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. 2010 Feb;33(2):311-6.
doi: 10.2337/dc09-1215. Epub 2009 Nov 16.

Diabetes as a determinant of mortality in cystic fibrosis

Parinya Chamnan  1 , Brian S F Shine, Charles S Haworth, Diana Bilton, Amanda I Adler
Affiliations

Diabetes as a determinant of mortality in cystic fibrosis

Parinya Chamnan et al. Diabetes Care. 2010 Feb.

Abstract

Objective: Diabetes is increasingly common in cystic fibrosis, but little information describing its influence on mortality exists. Using national U.K. data, in this study we document diabetes-specific mortality rates, estimate the impact of diabetes on survival, and estimate population-attributable fractions.

Research design and methods: This retrospective cohort study identified 8,029 individuals aged 0-65 years from the U.K. Cystic Fibrosis Registry (1996-2005). A total of 5,892 patients were included in analyses of mortality rates, and 4,234 were included in analyses of risk factors. We calculated age-adjusted mortality rates using Poisson regression, standardized mortality ratios using the population of England and Wales, and relative risks using proportional hazards modeling.

Results: During 17,672 person-years of follow-up, 393 subjects died. The age-adjusted mortality rate was 1.8 per 100 person-years (95% CI 1.6-2.0). The age-adjusted mortality rates per 100 person-years were 2.0 (1.8-2.4) in female subjects and 1.6 (1.4-1.9) in male subjects, and 4.2 (3.4-5.1) in individuals with diabetes vs. 1.5 (1.3-1.7) in those without diabetes. Independent risk factors for death included diabetes (hazard ratio 1.31 [95% CI 1.03-1.67], female sex (1.71 [1.36-2.14]) plus poorer pulmonary function, lower BMI, Burkholderia cepacia infection, absence of Staphylococcus aureus infection, allergic bronchopulmonary aspergillosis, liver disease, prior organ transplantation, and corticosteroid use.

Conclusions: Individuals with cystic fibrosis die earlier if they have diabetes, which, if delayed or better treated, might reasonably extend survival; this hypothesis merits testing.

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Figures

Figure 1
Figure 1
Mortality rates with 95% CI by age and sex in patients with cystic fibrosis. □, Male patients; ■, female patients. *P < 0.05, difference between sexes.
Figure 2
Figure 2
Mortality rates with 95% CI by age and diabetes in patients with cystic fibrosis. □, Patients without diabetes; ■, patients with diabetes. *P < 0.05, difference between individuals with and without diabetes.
Figure 3
Figure 3
Risk factors for death in cystic fibrosis. Cox proportional hazards modeling adjusted for age and all risk factors in the figure. n = 4,234.
See this image and copyright information in PMC

References

    1. Cystic Fibrosis Foundation Patient Registry 2007 Annual Data Report, Bethesda, MD
    1. Dodge JA, Lewis PA, Stanton M, Wilsher J. Cystic fibrosis mortality and survival in the UK: 1947–2003. Eur Respir J 2007; 29: 522– 526 - PubMed
    1. Bellis G, Cazes MH, Parant A, Gaimard M, Travers C, Le Roux E, Ravilly S, Rault G. Cystic fibrosis mortality trends in France. J Cyst Fibros 2007; 6: 179– 186 - PubMed
    1. Dodge JA, Morison S, Lewis PA, Coles EC, Geddes D, Russell G, Littlewood JM, Scott MT. Incidence, population, and survival of cystic fibrosis in the UK, 1968–95. UK Cystic Fibrosis Survey Management Committee. Arch Dis Child 1997; 77: 493– 496 - PMC - PubMed
    1. Adler AI, Shine BS, Chamnan P, Haworth CS, Bilton D. Genetic determinants and epidemiology of cystic fibrosis-related diabetes: results from a British cohort of children and adults. Diabetes Care 2008; 31: 1789– 1794 - PMC - PubMed

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