Increased cardiovascular and renal disease but not reduced life expectancy among diabetic participants in the general Northern Greek population.

We compared life expectancy and causes of death based on death certificates of 269 diabetic participants (group A) and 5659 nondiabetic participants (group B) who died from January 1, 1991 to December 31, 2010, in 3 small towns of Northern Greece. Age at death was significantly (P = .011) higher in group A (77.2 ± 8.7 years) than in group B (75.7 ± 18.9 years). Males with diabetes lived longer with a mean difference of 4.7 (2.8-6.6) years (P < .001), whereas females without diabetes lived longer, with a mean difference of 2.3 (1.1-5.6) years (P = .004). Diabetic participants died more frequently of myocardial infarction (P = .001), chronic renal failure (P < .001), followed by pneumonia (P = .010) and hyperosmolar non-ketotic coma (P < .001). Nondiabetic participants died more frequently of lung cancer (P < .001), old age (P < .001), and car accidents (P = .004). In conclusion, the cardiovascular and renal disease burden among diabetic participants did not reduce life expectancy, especially in men.

TLR4 gene polymorphisms: evidence for protection against type 2 diabetes but not for diabetes-associated ischaemic heart disease.

OBJECTIVE: Several factors either predisposing or protecting from the onset of diabetes mellitus type 2 (DM2) have been proposed. Two specific polymorphisms of toll-like receptor 4 (TLR4; Asp299Gly and Thr399Ile) have recently been identified either as candidate protector genes against DM2 and associated neuropathy or risk alleles for the manifestation of diabetic retinopathy. The impact of these alleles on the risk for ischaemic heart disease (IHD) is controversial while their role in diabetes-associated IHD has never been studied. DESIGN AND METHODS: In order to clarify the potential impact of TLR4 polymorphisms on the predisposition for DM2 as well as on diabetes-related IHD vulnerability, the distribution of the mutant TLR4 Asp299Gly and Thr399Ile alleles in 286 DM2 patients and 413 non-DM2 controls with or without IHD, was examined. RESULTS: Mutant alleles were predominantly detected in 79/413 non-diabetic individuals versus 15/286 DM2 patients (P<0.0001). The rates of positivity for mutant alleles were similar among diabetic patients with or without IHD (7/142 vs 8/144, P>0.1), whereas they proved different among non-diabetic individuals with or without IHD (39/145 vs 40/268, P=0.004). Following multivariate analysis, the difference between diabetic and non-diabetic subjects, with regard to TLR4 mutations alone, remained significant (P=0.04). CONCLUSIONS: Mutant TLR4 alleles confer protection against DM2. However, their presence does not seem to play any role, protective or aggravating, in the manifestation of IHD either in diabetic or in non-diabetic individuals.