Self-reported diabetes and mortality in a prospective Chinese elderly cohort study in Hong Kong.
OBJECTIVE
In Western countries, diabetes mellitus is positively associated with death from all- and specific-causes including cancer, cardiovascular and respiratory diseases. In a Chinese setting with a different disease pattern: high diabetes rates in a relatively non-obese population with low ischemic heart disease (IHD) rates where diabetes is positively associated with IHD, we examined the association of self-reported diabetes with death among older people.


METHODS
Multivariable Cox regression analysis was used in a population-based prospective cohort of 66,820 Chinese (65+ years) enrolled from July 1998 to December 2001 at Elderly Health Centers of the Hong Kong Government Department of Health, followed until May 31, 2012.


RESULTS
During 10.9 years of follow-up, 19,845 deaths occurred. Self-reported diabetes was associated with death from all-causes (hazard ratio (HR)=1.56, 95% confidence interval (CI) 1.51, 1.62), cardiovascular disease (HR=1.84, 95% CI 1.72, 1.96), cancer (HR=1.11, 95% CI 1.03 to 1.20), liver cancer (HR=1.38, 95% CI 1.13 to 1.69) and stomach cancer (HR=1.38, 95% CI 1.03 to 1.85), adjusted for age, sex, socio-economic position, alcohol use, smoking, exercise and body mass index.


CONCLUSIONS
Such a pattern of associations suggests that further investigation into the drivers of diabetes is required in this and similar populations.
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Chen
C
Shen
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; City University of New York , School of Public Health and Hunter College, NY, USA. Electronic address: cms1@hkucc.hku.hk.
C Mary
CM
Schooling
Department of Health, Government of Hong Kong SAR, Hong Kong, China.
Wai Man
WM
Chan
Department of Health, Government of Hong Kong SAR, Hong Kong, China.
Siu Yin
SY
Lee
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Gabriel M
GM
Leung
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Tai Hing
TH
Lam
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D016009:Chi-Square Distribution; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality*; D015444:Exercise; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000401:mortality*; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D057566:Self Report; D012907:Smoking / Q000453:epidemiology*; D012923:Social Class
Aging; Cohort study; Diabetes; Mortality