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Association of arterial stiffness with all-cause and cause-specific mortality in the diabetic population: A national cohort study

Title: Association of arterial stiffness with all-cause and cause-specific mortality in the diabetic population: A national cohort study
Authors: Liu, Cun; Pan, Huachun; Kong, Fanliang; Yang, Shumin; Shubhra, Quazi T. H.; Li, Dandan; Chen, Siwei; 1 Department of Hypertension and Plateau Disease, Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, Qinghai, China; 2 College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China; 3 Department of Cardiology and Pneumology, University Medical Center of Göttingen, Georg-August University, Göttingen, Germany; 5 State Key Laboratory of Agriculture Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China; 6 Stomatology Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China; 8 Department of Nursing, Zaozhuang Vocational College, Shandong, China; 9 Department of Cardiovascular Medicine, The Third Hospital of Nanchang, Jiangxi, China
Contributors: Liu, Cun; Pan, Huachun; Kong, Fanliang; Yang, Shumin; Shubhra, Quazi T. H.; Li, Dandan; Chen, Siwei; 1 Department of Hypertension and Plateau Disease, Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, Qinghai, China; 2 College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China; 3 Department of Cardiology and Pneumology, University Medical Center of Göttingen, Georg-August University, Göttingen, Germany; 5 State Key Laboratory of Agriculture Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China; 6 Stomatology Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China; 8 Department of Nursing, Zaozhuang Vocational College, Shandong, China; 9 Department of Cardiovascular Medicine, The Third Hospital of Nanchang, Jiangxi, China
Publication Year: 2023
Collection: Georg-August-Universität Göttingen: GoeScholar
Description: Background Estimated pulse wave velocity (ePWV) has been proposed as a potential alternative to carotid-femoral pulse wave velocity to assess the degree of aortic stiffness, and may predict cardiovascular disease (CVD) outcomes and mortality in the general population. However, whether arterial stiffness estimated by ePWV predicts all-cause and cause-specific mortality in patients with diabetes mellitus (DM) has not been reported. Methods This was a prospective cohort study with data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014 and followed up until the end of December 2019. 5,235U.S. adults with DM (age≥20years) were included in the study. Arterial stiffness was estimated by ePWV. Survey-weighted Cox proportional hazards models were performed to assess the hazard ratios (HRs), and 95% confidence intervals (CIs) for the associations of ePWV with all-cause and cause-specific mortality. Meanwhile, the generalized additive model was used to visually assess the dose-dependent relationship between ePWV and mortality. As a complementary analysis, the relationship between mean blood pressure (MBP) and risk of mortality was also examined. Multiple imputations accounted for missing data. Results For the 5,235 DM patients, the weighted mean age was 57.4 years, and 51.07% were male. During a median follow-up period of 115 months (interquartile range 81-155 months; 53,159 person-years), 1,604 all-cause deaths were recorded. In the fully adjusted Cox regression model, every 1 m/s increase in ePWV was associated with 56% (HR 1.56; 95% CI, 1.44 to 1.69) increase in the risk of all-cause. In addition, a nonlinear relationship between ePWV and all-cause mortality was observed (P for non-linear=0.033). Similar results were obtained after subgroup analysis and multiple imputations. Besides, the risk of most cause-specific mortality, except for accident and renal disease-specific mortality, increased from 53% to 102% for every 1 m/s increase in ePWV. Conclusions In the diabetic population, ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.3389/fendo.2023.1145914
Availability: https://resolver.sub.uni-goettingen.de/purl?gro-2/123062; https://doi.org/10.3389/fendo.2023.1145914
Rights: info:eu-repo/semantics/openAccess ; CC BY 4.0 ; http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.84F3ECA1
Database: BASE