Influence of type 2 diabetes mellitus on cardiovascular disease mortality: findings from the Hawaii-Los Angeles-Hiroshima study.
The present study addressed whether diabetes mellitus was a strong risk factor for cardiovascular disease (CVD) death. Between 1976 and 1984, 927 (404 men) Japanese-Americans in Hawaii aged 40-79 years participated at baseline examination including a 75 g oral glucose tolerance test. Diabetes was defined as fasting serum glucose >or=140 mg/dl, 2 h postload glucose >or=180 mg/dl, or the use of drugs for diabetes. Causes of death were classified by ICD-9 codes on the reports from the Hawaii State Public Health Bureau. Until 1994, 178 individuals suffered death; 81 were attributed to CVD and 43 to coronary heart disease (CHD). The age-adjusted and coronary risk factors-adjusted relative risks for CHD and CVD mortality were significant for diabetes both in men and women. The impact of diabetes on CHD mortality was greater for women. However, no gender difference in the contribution of diabetes to fatal CVD was observed. Serum fasting glucose levels tended to be associated with CHD death and were associated with CVD death in diabetic subjects. In conclusion, diabetes is a strong independent risk factor for CVD mortality in Japanese-American men and women. Hyperglycemia is associated with CVD mortality in diabetic subjects.
Imazu
Michinori
M
Second Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima-city, Japan. imazu@hiroshima-u.ac.jp
Sumii
Kotaro
K
Yamamoto
Hideya
H
Toyofuku
Mamoru
M
Tadehara
Futoshi
F
Okubo
Masamichi
M
Yamakido
Michio
M
Kohno
Nobuoki
N
Onaka
Alvin T
AT
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000401:mortality*; D005260:Female; D005951:Glucose Tolerance Test; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D007328:Insulin / Q000097:blood; D007564:Japan / Q000453:epidemiology; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol