Dunya Tomic, Agus Salim, Elizabeth L. M. Barr, Paul Z. Zimmet, Dianna J. Magliano, Jonathan E. Shaw
{"title":"澳大利亚糖尿病、肥胖和生活方式(AusDiab)研究的短期和长期死亡率预测。","authors":"Dunya Tomic, Agus Salim, Elizabeth L. M. Barr, Paul Z. Zimmet, Dianna J. Magliano, Jonathan E. Shaw","doi":"10.1111/imj.70015","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>While identification of key risk factors for mortality has contributed to advances in healthcare, the effect of these risk factors in predicting mortality over different time horizons remains unclear.</p>\n </section>\n \n <section>\n \n <h3> Aims</h3>\n \n <p>We sought to determine how risk factors predicted shorter-term and longer-term mortality across the age spectrum in adults.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We used data from 11 247 adults of the Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Cox multivariable regression models were used to estimate hazard ratios (HRs) of shorter-term (0–10 years) and longer-term (10–20 years) all-cause and cardiovascular disease (CVD)-related mortality associated with risk factors. Models with interaction between baseline age and each risk factor were also fitted.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>During a 20-year follow-up, 2185 deaths occurred. Smoking, diabetes, male sex and albuminuria all independently predicted shorter- and longer-term all-cause and CVD mortality. Most associations were stronger in the shorter term compared to the longer term. A notable exception was the association between smoking and CVD mortality, which was stronger in the longer term (HR 3.55, 95% confidence interval (CI) 2.57–4.90) compared to the shorter term (HR 2.06, 95% CI 1.33–3.20). The magnitude of association between most risk factors and mortality attenuated with age.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Classical risk factors for total and CVD mortality remain important up to 20 years after their measurement. In unselected adult cohorts, longer-term follow-up (e.g. beyond 10 years) may not provide additional information on associations of risk factors with mortality beyond that obtained in shorter-term follow-up.</p>\n </section>\n </div>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 6","pages":"922-931"},"PeriodicalIF":1.5000,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70015","citationCount":"0","resultStr":"{\"title\":\"Shorter-term and longer-term mortality prediction in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study\",\"authors\":\"Dunya Tomic, Agus Salim, Elizabeth L. M. Barr, Paul Z. Zimmet, Dianna J. Magliano, Jonathan E. Shaw\",\"doi\":\"10.1111/imj.70015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>While identification of key risk factors for mortality has contributed to advances in healthcare, the effect of these risk factors in predicting mortality over different time horizons remains unclear.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>We sought to determine how risk factors predicted shorter-term and longer-term mortality across the age spectrum in adults.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We used data from 11 247 adults of the Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Cox multivariable regression models were used to estimate hazard ratios (HRs) of shorter-term (0–10 years) and longer-term (10–20 years) all-cause and cardiovascular disease (CVD)-related mortality associated with risk factors. Models with interaction between baseline age and each risk factor were also fitted.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>During a 20-year follow-up, 2185 deaths occurred. Smoking, diabetes, male sex and albuminuria all independently predicted shorter- and longer-term all-cause and CVD mortality. Most associations were stronger in the shorter term compared to the longer term. A notable exception was the association between smoking and CVD mortality, which was stronger in the longer term (HR 3.55, 95% confidence interval (CI) 2.57–4.90) compared to the shorter term (HR 2.06, 95% CI 1.33–3.20). The magnitude of association between most risk factors and mortality attenuated with age.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Classical risk factors for total and CVD mortality remain important up to 20 years after their measurement. In unselected adult cohorts, longer-term follow-up (e.g. beyond 10 years) may not provide additional information on associations of risk factors with mortality beyond that obtained in shorter-term follow-up.</p>\\n </section>\\n </div>\",\"PeriodicalId\":13625,\"journal\":{\"name\":\"Internal Medicine Journal\",\"volume\":\"55 6\",\"pages\":\"922-931\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-03-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70015\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Internal Medicine Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/imj.70015\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internal Medicine Journal","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/imj.70015","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景:虽然确定死亡率的关键风险因素有助于医疗保健的进步,但这些风险因素在预测不同时间范围内死亡率方面的影响仍不清楚。目的:我们试图确定风险因素如何预测成人各年龄段的短期和长期死亡率。方法:我们使用了来自澳大利亚糖尿病、肥胖和生活方式(AusDiab)研究的11247名成年人的数据。使用Cox多变量回归模型估计与危险因素相关的短期(0-10年)和长期(10-20年)全因和心血管疾病(CVD)相关死亡率的危险比(hr)。还拟合了基线年龄与各危险因素之间相互作用的模型。结果:在20年的随访期间,发生了2185例死亡。吸烟、糖尿病、男性和蛋白尿都能独立预测短期和长期的全因死亡率和心血管疾病死亡率。大多数关联在短期内比在长期内更强。一个值得注意的例外是吸烟与心血管疾病死亡率之间的关联,与短期(HR 2.06, 95% CI 1.33-3.20)相比,长期(HR 3.55, 95%可信区间(CI) 2.57-4.90)更强。大多数危险因素与死亡率之间的关联程度随着年龄的增长而减弱。结论:总死亡率和心血管疾病死亡率的经典危险因素在测量后20年内仍然重要。在未选择的成人队列中,长期随访(例如超过10年)可能无法提供短期随访获得的风险因素与死亡率关联的额外信息。
Shorter-term and longer-term mortality prediction in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study
Background
While identification of key risk factors for mortality has contributed to advances in healthcare, the effect of these risk factors in predicting mortality over different time horizons remains unclear.
Aims
We sought to determine how risk factors predicted shorter-term and longer-term mortality across the age spectrum in adults.
Methods
We used data from 11 247 adults of the Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Cox multivariable regression models were used to estimate hazard ratios (HRs) of shorter-term (0–10 years) and longer-term (10–20 years) all-cause and cardiovascular disease (CVD)-related mortality associated with risk factors. Models with interaction between baseline age and each risk factor were also fitted.
Results
During a 20-year follow-up, 2185 deaths occurred. Smoking, diabetes, male sex and albuminuria all independently predicted shorter- and longer-term all-cause and CVD mortality. Most associations were stronger in the shorter term compared to the longer term. A notable exception was the association between smoking and CVD mortality, which was stronger in the longer term (HR 3.55, 95% confidence interval (CI) 2.57–4.90) compared to the shorter term (HR 2.06, 95% CI 1.33–3.20). The magnitude of association between most risk factors and mortality attenuated with age.
Conclusions
Classical risk factors for total and CVD mortality remain important up to 20 years after their measurement. In unselected adult cohorts, longer-term follow-up (e.g. beyond 10 years) may not provide additional information on associations of risk factors with mortality beyond that obtained in shorter-term follow-up.
期刊介绍:
The Internal Medicine Journal is the official journal of the Adult Medicine Division of The Royal Australasian College of Physicians (RACP). Its purpose is to publish high-quality internationally competitive peer-reviewed original medical research, both laboratory and clinical, relating to the study and research of human disease. Papers will be considered from all areas of medical practice and science. The Journal also has a major role in continuing medical education and publishes review articles relevant to physician education.