1. Association between all-cause mortality and vascular complications in U.S. adults with newly diagnosed type 2 diabetes (NHANES 1999-2018).
- Author
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Zhang TY, Wang XN, Kuang HY, Zhang ZM, Xu CY, Zhao KQ, Ha-Si WY, Zhang C, and Hao M
- Subjects
- Humans, Male, Female, Middle Aged, Adult, United States epidemiology, Aged, Cause of Death, Proportional Hazards Models, Diabetic Retinopathy epidemiology, Diabetic Retinopathy mortality, Diabetic Retinopathy diagnosis, Risk Factors, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 mortality, Diabetic Angiopathies mortality, Diabetic Angiopathies epidemiology, Diabetic Angiopathies diagnosis, Nutrition Surveys
- Abstract
Aims: The impact of macrovascular and microvascular complications, the common vascular complications of type 2 diabetes, on long-term mortality has been well evaluated, but the impact of different complications of newly diagnosed type 2 diabetes (diagnosed within the past 2 years) on long-term mortality has not been reported. We aimed to investigate the relationship between all-cause mortality and vascular complications in U.S. adults (aged ≥ 20 years) with newly diagnosed type 2 diabetes., Methods: We used data from the 1999-2018 National Health and Nutritional Examination Surveys (NHANES). Cox proportional hazard models was used to assess hazard ratios (HR) and 95% confidence intervals for all-cause mortality., Results: A total of 928 participants were enrolled in this study. At a mean follow-up of 10.8 years, 181 individuals died. In the fully adjusted model, the hazard ratio (HR) (95% confidence interval [CI]) of all-cause mortality for individuals with any single complication compared with those with newly diagnosed type 2 diabetes without complications was 2.24 (1.37, 3.69), and for individuals with two or more complications was 5.34 (3.01, 9.46).Co-existing Chronic kidney disease (CKD) and diabetic retinopathy (DR) at baseline were associated with the highest risk of death (HR 6.07[2.92-12.62]), followed by CKD and cardiovascular disease (CVD) (HR 4.98[2.79-8.89]) and CVD and DR (HR 4.58 [1.98-10.57])., Conclusion: The presence of single and combined diabetes complications exerts a long-term synergistic adverse impact on overall mortality in newly diagnosed U.S. adults with type 2 diabetes, underscoring the importance of comprehensive complication screening to enhance risk stratification and treatment., Competing Interests: Declarations. Approval of the research protocol: The study was approved by the local Human Ethics Committee and conducted in accordance with the principles expressed in the Declaration of Helsinki. All subjects provided written informed consent prior to enrollment. Approval date of Registry and the Registration No. of the study/trial: NHANES 1999–2004, Protocol #98 − 12. NHANES 2005–2006, Protocol #2005-06. NHANES 2007–2008, Continuation of Protocol #2005-06. NHANES 2009–2010, Continuation of Protocol #2005-06. NHANES 2011–2012, Protocol #2011-17. NHANES 2013–2014, Continuation of Protocol #2011-17. NHANES 2015–2016, Continuation of Protocol #2011-17. NHANES 2017–2018, Continuation of Protocol #2011-17 (Effective through October 26, 2017). Protocol #2018-01 (Effective beginning October 26, 2017) Informed consent: All subjects provided written informed consent prior to enrollment. Competing interests: The authors declare no conflict of interest., (© 2024. Springer-Verlag Italia S.r.l., part of Springer Nature.)
- Published
- 2025
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