Associations of mortality and cardiovascular disease risks with diabetes and albuminuria in urban Indigenous Australians: the DRUID follow-up study

E. L.M. Barr, J M Cunningham, S. Tatipata, Terry Dunbar, Nadarajan Kangaharan, Steve Guthridge, S. Q. Li, J. R. Condon, J. E. Shaw, K. O'Dea, Louise J Maple-Brown

Research output: Contribution to journalArticleResearchpeer-review

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.

Original languageEnglish
Pages (from-to)946-957
Number of pages12
JournalDiabetic Medicine
Volume34
Issue number7
DOIs
Publication statusPublished - 1 Jul 2017
Externally publishedYes

Cite this

Barr, E. L. M., Cunningham, J. M., Tatipata, S., Dunbar, T., Kangaharan, N., Guthridge, S., ... Maple-Brown, L. J. (2017). Associations of mortality and cardiovascular disease risks with diabetes and albuminuria in urban Indigenous Australians: the DRUID follow-up study. Diabetic Medicine, 34(7), 946-957. https://doi.org/10.1111/dme.13360
Barr, E. L.M. ; Cunningham, J M ; Tatipata, S. ; Dunbar, Terry ; Kangaharan, Nadarajan ; Guthridge, Steve ; Li, S. Q. ; Condon, J. R. ; Shaw, J. E. ; O'Dea, K. ; Maple-Brown, Louise J. / Associations of mortality and cardiovascular disease risks with diabetes and albuminuria in urban Indigenous Australians : the DRUID follow-up study. In: Diabetic Medicine. 2017 ; Vol. 34, No. 7. pp. 946-957.
@article{ba4409088aa441e382015fbb216b0f29,
title = "Associations of mortality and cardiovascular disease risks with diabetes and albuminuria in urban Indigenous Australians: the DRUID follow-up study",
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.",
author = "Barr, {E. L.M.} and Cunningham, {J M} and S. Tatipata and Terry Dunbar and Nadarajan Kangaharan and Steve Guthridge and Li, {S. Q.} and Condon, {J. R.} and Shaw, {J. E.} and K. O'Dea and Maple-Brown, {Louise J}",
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Barr, ELM, Cunningham, JM, Tatipata, S, Dunbar, T, Kangaharan, N, Guthridge, S, Li, SQ, Condon, JR, Shaw, JE, O'Dea, K & Maple-Brown, LJ 2017, 'Associations of mortality and cardiovascular disease risks with diabetes and albuminuria in urban Indigenous Australians: the DRUID follow-up study' Diabetic Medicine, vol. 34, no. 7, pp. 946-957. https://doi.org/10.1111/dme.13360

Associations of mortality and cardiovascular disease risks with diabetes and albuminuria in urban Indigenous Australians : the DRUID follow-up study. / Barr, E. L.M.; Cunningham, J M; Tatipata, S.; Dunbar, Terry; Kangaharan, Nadarajan; Guthridge, Steve; Li, S. Q.; Condon, J. R.; Shaw, J. E.; O'Dea, K.; Maple-Brown, Louise J.

In: Diabetic Medicine, Vol. 34, No. 7, 01.07.2017, p. 946-957.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Associations of mortality and cardiovascular disease risks with diabetes and albuminuria in urban Indigenous Australians

T2 - the DRUID follow-up study

AU - Barr, E. L.M.

AU - Cunningham, J M

AU - Tatipata, S.

AU - Dunbar, Terry

AU - Kangaharan, Nadarajan

AU - Guthridge, Steve

AU - Li, S. Q.

AU - Condon, J. R.

AU - Shaw, J. E.

AU - O'Dea, K.

AU - Maple-Brown, Louise J

PY - 2017/7/1

Y1 - 2017/7/1

N2 - 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.

AB - 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.

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U2 - 10.1111/dme.13360

DO - 10.1111/dme.13360

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VL - 34

SP - 946

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JF - Diabetic Medicine

SN - 0742-3071

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