[Relationship between metabolic diseases and all-cause and cardiovascular death in an elderly male population during a 15-year follow-up]

Abstract

Objective: To explore the relationship between metabolic diseases and death from all causes, cardiovascular diseases (CVD) in an elderly male population.

Methods: A cohort of 1 447 elderly males was followed up for 15 years from 1996 to 2011. All of them received annual check-ups at our hospital. The Cox proportional hazard model was applied to multivariate survival analysis for all-cause and CVD mortality. And the cumulative survival rates were calculated by Kaplan-Meier method and log-rank test was used to compare the survival rates.

Results: During a 15-year follow-up, 639 subjects died, including 186 deaths from cardiovascular causes. Multivariate Cox regression analysis showed that age [relative risk (RR) = 1.131, 95% confidence interval (CI) 1.114-1.148], impaired glucose metabolism (RR = 1.344, 95% CI 1.139-1.585), hypertension (RR = 1.241, 95% CI 1.055-1.460) , elevated fasting glucose level (RR = 1.101, 95% CI 1.031-1.177) and lower body mass index (BMI) (RR = 0.968, 95% CI 0.943-0.993) increased the risks of all-cause mortality while age (RR = 1.119, 95% CI 1.086-1.153) , impaired glucose metabolism (RR = 1.856, 95% CI 1.386-2.458) and hypertension (RR = 1.699, 95% CI 1.242-2.324) elevated the risks of CVD mortality. The cumulative survival rates from all-cause and CVD mortality in impaired glucose regulation and diabetes group were significantly lower than those in normal glucose tolerance group (P < 0.01) . However, no difference existed between impaired glucose regulation (IGR) and diabetes groups. The cumulative survival rates from all-cause and CVD mortality significantly decreased in cases of impaired glucose metabolism and hypertension (P < 0.01) . The cumulative survival rates from all-cause mortality in low BMI group were significantly lower than those in normal and high BMI groups (P < 0.05) . A substantially higher risk of all-cause and CVD mortality was present in those with 2 or more metabolic disorders versus those with 0-1 metabolic disorder (P < 0.01).

Conclusions: Malignant tumor and CVD are the main cause of death for Chinese elderly male population. Advanced age, impaired glucose metabolism, hypertension and 2 or more concurrent metabolic disorders are risk factors of all-cause and CVD mortality. And underweight is associated with an increased risk of death in elders.