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Combined effects of diabetes and low household income on mortality: a 12‐year follow‐up study of 505 677 Korean adults

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Titel: Combined effects of diabetes and low household income on mortality: a 12‐year follow‐up study of 505 677 Korean adults
Autoren: W. Y. Shin, H. C. Kim, T. Lee, D.‐H. Jeon, K. H. Ha, D. J. Kim, H.‐J. Chang
Weitere Verfasser: W. Y. Shin, H. C. Kim, T. Lee, D.‐H. Jeon, K. H. Ha, D. J. Kim, H.‐J. Chang, Kim, Hyeon Chang
Quelle: Diabetic Medicine. 35:1345-1354
Verlagsinformationen: Wiley, 2018.
Publikationsjahr: 2018
Schlagwörter: Adult, Male, Diabetic Angiopathies/epidemiology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Diabetes Mellitus/mortality, Republic of Korea, Diabetes Mellitus, Cardiovascular Diseases/economics, Humans, Mortality, Cardiovascular Diseases/mortality, 2. Zero hunger, Cardiovascular Diseases/epidemiology, 1. No poverty, Middle Aged, 3. Good health, Diabetic Angiopathies/economics, Socioeconomic Factors, Income/statistics & numerical data, Cardiovascular Diseases, Income, Diabetes Mellitus/epidemiology, Diabetic Angiopathies/mortality, Female, Republic of Korea/epidemiology, Diabetes Mellitus/economics, Diabetic Angiopathies, Follow-Up Studies
Beschreibung: AimTo examine the effects of diabetes, low income and their combination on mortality in the Korean population.MethodsWe analysed a total of 505 677 people (53.9% male) aged 40–79 years old from the National Health Insurance Service‐National Health Screening (NHIS‐HEALS) cohort. Ten levels of household income were used as indicators of economic status. Diabetes was defined as elevated fasting blood glucose (≥ 6.9 mmol/l) and/or use of glucose‐lowering drugs or insulin. Covariates of age, sex, BMI, smoking and Charlson Comorbidity Index were determined at baseline. Outcomes were total and cause‐specific mortality over 12 years. Cox's proportional hazard regression models were used to estimate hazard ratios (HRs) for mortality according to the presence of diabetes, household income and their combination.ResultsLower household income was associated with higher mortality from all causes, cardiovascular disease, cancer and non‐cancer non‐cardiovascular causes. Excessive mortality due to low incomes was observed in both people with and without diabetes. In men, the adjusted HR [95% confidence interval (CI)] of mortality was 1.38 (1.34 to 1.42) for low‐income only, 1.48 (1.42 to 1.55) for diabetes only and 1.95 (1.86 to 2.05) for diabetes and low‐income combined, relative to the normal glucose and high income group. Corresponding HR (95% CI) in women were 1.19 (1.14 to 1.24), 1.54 (1.44 to 1.64) and 1.87 (1.75 to 2.01), respectively.ConclusionBoth low household income and the presence of diabetes independently increase the risk of mortality, but their combined effects on mortality may be different between men and women.
Publikationsart: Article
Sprache: English
ISSN: 1464-5491
0742-3071
DOI: 10.1111/dme.13695
Zugangs-URL: https://pubmed.ncbi.nlm.nih.gov/29851428
https://www.ncbi.nlm.nih.gov/pubmed/29851428
https://europepmc.org/article/MED/29851428
https://yonsei.pure.elsevier.com/en/publications/combined-effects-of-diabetes-and-low-household-income-on-mortalit
https://onlinelibrary.wiley.com/doi/abs/10.1111/dme.13695
https://ir.ymlib.yonsei.ac.kr/handle/22282913/167179;
Rights: Wiley Online Library User Agreement
CC BY NC ND
Dokumentencode: edsair.doi.dedup.....403f7dd787b842eb52fffcd5d10d6b03
Datenbank: OpenAIRE
Beschreibung
Abstract:AimTo examine the effects of diabetes, low income and their combination on mortality in the Korean population.MethodsWe analysed a total of 505 677 people (53.9% male) aged 40–79 years old from the National Health Insurance Service‐National Health Screening (NHIS‐HEALS) cohort. Ten levels of household income were used as indicators of economic status. Diabetes was defined as elevated fasting blood glucose (≥ 6.9 mmol/l) and/or use of glucose‐lowering drugs or insulin. Covariates of age, sex, BMI, smoking and Charlson Comorbidity Index were determined at baseline. Outcomes were total and cause‐specific mortality over 12 years. Cox's proportional hazard regression models were used to estimate hazard ratios (HRs) for mortality according to the presence of diabetes, household income and their combination.ResultsLower household income was associated with higher mortality from all causes, cardiovascular disease, cancer and non‐cancer non‐cardiovascular causes. Excessive mortality due to low incomes was observed in both people with and without diabetes. In men, the adjusted HR [95% confidence interval (CI)] of mortality was 1.38 (1.34 to 1.42) for low‐income only, 1.48 (1.42 to 1.55) for diabetes only and 1.95 (1.86 to 2.05) for diabetes and low‐income combined, relative to the normal glucose and high income group. Corresponding HR (95% CI) in women were 1.19 (1.14 to 1.24), 1.54 (1.44 to 1.64) and 1.87 (1.75 to 2.01), respectively.ConclusionBoth low household income and the presence of diabetes independently increase the risk of mortality, but their combined effects on mortality may be different between men and women.
ISSN:14645491
07423071
DOI:10.1111/dme.13695