Anaemia, haemoglobin level and cause-specific mortality in people with and without diabetes

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dc.contributor.authorKengne, Andre Pascalen_ZA
dc.contributor.authorCzernichow, Sébastienen_ZA
dc.contributor.authorHamer, Marken_ZA
dc.contributor.authorBatty, G Daviden_ZA
dc.contributor.authorStamatakis, Emmanuelen_ZA
dc.date.accessioned2016-01-11T06:56:03Z
dc.date.available2016-01-11T06:56:03Z
dc.date.issued2012en_ZA
dc.description.abstractBACKGROUND: Both anaemia and cardiovascular disease (CVD) are common in people with diabetes. While individually both characteristics are known to raise mortality risk, their combined influence has yet to be quantified. In this pooling project, we examined the combined impact of baseline haemoglobin levels and existing CVD on all-cause and CVD mortality in people with diabetes. We draw comparison of these effects with those apparent in diabetes-free individuals. Methods/Principal FINDINGS: A combined analyses of 7 UK population-based cohorts resulted in 26,480 study members. There were 946 participants with physician-diagnosed diabetes, 2227 with anaemia [haemoglobin<13 g/dl (men) or <12 (women)], 2592 with existing CVD (stroke, ischaemic heart disease), and 21,396 with none of the conditions. Across diabetes and anaemia subgroups, and using diabetes-free, non-anaemic participants as the referent group, the adjusted hazard ratios (HR) were 1.46 (95% CI: 1.30-1.63) for anaemia, 1.67 (1.45-1.92) for diabetes, and 2.10 (1.55-2.85) for diabetes and anaemia combined. Across combined diabetes, anaemia and CVD subgroups, and compared with non-anaemic, diabetes-free and CVD-free participants, HR (95% CI) for all-cause mortality were 1.49 (1.32-1.69) anaemia, 1.60 (1.46-1.76) for existing CVD, and 1.66 (1.39-1.97) for diabetes alone. Equivalents were 2.13 (1.48-3.07) for anaemia and diabetes, 2.68 (2.14-3.36) for diabetes and existing CVD, and 3.25 (1.88-5.62) for the three combined. Patterns were similar for CVD mortality. Conclusions/Significance Individually, anaemia and CVD confer similar mortality risks in people with diabetes, and are excessively fatal in combination. Screening for anaemia would identify vulnerable diabetic patients whose outcomes can potentially be improved.en_ZA
dc.identifier.apacitationKengne, A. P., Czernichow, S., Hamer, M., Batty, G. D., & Stamatakis, E. (2012). Anaemia, haemoglobin level and cause-specific mortality in people with and without diabetes. <i>PLoS One</i>, http://hdl.handle.net/11427/16301en_ZA
dc.identifier.chicagocitationKengne, Andre Pascal, Sébastien Czernichow, Mark Hamer, G David Batty, and Emmanuel Stamatakis "Anaemia, haemoglobin level and cause-specific mortality in people with and without diabetes." <i>PLoS One</i> (2012) http://hdl.handle.net/11427/16301en_ZA
dc.identifier.citationKengne, A. P., Czernichow, S., Hamer, M., Batty, G. D., & Stamatakis, E. (2012). Anaemia, haemoglobin level and cause-specific mortality in people with and without diabetes. PloS one, 7(8), e41875. doi:10.1371/journal.pone.0041875en_ZA
dc.identifier.ris TY - Journal Article AU - Kengne, Andre Pascal AU - Czernichow, Sébastien AU - Hamer, Mark AU - Batty, G David AU - Stamatakis, Emmanuel AB - BACKGROUND: Both anaemia and cardiovascular disease (CVD) are common in people with diabetes. While individually both characteristics are known to raise mortality risk, their combined influence has yet to be quantified. In this pooling project, we examined the combined impact of baseline haemoglobin levels and existing CVD on all-cause and CVD mortality in people with diabetes. We draw comparison of these effects with those apparent in diabetes-free individuals. Methods/Principal FINDINGS: A combined analyses of 7 UK population-based cohorts resulted in 26,480 study members. There were 946 participants with physician-diagnosed diabetes, 2227 with anaemia [haemoglobin<13 g/dl (men) or <12 (women)], 2592 with existing CVD (stroke, ischaemic heart disease), and 21,396 with none of the conditions. Across diabetes and anaemia subgroups, and using diabetes-free, non-anaemic participants as the referent group, the adjusted hazard ratios (HR) were 1.46 (95% CI: 1.30-1.63) for anaemia, 1.67 (1.45-1.92) for diabetes, and 2.10 (1.55-2.85) for diabetes and anaemia combined. Across combined diabetes, anaemia and CVD subgroups, and compared with non-anaemic, diabetes-free and CVD-free participants, HR (95% CI) for all-cause mortality were 1.49 (1.32-1.69) anaemia, 1.60 (1.46-1.76) for existing CVD, and 1.66 (1.39-1.97) for diabetes alone. Equivalents were 2.13 (1.48-3.07) for anaemia and diabetes, 2.68 (2.14-3.36) for diabetes and existing CVD, and 3.25 (1.88-5.62) for the three combined. Patterns were similar for CVD mortality. Conclusions/Significance Individually, anaemia and CVD confer similar mortality risks in people with diabetes, and are excessively fatal in combination. Screening for anaemia would identify vulnerable diabetic patients whose outcomes can potentially be improved. DA - 2012 DB - OpenUCT DO - 10.1371/journal.pone.0041875 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - Anaemia, haemoglobin level and cause-specific mortality in people with and without diabetes TI - Anaemia, haemoglobin level and cause-specific mortality in people with and without diabetes UR - http://hdl.handle.net/11427/16301 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16301
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0041875
dc.identifier.vancouvercitationKengne AP, Czernichow S, Hamer M, Batty GD, Stamatakis E. Anaemia, haemoglobin level and cause-specific mortality in people with and without diabetes. PLoS One. 2012; http://hdl.handle.net/11427/16301.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© Kengne et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherDiabetes mellitusen_ZA
dc.subject.otherAnemiaen_ZA
dc.subject.otherCardiovascular diseasesen_ZA
dc.subject.otherCholesterolen_ZA
dc.subject.otherBlood pressureen_ZA
dc.subject.otherConfidence intervalsen_ZA
dc.subject.otherBody mass indexen_ZA
dc.subject.otherChronic kidney diseaseen_ZA
dc.titleAnaemia, haemoglobin level and cause-specific mortality in people with and without diabetesen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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