Diabetes and infectious disease mortality in Mexico City

被引：2

作者：

Bragg, Fiona ^{[1
,2
,3
]}

Kuri-Morales, Pablo ^{[4
,5
]}

Berumen, Jaime ^{[6
]}

Garcilazo-Avila, Adrian ^{[6
]}

Gonzales-Carballo, Carlos ^{[6
]}

Ramirez-Reyes, Raul ^{[6
]}

Santacruz-Benitez, Rogelio ^{[6
]}

Aguilar-Ramirez, Diego ^{[2
,3
]}

Gnatiuc Friedrichs, Louisa ^{[1
,2
,3
]}

Herrington, William G. ^{[2
,3
]}

Hill, Michael ^{[1
,2
,3
]}

Trichia, Eirini ^{[1
,2
,3
]}

Wade, Rachel ^{[1
,2
,3
]}

Collins, Rory ^{[2
,3
]}

Peto, Richard ^{[2
,3
]}

Emberson, Jonathan R. ^{[1
,2
,3
]}

Alegre-Diaz, Jesus ^{[6
]}

Tapia-Conyer, Roberto ^{[4
]}

机构：

[1] Univ Oxford, Nuffield Dept Populat Hlth, MRC Populat Hlth Res Unit, Oxford, England

[2] Univ Oxford, Nuffield Dept Populat Hlth, Clin Trial Serv Unit, Oxford, England

[3] Univ Oxford, Nuffield Dept Populat Hlth, Epidemiol Studies Unit, Oxford, England

[4] Univ Nacl Autonoma Mexico, Fac Med, Mexico City, Mexico

[5] Monterrey Inst Technol & Higher Educ, Monterrey, Nuevo Leon, Mexico

[6] Univ Nacl Autonoma Mexico, Fac Med, Expt Res Unit, Mexico City, Mexico

来源：

BMJ OPEN DIABETES RESEARCH & CARE | 2023年 / 11卷 / 02期

基金：

英国医学研究理事会; 英国惠康基金;

关键词：

Diabetes Mellitus; Type; 2; Infections; Cohort Studies; GLYCEMIC CONTROL; RISK; MELLITUS; TYPE-1; METAANALYSIS; ASSOCIATION; POPULATION; GLUCOSE;

D O I：

10.1136/bmjdrc-2022-003199

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

IntroductionAlthough higher risks of infectious diseases among individuals with diabetes have long been recognized, the magnitude of these risks is poorly described, particularly in lower income settings. This study sought to assess the risk of death from infection associated with diabetes in Mexico.Research design and methodsBetween 1998 and 2004, a total of 159 755 adults >= 35 years were recruited from Mexico City and followed up until January 2021 for cause-specific mortality. Cox regression yielded adjusted rate ratios (RR) for death due to infection associated with previously diagnosed and undiagnosed (HbA1c >= 6.5%) diabetes and, among participants with previously diagnosed diabetes, with duration of diabetes and with HbA1c.ResultsAmong 130 997 participants aged 35-74 and without other prior chronic diseases at recruitment, 12.3% had previously diagnosed diabetes, with a mean (SD) HbA1c of 9.1% (2.5%), and 4.9% had undiagnosed diabetes. During 2.1 million person-years of follow-up, 2030 deaths due to infectious causes were recorded at ages 35-74. Previously diagnosed diabetes was associated with an RR for death from infection of 4.48 (95% CI 4.05-4.95), compared with participants without diabetes, with notably strong associations with death from urinary tract (9.68 (7.07-13.3)) and skin, bone and connective tissue (9.19 (5.92-14.3)) infections and septicemia (8.37 (5.97-11.7)). In those with previously diagnosed diabetes, longer diabetes duration (1.03 (1.02-1.05) per 1 year) and higher HbA1c (1.12 (1.08-1.15) per 1.0%) were independently associated with higher risk of death due to infection. Even among participants with undiagnosed diabetes, the risk of death due to infection was nearly treble the risk of those without diabetes (2.69 (2.31-3.13)).ConclusionsIn this study of Mexican adults, diabetes was common, frequently poorly controlled, and associated with much higher risks of death due to infection than observed previously, accounting for approximately one-third of all premature mortality due to infection.

引用

页数：10

共 35 条

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