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. 2018 Jul 9;13(7):e0197376.
doi: 10.1371/journal.pone.0197376. eCollection 2018.

Causes and predictors of mortality in Asian Indians with and without diabetes-10 year follow-up of the Chennai Urban Rural Epidemiology Study (CURES - 150)

Ranjit Mohan Anjana  1 , Ranjit Unnikrishnan  1 , Poongkunran Mugilan  1 , Padoor Sethuraman Jagdish  1 , Balasubramanian Parthasarathy  1 , Mohan Deepa  1 , Geetha Loganathan  1 , Rajendran Ashok Kumar  1 , Thangarajan Rahulashankiruthiyayan  1 , Ganesan Uma Sankari  1 , Ulagamathesan Venkatesan  1 , Viswanathan Mohan  1 , Coimbatore Subramanian Shanthi Rani  1
Affiliations

Causes and predictors of mortality in Asian Indians with and without diabetes-10 year follow-up of the Chennai Urban Rural Epidemiology Study (CURES - 150)

Ranjit Mohan Anjana et al. PLoS One. .

Abstract

Background: The incidence and prevalence of diabetes is increasing worldwide and it is the fifth leading cause of mortality accounting for over 3.8 million deaths annually. Despite the enormity of the diabetes-related health burdens, very few studies have evaluated the factors associated with mortality among people with diabetes in India. We sought to study the causes and predictors of mortality among urban Asian Indians with and without diabetes.

Methods and findings: Of 2273 adults (27,850 person-years of follow-up) from the 10-year follow-up of the Chennai Urban Rural Epidemiology Study (CURES), the cause of death could be ascertained in 552 individuals out of the 671 who had died (response rate 82.3%). Verbal autopsy was obtained from the family members of the deceased and this was adjudicated by trained physicians. The age-standardized mortality rate was 28.2 (95%CI 25.9-30.6) per 100,000 population. Mortality rates were significantly higher in individuals with diabetes compared to those without [27.9(95% CI 25.5-30.6) vs. 8.0 (6.6-9.9) per 1000 person years]. Compared to individuals of normal body mass index, underweight individuals had higher risk of mortality (Hazard ratio 1.49; 95% CI 1.11-2.0), whereas overweight and obese individuals did not show a higher risk. The population-attributable risk for all-cause mortality in the entire study cohort was highest for ischemic heart disease and diabetes. The excess mortality attributable to diabetes was highest in the age group of 51 to 70 years, and was mostly accounted for by renal disease (Rate ratio 5.68, 95%CI 2.43-6.23), ischemic heart disease (4.23,2.78-6.67), and cerebrovascular disease (4.00,1.87-9.81).

Conclusion: Underweight (but not overweight or obesity) was strongly associated with mortality in this Asian Indian population. Ischemic heart disease and diabetes contributed the most to risk for all cause mortality. Excess mortality due to diabetes was higher in relatively younger individuals and was mostly accounted for by renal disease.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of the study cohort.
Fig 2
Fig 2. Hazard ratios for all-cause mortality based on BMI.
Fig 3
Fig 3. Excess mortality among individuals with and without diabetes.
See this image and copyright information in PMC

References

    1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004. May; 27(5):1047–53. - PubMed
    1. Yoon U, Kwok LL, Magkidis A. Efficacy of lifestyle interventions in reducing diabetes incidence in patients with impaired glucose tolerance: a systematic review of randomized controlled trials. Metabolism. 2013. February;62(2):303–14. doi: 10.1016/j.metabol.2012.07.009 - DOI - PubMed
    1. Roglic G, Unwin N, Bennett PH, Mathers C, Tuomilehto J, Nag S, et al. The burden of mortality attributable to diabetes: realistic estimates for the year 2000. Diabetes Care. 2005. September;28(9):2130–5. - PubMed
    1. Ballotari P, Ranieri SC, Luberto F, Caroli S, Greci M, Giorgi Rossi P, et al. Sex differences in cardiovascular mortality in diabetics and nondiabetic subjects: a population-based study (Italy). Int J Endocrinol. 2015; 2015;2015:914057 - PMC - PubMed
    1. Preis SR, Hwang SJ, Coady S, Pencina MJ, D'Agostino RB Sr, Savage PJ, et al. Trends in all-cause and cardiovascular disease mortality among women and men with and without diabetes mellitus in the Framingham Heart Study, 1950 to 2005. Circulation. 2009. April 7;119(13):1728–35. doi: 10.1161/CIRCULATIONAHA.108.829176 - DOI - PMC - PubMed

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