Relationship of glycemic control, exogenous insulin, and C-peptide levels to ischemic heart disease mortality over a 16-year period in people with older-onset diabetes: the Wisconsin Epidermologic Study of Diabetic Retinopathy (WESDR)
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Publication Date: | 2008 |
Other Authors: | , , |
Format: | Article |
Language: | eng |
Source: | Repositório Institucional da UNIFESP |
Download full: | http://repositorio.unifesp.br/handle/11600/30476 http://dx.doi.org/10.2337/dc07-1161 |
Summary: | OBJECTIVE - the purpose of this study was to examine the relationship of glycemic control and exogenous and endogenous insulin levels with all-cause and cause-specific mortality (ischemic heart disease and stroke) in an older-onset diabetic population.RESEARCH DESIGN and METHODS - the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) is an ongoing, prospective, population-based cohort study of individuals with diabetes first examined in 1980-1982. A stratified sample of all individuals with diabetes diagnosed at 30 years of age or older was labeled older-onset (n = 1,370). Those participating in the 1984-1986 examination phase (n = 1,007) were included in the analysis. Endogenous insulin was determined by measurements of plasma C-peptide (in nanomoles per liter), and exogenous insulin was calculated in units per kilogram per day. Glycemic control was determined by levels of glycosylated hemoglobin (HbA(1)).RESULTS - After 16 years of follow-up, 824 individuals died (all-cause mortality); 358 deaths involved ischemic heart disease and 137 involved stroke. C-peptide and HbA(1) were significantly associated with all-cause and ischemic heart disease mortality in our study. the hazard ratio (95% CI) values for all-cause mortality were 1.12 (1.07-1.17) per 1% increase in HbA, 1.20 (0.85-1.69) per 1 unit . kg(-1) - day(-1) increase in exogenous insulin, and 1.15 (1.04-1.29) per 1 nmol/l increase in C-peptide and for ischemic heart disease mortality were 1.14 (1.06-1.22), 1.50 (0.92-2.46), and 1.19 (1.02-1.39) for HbA(1), exogenous insulin, and C-peptide, respectively, after adjusting for relevant confounders. C-peptide was associated with stroke mortality only among men (1.65 [1.07-2.53]).CONCLUSIONS - Our results show that individuals with higher endogenous insulin levels are at higher risk of all-cause, ischemic heart disease, and stroke mortality. |
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Hirai, Flávio Eduardo [UNIFESP]Moss, Scot E.Klein, Barbara E. K.Klein, RonaldUniv WisconsinUniversidade Federal de São Paulo (UNIFESP)2016-01-24T13:49:36Z2016-01-24T13:49:36Z2008-03-01Diabetes Care. Alexandria: Amer Diabetes Assoc, v. 31, n. 3, p. 493-497, 2008.0149-5992http://repositorio.unifesp.br/handle/11600/30476http://dx.doi.org/10.2337/dc07-116110.2337/dc07-1161WOS:000253801100024OBJECTIVE - the purpose of this study was to examine the relationship of glycemic control and exogenous and endogenous insulin levels with all-cause and cause-specific mortality (ischemic heart disease and stroke) in an older-onset diabetic population.RESEARCH DESIGN and METHODS - the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) is an ongoing, prospective, population-based cohort study of individuals with diabetes first examined in 1980-1982. A stratified sample of all individuals with diabetes diagnosed at 30 years of age or older was labeled older-onset (n = 1,370). Those participating in the 1984-1986 examination phase (n = 1,007) were included in the analysis. Endogenous insulin was determined by measurements of plasma C-peptide (in nanomoles per liter), and exogenous insulin was calculated in units per kilogram per day. Glycemic control was determined by levels of glycosylated hemoglobin (HbA(1)).RESULTS - After 16 years of follow-up, 824 individuals died (all-cause mortality); 358 deaths involved ischemic heart disease and 137 involved stroke. C-peptide and HbA(1) were significantly associated with all-cause and ischemic heart disease mortality in our study. the hazard ratio (95% CI) values for all-cause mortality were 1.12 (1.07-1.17) per 1% increase in HbA, 1.20 (0.85-1.69) per 1 unit . kg(-1) - day(-1) increase in exogenous insulin, and 1.15 (1.04-1.29) per 1 nmol/l increase in C-peptide and for ischemic heart disease mortality were 1.14 (1.06-1.22), 1.50 (0.92-2.46), and 1.19 (1.02-1.39) for HbA(1), exogenous insulin, and C-peptide, respectively, after adjusting for relevant confounders. C-peptide was associated with stroke mortality only among men (1.65 [1.07-2.53]).CONCLUSIONS - Our results show that individuals with higher endogenous insulin levels are at higher risk of all-cause, ischemic heart disease, and stroke mortality.Univ Wisconsin, Sch Med & Publ Hlth, Dept Ophthalmol & Visual Sci, Madison, WI 53726 USAUniversidade Federal de São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, EPM, São Paulo, BrazilWeb of Science493-497engAmer Diabetes AssocDiabetes CareRelationship of glycemic control, exogenous insulin, and C-peptide levels to ischemic heart disease mortality over a 16-year period in people with older-onset diabetes: the Wisconsin Epidermologic Study of Diabetic Retinopathy (WESDR)info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP11600/304762022-11-03 10:40:50.642metadata only accessoai:repositorio.unifesp.br:11600/30476Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-05-25T12:27:48.649827Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Relationship of glycemic control, exogenous insulin, and C-peptide levels to ischemic heart disease mortality over a 16-year period in people with older-onset diabetes: the Wisconsin Epidermologic Study of Diabetic Retinopathy (WESDR) |
