國家衛生研究院 NHRI:Item 3990099045/7478
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/7478


    Title: Diabetes and end-stage renal disease synergistically contribute to increased incidence of cardiovascular events: A nationwide follow-up study during 1998-2009
    Authors: YT, C;Wu JL;Hsu CC;JD, W;JM., S
    Contributors: Division of Health Services and Preventive Medicine
    Abstract: Objective This study aimed to investigate the interaction of diabetes and end-stage renal disease (ESRD) on the risks of cardiovascular (CV) events. Research Design and Methods By using two representative national cohorts, we determined the age- and sex-specific incidences, twenty-year risks of incident CV events, including acute myocardial infarction (AMI), stroke and congestive heart failure (CHF), stratified by the presence of diabetes, de novo diabetes after ESRD or ESRD. Individuals were excluded if aged below 18 years or the presence of previous CV events or malignancy before enrollment. Cox proportional hazard models were also constructed with adjustments for competing risk of mortality. Results A total 648,851 non-ESRD individuals and 71,397 ESRD patients, including 53,342 and 34,754 diabetic patients respectively, were followed up during 1998-2009. A monotonic risk pattern of CV-related incidences was noted with the presence of diabetes, ESRD or both, respectively, after stratified by age and sex. De novo diabetes showed similar increased risks for CV incidences, especially AMI and stroke. There is a multiplicatively synergistic effect of diabetes and ESRD for CV related risks, especially for AMI and stroke, of which the adjusted hazard ratios (aHRs) [95% confidence intervals] were 5.24 [4.83-5.68] and 2.43[2.32-2.55], respectively in comparison with people without diabetes or ESRD; de novo diabetes after ESRD had similar effects with aHRs of 4.12[3.49-4.87] and 1.75[1.57-1.95], respectively. Conclusions Diabetes and ESRD synergistically increase risks of CV events. Proactive screening and control for diabetes in patients with ESRD should be built into our daily practice.
    Date: 2014-01
    Relation: Diabetes Care. 2014 Jan;37(1):277-285.
    Link to: http://dx.doi.org/10.2337/dc13-0781
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0149-5992&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000328676000050
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84890428519
    Appears in Collections:[Chih-Cheng Hsu] Periodical Articles

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