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Type: Journal article
Title: Associations of mortality and cardiovascular disease risks with diabetes and albuminuria in urban Indigenous Australians: the DRUID follow-up study
Author: Barr, E.
Cunningham, J.
Tatipata, S.
Dunbar, T.
Kangaharan, N.
Guthridge, S.
Li, S.
Condon, J.
Shaw, J.
O'Dea, K.
Maple-Brown, L.
Citation: Diabetic Medicine, 2017; 34(7):946-957
Publisher: Wiley/Blackwell
Issue Date: 2017
ISSN: 0742-3071
Statement of
E. L. M. Barr, J. Cunningham, S. Tatipata, T. Dunbar, N. Kangaharan, S. Guthridge, S. Q. Li, J. R. Condon, J. E. Shaw, K. O, Dea and L. J. Maple-Brown
Abstract: Aim: To assess the relationships of diabetes and albuminuria with all-cause mortality and cardiovascular disease outcomes in a population without prior cardiovascular disease using data from the Darwin Region Urban Indigenous Diabetes (DRUID) study. Methods: We conducted a prospective cohort study of 706 participants (aged 15-81 years, 68% women) without prior cardiovascular disease who underwent a 75-g oral glucose tolerance test. Deaths and fatal or non-fatal cardiovascular disease were determined over 7 years, and hazard ratios with 95% CIs and population attributable risks were estimated for baseline glycaemia and albuminuria. Results: Compared with normoglycaemia and after adjustment for age, sex, hypertension, dyslipidaemia and smoking, known diabetes was associated with an adjusted hazard ratio of 4.8 (95% CI 1.5-14.7) for all-cause mortality and 5.6 (95% CI 2.1-15.2) for cardiovascular disease. Compared with normoalbuminuria, the respective adjusted risks for macroalbuminuria were 10.9 (95% CI 3.7-32.1) and 3.9 (95% CI 1.4-10.8). The Adjusted all-cause mortality and cardiovascular disease estimated population attributable risks for diabetes were 27% and 32%, and for albuminuria they were 32% and 21%, respectively. Conclusions: In our study population, the burden of mortality and cardiovascular disease was largely driven by diabetes and albuminuria. This finding on the influence of diabetes and albuminuria is consistent with reports in other high-risk Indigenous populations and should be better reflected in risk scores and intervention programmes.
Keywords: Humans; Diabetic Nephropathies; Albuminuria; Cardiovascular Diseases; Diabetic Angiopathies; Health Surveys; Incidence; Prevalence; Mortality; Proportional Hazards Models; Risk Factors; Cohort Studies; Follow-Up Studies; Prospective Studies; Adolescent; Adult; Aged; Oceanic Ancestry Group; Urban Health; Australia; Female; Male; Renal Insufficiency, Chronic; Diabetic Cardiomyopathies
Description: Accepted 28 March 2017. Special Issue on Diabetes Epidemiology
Rights: © 2017 Diabetes UK
RMID: 0030069060
DOI: 10.1111/dme.13360
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