title |
Relationship of glycemic control, exogenous insulin, and C-peptide levels to ischemic heart disease mortality over a 16-year period in people with older-onset diabetes: the Wisconsin Epidermologic Study of Diabetic Retinopathy (WESDR) |
spellingShingle |
Relationship of glycemic control, exogenous insulin, and C-peptide levels to ischemic heart disease mortality over a 16-year period in people with older-onset diabetes: the Wisconsin Epidermologic Study of Diabetic Retinopathy (WESDR) Hirai, Flávio Eduardo [UNIFESP] |
title_short |
Relationship of glycemic control, exogenous insulin, and C-peptide levels to ischemic heart disease mortality over a 16-year period in people with older-onset diabetes: the Wisconsin Epidermologic Study of Diabetic Retinopathy (WESDR) |
title_full |
Relationship of glycemic control, exogenous insulin, and C-peptide levels to ischemic heart disease mortality over a 16-year period in people with older-onset diabetes: the Wisconsin Epidermologic Study of Diabetic Retinopathy (WESDR) |
title_fullStr |
Relationship of glycemic control, exogenous insulin, and C-peptide levels to ischemic heart disease mortality over a 16-year period in people with older-onset diabetes: the Wisconsin Epidermologic Study of Diabetic Retinopathy (WESDR) |
title_full_unstemmed |
Relationship of glycemic control, exogenous insulin, and C-peptide levels to ischemic heart disease mortality over a 16-year period in people with older-onset diabetes: the Wisconsin Epidermologic Study of Diabetic Retinopathy (WESDR) |
title_sort |
Relationship of glycemic control, exogenous insulin, and C-peptide levels to ischemic heart disease mortality over a 16-year period in people with older-onset diabetes: the Wisconsin Epidermologic Study of Diabetic Retinopathy (WESDR) |
author |
Hirai, Flávio Eduardo [UNIFESP] |
author_facet |
Hirai, Flávio Eduardo [UNIFESP] Moss, Scot E. Klein, Barbara E. K. Klein, Ronald |
author_role |
author |
author2 |
Moss, Scot E. Klein, Barbara E. K. Klein, Ronald |
author2_role |
author author author |
dc.contributor.institution.none.fl_str_mv |
Univ Wisconsin Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Hirai, Flávio Eduardo [UNIFESP] Moss, Scot E. Klein, Barbara E. K. Klein, Ronald |
description |
OBJECTIVE - the purpose of this study was to examine the relationship of glycemic control and exogenous and endogenous insulin levels with all-cause and cause-specific mortality (ischemic heart disease and stroke) in an older-onset diabetic population.RESEARCH DESIGN and METHODS - the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) is an ongoing, prospective, population-based cohort study of individuals with diabetes first examined in 1980-1982. A stratified sample of all individuals with diabetes diagnosed at 30 years of age or older was labeled older-onset (n = 1,370). Those participating in the 1984-1986 examination phase (n = 1,007) were included in the analysis. Endogenous insulin was determined by measurements of plasma C-peptide (in nanomoles per liter), and exogenous insulin was calculated in units per kilogram per day. Glycemic control was determined by levels of glycosylated hemoglobin (HbA(1)).RESULTS - After 16 years of follow-up, 824 individuals died (all-cause mortality); 358 deaths involved ischemic heart disease and 137 involved stroke. C-peptide and HbA(1) were significantly associated with all-cause and ischemic heart disease mortality in our study. the hazard ratio (95% CI) values for all-cause mortality were 1.12 (1.07-1.17) per 1% increase in HbA, 1.20 (0.85-1.69) per 1 unit . kg(-1) - day(-1) increase in exogenous insulin, and 1.15 (1.04-1.29) per 1 nmol/l increase in C-peptide and for ischemic heart disease mortality were 1.14 (1.06-1.22), 1.50 (0.92-2.46), and 1.19 (1.02-1.39) for HbA(1), exogenous insulin, and C-peptide, respectively, after adjusting for relevant confounders. C-peptide was associated with stroke mortality only among men (1.65 [1.07-2.53]).CONCLUSIONS - Our results show that individuals with higher endogenous insulin levels are at higher risk of all-cause, ischemic heart disease, and stroke mortality. |
publishDate |
2008 |
dc.date.issued.fl_str_mv |
2008-03-01 |
dc.date.accessioned.fl_str_mv |
2016-01-24T13:49:36Z |
dc.date.available.fl_str_mv |
2016-01-24T13:49:36Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Diabetes Care. Alexandria: Amer Diabetes Assoc, v. 31, n. 3, p. 493-497, 2008. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/30476 http://dx.doi.org/10.2337/dc07-1161 |
dc.identifier.issn.none.fl_str_mv |
0149-5992 |
dc.identifier.doi.none.fl_str_mv |
10.2337/dc07-1161 |
dc.identifier.wos.none.fl_str_mv |
WOS:000253801100024 |
identifier_str_mv |
Diabetes Care. Alexandria: Amer Diabetes Assoc, v. 31, n. 3, p. 493-497, 2008. 0149-5992 10.2337/dc07-1161 WOS:000253801100024 |
url |
http://repositorio.unifesp.br/handle/11600/30476 http://dx.doi.org/10.2337/dc07-1161 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
Diabetes Care |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
493-497 |
dc.publisher.none.fl_str_mv |
Amer Diabetes Assoc |
publisher.none.fl_str_mv |
Amer Diabetes Assoc |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
|
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1783460293924356096 |