Causas principales de mortalidad precoz y exceso de mortalidad en la población diabética española. Estudio DRECE III / No disponible

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[1991-2004 follow-up of a Spanish general population cohort. Mortality and raising risk factors in the DRECE III Study (Diet and Risk of Cardiovascular Diseases in Spain)]. / Seguimiento de 1991 a 2004 de la mortalidad y los factores de riesgo emergentes en una cohorte de población general española. Estudio Drece III (Dieta y Riesgo de Enfermedades Cardiovasculares en España).

BACKGROUND: The DRECE III study is based on the follow up of a cohort representative of the Spanish general population. The mortality, its main causes and relevant risk factors have been analyzed. METHODS: The DRECE cohort is composed of 4783 subjects followed since 1991 to 2004 (70930 person-years). In 1991 a general medical exam including blood analysis and nutritional questionnaire was undertaken. Currently the age spam is from 18 to 73 years. Vital status and mortality causes were provided by the National Institute of Statistics. RESULTS: In this period, 125 deaths were registered: 53 persons (42.4%) due to cancer; 31 persons (24.8%) due to circulatory causes, of which 24 were due to cardiovascular origin. The remaining 41 (32.8%) deaths were included under the ICD 10 "Other chapters". For the all causes mortality the independent associated variables were: creatinina 1.5 mgr/dl, HR 3.78 (95% CI: 1.52-9.40); diabetes, HR 2.80 (95% CI: 1.74-4.46); male sex, HR 2.39 (I95% CI: 1.61-3.55); age, HR 1.08 (I95% CI: 1.07-1.10); and gammaglutamil transpeptidasa, HR 1.001 (I95% CI: 1.000-1.003). In the case of cancer mortality the risk factors founded were: age, HR 1.12 (I95% CI: 1.09-1.16); and tobacco, HR 1.33 (I95% CI: 1.14-1.54). For cardiovascular mortality were creatinina 1.5 mg/dl, HR 19.40 (I95% CI: 5.45-69.12); diabetes, HR 9.82 (I95% CI: 4.19-23.04); and age, HR 1.10 (I95% CI: 1.05-1.15). CONCLUSIONS: We obtain a mortality pattern where cancer is the most frequent cause. Classic risk factors appear associated to main death causes. Diabetes mellitus has an outstanding role as risk factor associated to early mortality. No specific diet data was associated neither to all causes mortality, nor to cardiovascular or cancer.

Seguimiento de 1991 a 2004 de la mortalidad y los factores de riesgo emergentes en una cohorte de población general española. Estudio DRECE III (dieta y riesgo de enfermedades cardiovasculares en España) / 1991-2004 follow up of an spanish general population cohort. Mortality and raising risk factors in the DRECE III study. (Diet and risk of cardiovascular diseases in Spain)

Fundamento: El estudio DRECE III se basa en el seguimiento de una cohorte de población general representativa de la sociedad española. El objetivo de este trabajo es analizar, tras 13 años de seguimiento, la mortalidad general, la distribución de la mortalidad por causas y los principales factores de riesgo asociados. Métodos: La cohorte DRECE se compone de 4.783 sujetos seguidos desde 1991 hasta 2004, el rango de edad al final se extiende desde los 18 a 73 años. Las personas participantes fueron seleccionadas mediante muestreo estratificado polietápico. Las causas de mortalidad han sido proporcionados por el Instituto nacional de Estadística. Las tasas se calcularon mediante regresión de Poisson y la identificación de factores de riesgo mediante la regresión de riesgos proporcionales de Cox. Resultados: En el periodo 1991-2004 fallecieron 125 sujetos, lo que se corresponde con una tasa de mortalidad total de 1.76 por 1000 habitantes. La distribución por causa de muerte fue: 53 personas por cáncer (42,4%) y 31 por causas circulatorias (24,8%) (24 por causa cardiovascular). Las 41 defunciones restantes (32,8%) se englobaron dentro de la categoría CIE 10 de "Otras". Para la mortalidad total las variables independientes asociadas fueron: creatinina1,5 mgr/dl, hazard ratio (HR) 3.78(IC 95%: 1,52-9,40); diabetes, HR 2,80; sexo masculino, HR 2,39 (I C95%: 1,61-3,55) ; edad, HR 1,08 (IC95%: 1,07-1,10); gammaglutamil transpeptidasa, HR 1,001 (IC95%: 1,000-1,003). Factores de riesgo asociados a cáncer fueron: edad, HR 1,12 (IC95%: 1,09-1,16); y tabaco, HR 1,33 (IC 95%: 1,14-1,54). Para la mortalidad cardiovascular fueron: creatinina 1.5 mg/dl, HR 19,40 (IC 95%: 5,45-69,12); diabetes, HR 9,82 (IC 95%: 4,19-23,04); y edad, HR 1,10 (IC 95%: 1,05-1,15). Conclusión: Se obtuvo un patrón de mortalidad en el que predomina el cáncer como causa más frecuente. Aparecen factores de riesgo clásicos asociados a las principales causas. La diabetes emerge como un factor muy llamativo asociado a mortalidad precoz. La dieta no se asoció a la mortalidad total (AU)

Background: The DRECE III study is based on the follow up of a cohort representative of the Spanish general population. The mortality, its main causes and relevant risk factors have been analyzed. Methods: The DRECE cohort is composed of 4783 subjects followed since 1991 to 2004 (70930 person-years). In 1991 a general medical exam including blood analysis and nutritional questionnaire was undertaken. Currently the age spam is from 18 to 73 years. Vital status and mortality causes were provided by the National Institute of Statistics. Results: In this period, 125 deaths were registered: 53 persons (42.4%) due to cancer; 31 persons (24.8%) due to circulatory causes, of which 24 were due to cardiovascular origin. The remaining 41 (32.8%) deaths were included under the ICD 10 "Other chapters". For the all causes mortality the independent associated variables were: creatinina 1.5 mgr/dl, HR 3.78 (95% CI: 1.52-9.40); diabetes, HR 2.80 (95% CI: 1.74-4.46); male sex, HR 2.39 (I95% CI: 1.61-3.55); age, HR 1.08 (I95% CI: 1.07-1.10); and gammaglutamil transpeptidasa, HR 1.001 (I95% CI: 1.000-1.003). In the case of cancer mortality the risk factors founded were: age, HR 1.12 (I95% CI: 1.09-1.16); and tobacco, HR 1.33 (I95% CI: 1.14-1.54). For cardiovascular mortality were creatinina 1.5 mg/dl, HR 19.40 (I95% CI: 5.45-69.12); diabetes, HR 9.82 (I95% CI: 4.19-23.04); and age, HR 1.10 (I95% CI: 1.05-1.15). Conclusions: We obtain a mortality pattern where cancer is the most frequent cause. Classic risk factors appear associated to main death causes. Diabetes mellitus has an outstanding role as risk factor associated to early mortality. No specific diet data was associated neither to all causes mortality, nor to cardiovascular or cancer (AU)