are useful for assessing CVD mortality risk in East Asian populations.<h4>Research design and methods</h4>The risk for cardiovascular death was evaluated in a large cohort of participants selected randomly from the overall Japanese population. A total of 7,120 participants (2,962 men and 4,158 women; mean age 52.3 years) free of ...[more]

PMID: 23877989

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Project description:BackgroundPlasticizers, also called phthalates, are a group of chemicals widely used in daily life. A previous report showed no significant association between phthalate metabolite concentrations and mortality. We investigated the association of urinary phthalate levels and individual phthalate metabolite levels with all-cause and cardiovascular disease (CVD) mortality after standardizing the phthalate concentration.MethodsA total of 6,625 participants were recruited from a nationally representative sample of adults aged 40 years or older who were enrolled in the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2014 and were followed up through December 31, 2015. Data were analyzed from January 2021 to June 2021. NHANES-linked updated National Death Index public access files were used to acquire information on mortality status and cause of death. The present study conducted extended follow-up of an earlier analysis. Cox proportional hazard models were performed to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of covariate-adjusted creatinine standardization urinary phthalate concentrations with all-cause and CVD mortality after adjusting for demographics, lifestyle factors and comorbidity variables.ResultsThe mean ± standard deviation age of all participants in the final study was 59.9±12.6 years old, and 49.6% of the participants were male. The median follow-up time was 73 months (range 1-157 months). At the censoring date of December 31, 2015, 3,023 participants were identified as deceased (13.4%). A fully adjusted Cox model showed that a urinary di(2-ethylhexyl) phthalate (DEHP) concentration >= 83.4 ng/mL was associated with a slight increase in all-cause mortality (HR 1.27, 95% CI 1.03, 1.57, P for trend= 0.014) and CVD mortality (HR 2.19, 95% CI 1.35, 3.54, P for trend= 0.002). Similarly, urinary mono-2-ethyl-5-carboxypentyl phthalate (MECPP) levels >= 39.2 ng/mL were associated with increased CVD mortality (HR 2.33, 95% CI 1.45, 3.73, P for trend < 0.001). Restricted cubic spline analyses suggested linear associations of DEHP and MECPP levels with all-cause and CVD mortality.ConclusionIn this large nationally representative sample of American adults, high urinary DEHP and MECPP were significantly associated with all-cause and CVD mortality after adjusting for demographics, lifestyle factors and comorbidity variables.

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Dataset Information

HbA1c and the risks for all-cause and cardiovascular mortality in the general Japanese population: NIPPON DATA90.

Publications

HbA1c and the risks for all-cause and cardiovascular mortality in the general Japanese population: NIPPON DATA90.

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