Renal hyperfiltration is independently associated with increased all-cause mortality in individuals with type 2 diabetes: a prospective cohort study

IntroductionIn addition to favoring renal disease progression, renal ‘hyperfiltration’ has been associated with an increased risk of death, though it is unclear whether and how excess mortality is related to increased renal function. We investigated whether renal hyperfiltration is an independent predictor of death in patients with type 2 diabetes from the Renal Insufficiency And Cardiovascular Events Italian multicenter study.Research design and methodsThis observational, prospective cohort study enrolled 15 773 patients with type 2 diabetes consecutively attending 19 Italian diabetes clinics in 2006–2008. Serum creatinine, albuminuria, cardiovascular risk factors, and complications/comorbidities were assessed at baseline. Vital status on 31 October 2015 was retrieved for 15 656 patients (99.26%). Patients were stratified (A) by absolute estimated glomerular filtration rate (eGFR) values in eGFR deciles or Kidney Disease: Improving Global Outcomes (KDIGO) categories and (B) based on age-corrected thresholds or age and gender-specific 95th and 5th percentiles in hyperfiltration, hypofiltration, and normofiltration groups.ResultsThe highest eGFR decile/category and the hyperfiltration group included (partly) different individuals with similar clinical features. Age and gender-adjusted death rates were significantly higher in deciles 1, 9, and 10 (≥103.9, 50.9–62.7, and <50.9 mL/min/1.73 m2, respectively) versus the reference decile 3 (92.9–97.5 mL/min/1.73 m2). Mortality risk, adjusted for multiple confounders, was also increased in deciles 1 (HR 1.461 (95% CI 1.175 to 1.818), p=0.001), 9 (1.312 (95% CI 1.107 to 1.555), p=0.002), and 10 (1.976 (95% CI 1.673 to 2.333), p<0.0001) versus decile 3. Similar results were obtained by stratifying patients by KDIGO categories. Death rates and adjusted mortality risks were significantly higher in hyperfiltering and particularly hypofiltering versus normofiltering individuals.ConclusionsIn type 2 diabetes, both high-normal eGFR and hyperfiltration are associated with an increased risk of death from any cause, independent of confounders that may directly impact on mortality and/or affect GFR estimation. Further studies are required to clarify the nature of this relationship.Trial registration numberNCT00715481.

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Regular consumption of soft drinks is associated with type 2 diabetes incidence in Mexican adults: findings from a prospective cohort study

Nutrition Journal ◽

10.1186/s12937-020-00642-9 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Leticia Torres-Ibarra ◽

Berenice Rivera-Paredez ◽

Rubí Hernández-López ◽

Francisco Canto-Osorio ◽

Luz María Sánchez-Romero ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Prospective Cohort ◽

Soft Drinks ◽

Self Report ◽

Diabetes Incidence ◽

Increased Risk ◽

Mexican Adults ◽

Incident Cases

Abstract Background Although high consumption of soft drinks has been associated with excess of type 2 diabetes risk, the strength of this association in the Mexican population, where a type 2 diabetes genetic susceptibility has been well established, has been scarcely studied. This study aimed to estimate the risk of type 2 diabetes due to soft drinks consumption in a cohort of Mexicans. Methods We used data on 1445 participants from the Health Workers Cohort Study, a prospective cohort conducted in Cuernavaca, Mexico. Soft drinks consumption was assessed with a semi-quantitative 116-item food frequency questionnaire. Incident type 2 diabetes was defined as self-report of physician-diagnosed type 2 diabetes, fasting glucose > 126 mg/dl, or hypoglycemic medication at any examination. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models. Results With a total of 9526.2 person-years of follow-up, 109 incident cases of type 2 diabetes were observed. Type 2 diabetes incidence rate was 7.6, 11.0, and 17.1 per 1000 person-years across levels of soft drinks consumption of < 1, 1–4, and ≥ 5 servings/week, respectively (p < 0.001 for trend). The intake of ≥5 soft drinks/week was significantly associated with an increased risk of type 2 diabetes (HR 1.9 95% CI:1.0–3.5) compared with consumption of < 1/week (p-trend = 0.040). The HR was attenuated by further adjustment for body mass index (HR 1.5 95%CI:0.8–2.8) and abdominal obesity (HR 1.6 95%CI:0.8–3.0). Conclusions The consumption of soft drinks was associated with a higher risk of type 2 diabetes in a cohort of Mexican adults. Our results further support recommendations to limit soft drinks intake to address the growing diabetes epidemic in Mexico.

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Estimated glucose disposal rate and risk of stroke and mortality in type 2 diabetes: a nationwide cohort study

Cardiovascular Diabetology ◽

10.1186/s12933-021-01394-4 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Alexander Zabala ◽

Vladimer Darsalia ◽

Marcus Lind ◽

Ann-Marie Svensson ◽

Stefan Franzén ◽

...

