Contribution of type 2 diabetes to all-cause mortality, cardiovascular disease incidence and cancer incidence in white Europeans and South Asians: findings from the UK Biobank population-based cohort study

Muilwijk, M. et al. (2019) Contribution of type 2 diabetes to all-cause mortality, cardiovascular disease incidence and cancer incidence in white Europeans and South Asians: findings from the UK Biobank population-based cohort study. BMJ Open Diabetes Research and Care, 7(1), e000765. (doi: 10.1136/bmjdrc-2019-000765) (PMID:31908795) (PMCID:PMC6936483)

Abstract

Objective: To investigate whether the health implications of having type 2 diabetes (T2D) were different in South Asian compared with white European participants. Research design and methods: Prospective data from UK Biobank were used, and 457 935 participants of white European and 7102 of South Asian background were included. Cox proportional regression was performed to investigate the association between T2D and health outcome by ethnicity. Results: Over a mean of 7.0 years (IQR 6.3–7.6) of follow-up, 12 974 participants had died, and 30 347 and 27 159 developed cardiovascular disease (CVD) and cancer, respectively. South Asians had a higher risk for CVD mortality (HR: 1.42, 95% CI 1.07 to 1.89) and incidence (HR: 1.78, 95% CI 1.63 to 1.94), but a decreased risk for cancer mortality (HR: 0.59, 95% CI 0.41 to 0.85) and incidence (HR: 0.80, 95% CI 0.70 to 0.92) compared with white Europeans. Compared with individuals without T2D, both white Europeans and South Asians with T2D had a higher risk for all-cause mortality (1.59 (1.48 to 1.71) vs 2.83 (1.76 to 4.53)), CVD mortality (2.04 (1.82 to 2.28) vs 4.40 (2.37 to 8.16)) and CVD incidence (1.37 (1.31 to 1.44) vs 1.60 (1.31 to 1.95)), respectively. However, the magnitude of the risk was higher for South Asians than white Europeans. Conclusions: Although T2D was associated with a higher risk for all-cause mortality and CVD incidence and mortality, in both white Europeans and South Asians, the risk experienced by South Asians with T2D was higher than their white European counterparts.

• Item Type: Articles
• Additional Information: This work was supported by the Health Behaviours & Chronic Diseases, Amsterdam Public Health. MM received a travel grant.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Waddell, Miss Heather and Gill, Professor Jason and Sillars, Dr Anne and Ho, Dr Frederick and Ferguson, Dr Lyn and Brown, Miss Rosemary and Welsh, Professor Paul and Celis, Dr Carlos and Gray, Professor Stuart and Iliodromiti, Dr Stamatina and Pell, Professor Jill and Sattar, Professor Naveed
• Authors: Muilwijk, M., Ho, F., Waddell, H., Sillars, A., Welsh, P., Iliodromiti, S., Brown, R., Ferguson, L., Stronks, K., van Valkengoed, I., Pell, J. P., Gray, S. R., Gill, J. M. R., Sattar, N., and Celis-Morales, C.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: BMJ Open Diabetes Research and Care
• Publisher: BMJ Publishing Group
• ISSN: 2052-4897
• ISSN (Online): 2052-4897
• Published Online: 17 December 2019
• Copyright Holders: Copyright © 2019 The Authors
• First Published: First published in BMJ Open Diabetes Research and Care 7(1): e000765
• Publisher Policy: Reproduced under a Creative Commons License