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Cohort Study ◽

Cox Regression ◽

Glucose Disposal ◽

Risk Of Death ◽

Increased Risk ◽

Estimated Glucose Disposal Rate ◽

Glucose Disposal Rate

Abstract Background and aims Insulin resistance contributes to the development of type 2 diabetes (T2D) and is also a cardiovascular risk factor. The aim of this study was to investigate the potential association between insulin resistance measured by estimated glucose disposal rate (eGDR) and risk of stroke and mortality thereof in people with T2D. Materials and methods Nationwide population based observational cohort study that included all T2D patients from the Swedish national diabetes registry between 2004 and 2016 with full data on eGDR and categorised as following: < 4, 4–6, 6–8, and ≥ 8 mg/kg/min. We calculated crude incidence rates and 95% confidence intervals (CIs) and used multiple Cox regression to estimate hazard ratios (HRs) to assess the association between the risk of stroke and death, according to the eGDR categories in which the lowest category < 4 (i.e., highest grade of insulin resistance), served as a reference. The relative importance attributed of each factor in the eGDR formula was measured by the R2 (± SE) values calculating the explainable log-likelihoods in the Cox regression. Results A total of 104 697 T2D individuals, 44.5% women, mean age of 63 years, were included. During a median follow up-time of 5.6 years, 4201 strokes occurred (4.0%). After multivariate adjustment the HRs (95% CI) for stroke in patients with eGDR categories between 4–6, 6–8 and > 8 were: 0.77 (0.69–0.87), 0.68 (0.58–0.80) and 0.60 (0.48–0.76), compared to the reference < 4. Corresponding numbers for the risk of death were: 0.82 (0.70–0.94), 0.75 (0.64–0.88) and 0.68 (0.53–0.89). The attributed relative risk R2 (± SE) for each variable in the eGDR formula and stroke was for: hypertension (0.045 ± 0.0024), HbA1c (0.013 ± 0.0014), and waist (0.006 ± 0.0009), respectively. Conclusion A low eGDR (a measure of insulin resistance) is associated with an increased risk of stroke and death in individuals with T2D. The relative attributed risk was most important for hypertension.

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Serum uric acid levels are associated with increased risk of newly developed diabetic retinopathy among Japanese male patients with type 2 diabetes: A prospective cohort study (diabetes distress and care registry at Tenri [DDCRT 13])

Diabetes/Metabolism Research and Reviews ◽

10.1002/dmrr.2905 ◽

2017 ◽

Vol 33 (7) ◽

pp. e2905 ◽

Cited By ~ 9

Author(s):

Hirohito Kuwata ◽

Shintaro Okamura ◽

Yasuaki Hayashino ◽

Satoru Tsujii ◽

Hitoshi Ishii ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Retinopathy ◽

Uric Acid ◽

Cohort Study ◽

Prospective Cohort ◽

Diabetes Distress ◽

Japanese Male ◽

Increased Risk ◽

Male Patients

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Age and gender related effects on adipose tissue compartments of subjects with increased risk for type 2 diabetes: a whole body MRI / MRS study

Magnetic Resonance Materials in Physics Biology and Medicine ◽

10.1007/s10334-005-0104-x ◽

2005 ◽

Vol 18 (3) ◽

pp. 128-137 ◽

Cited By ~ 83

Author(s):

J. Machann ◽

C. Thamer ◽

B. Schnoedt ◽

N. Stefan ◽

M. Stumvoll ◽

...

Keyword(s):

Type 2 Diabetes ◽

Adipose Tissue ◽

Whole Body ◽

Age And Gender ◽

Whole Body Mri ◽

Increased Risk ◽

And Gender ◽

Tissue Compartments

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Regular Consumption of Soft Drinks is Associated with Type 2 Diabetes Incidence in Mexican Adults: Findings from a Prospective Cohort Study.

10.21203/rs.3.rs-51105/v1 ◽

2020 ◽

Author(s):

Leticia Torres-Ibarra ◽

Berenice Rivera-Paredez ◽

Rubí Hernández-López ◽

Francisco Canto-Osorio ◽

Luz María Sánchez-Romero ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Prospective Cohort ◽

Soft Drinks ◽

Diabetes Incidence ◽

Family History Of Diabetes ◽

Increased Risk ◽

Mexican Adults ◽

Incident Cases

Abstract Background: Although high consumption of soft drinks has been associated with excess of type 2 diabetes risk, the strength of this association in the Mexican population, where a type 2 diabetes genetic susceptibility has well established, has been scarcely studied. This study aimed to estimate the risk of type 2 diabetes due to soft drinks consumption in a cohort of Mexicans. Methods: We used data on 1,445 participants from the Health Workers Cohort Study, a prospective cohort conducted in Cuernavaca, Mexico. Soft drinks consumption was assessed with a semi-quantitative 116-item food frequency questionnaire. Incident type 2 diabetes was defined as self-report of physician-diagnosed type 2 diabetes, or fasting glucose >126 mg/dl, or use of hypoglycemic medication at any examination. Hazard ratios (HRs) along with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models.Results: With a total of 9,526.2 person-years of follow-up, 109 incident cases of type 2 diabetes were observed. Type 2 diabetes incidence rate was 7.6, 11.0, and 17.1 per 1,000 person-years across levels of soft drinks consumption of <1, 1-4, and ³5 servings/week, respectively (p<0.001 for trend). The intake of ≥5 soft drinks/week was significantly associated with an increased risk of type 2 diabetes (HR 2.0, 95%CI: 1.1–3.8) compared with consumption of <1/week. This association was not modified by family history of diabetes. The HR was attenuated by further adjustment for body mass index (HR 1.6, 95%CI: 0.8-2.9) and abdominal obesity (HR 1.7, 95%CI: 0.9-3.2). Conclusions: The consumption of soft drinks was associated with a higher risk of type 2 diabetes in a cohort of Mexican adults. Our results further support recommendations to limit intake of soft drinks to address the growing diabetes epidemic in Mexico.

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Type 2 diabetes and COVID-19 related mortality in the critical care setting: A national cohort study in England, March-July 2020

10.2337/figshare.13034210 ◽

2020 ◽

Author(s):

John M. Dennis ◽

Bilal A Mateen ◽

Raphael Sonabend ◽

Nicholas J Thomas ◽

Kashyap A Patel ◽

...

Keyword(s):

Type 2 Diabetes ◽

Critical Care ◽

Cohort Study ◽

Care Setting ◽

Critical Care Setting ◽

Risk Of Death ◽

Risk Increase ◽

Increased Risk ◽

All Cause Mortality

Objective: To describe the relationship between type 2 diabetes and all-cause mortality amongst adults with COVID-19 in the critical care setting. Research Design and Methods: Nationwide retrospective cohort study in people admitted to hospital in England with COVID-19 requiring admission to a high dependency unit (HDU) or intensive care unit (ICU) between March 1, 2020 and July 27, 2020. Cox proportional hazards models were used to estimate 30 day in-hospital all-cause mortality associated with type 2 diabetes, adjusted for age, sex, ethnicity, obesity, and other major comorbidities (chronic respiratory disease, asthma, chronic heart disease, hypertension, immunosuppression, chronic neurological disease, chronic renal disease, and chronic liver disease). Results: 19,256 COVID-19 related HDU and ICU admissions were included in the primary analysis, including 13,809 HDU (mean age 70), and 5,447 ICU admissions (mean age 58). 3,524 (18.3%) had type 2 diabetes. 5,077 people (26.4%) died during the study period. People with type 2 diabetes were at increased risk of death (adjusted hazard ratio (aHR) 1.23 [95%CI 1.14;1.32]), results were consistent in HDU and ICU subsets. The relative mortality risk associated with type 2 diabetes decreased with increasing age (age 18-49 aHR 1.50 [95%CI 1.05;2.15]; age 50-64 1.29 [1.10;1.51]; age 65 or greater 1.18 [1.09;1.29], p-value for age:type 2 diabetes interaction 0.002). Conclusions: Type 2 diabetes may be an independent prognostic factor for survival in people with severe COVID-19 requiring critical care treatment, and in this setting the risk increase associated with type 2 diabetes is greatest in younger people.

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Regular consumption of soft drinks is associated with type 2 diabetes incidence in Mexican adults: findings from a prospective cohort study.

10.21203/rs.3.rs-51105/v2 ◽

2020 ◽

Author(s):

Leticia Torres-Ibarra ◽

Berenice Rivera-Paredez ◽

Rubí Hernández-López ◽

Francisco Canto-Osorio ◽

Luz María Sánchez-Romero ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Prospective Cohort ◽

Soft Drinks ◽

Self Report ◽

Diabetes Incidence ◽

Increased Risk ◽

Mexican Adults ◽

Incident Cases

Abstract Background: Although high consumption of soft drinks has been associated with excess of type 2 diabetes risk, the strength of this association in the Mexican population, where a type 2 diabetes genetic susceptibility has been well established, has been scarcely studied. This study aimed to estimate the risk of type 2 diabetes due to soft drinks consumption in a cohort of Mexicans. Methods: We used data on 1,445 participants from the Health Workers Cohort Study, a prospective cohort conducted in Cuernavaca, Mexico. Soft drinks consumption was assessed with a semi-quantitative 116-item food frequency questionnaire. Incident type 2 diabetes was defined as self-report of physician-diagnosed type 2 diabetes, fasting glucose >126 mg/dl, or hypoglycemic medication at any examination. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models.Results: With a total of 9,526.2 person-years of follow-up, 109 incident cases of type 2 diabetes were observed. Type 2 diabetes incidence rate was 7.6, 11.0, and 17.1 per 1,000 person-years across levels of soft drinks consumption of <1, 1-4, and ³5 servings/week, respectively (p<0.001 for trend). The intake of ≥5 soft drinks/week was significantly associated with an increased risk of type 2 diabetes (HR 1.9 95% CI:1.0-3.5) compared with consumption of <1/week (p-trend=0.040). The HR was attenuated by further adjustment for body mass index (HR 1.5 95%CI:0.8-2.8) and abdominal obesity (HR 1.6 95%CI:0.8-3.0). Conclusions: The consumption of soft drinks was associated with a higher risk of type 2 diabetes in a cohort of Mexican adults. Our results further support recommendations to limit soft drinks intake to address the growing diabetes epidemic in Mexico.

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