Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Robitaille J[original query] |
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Lifetime risk, life expectancy, and years of life lost to type 2 diabetes in 23 high-income jurisdictions: a multinational, population-based study
Tomic D , Morton JI , Chen L , Salim A , Gregg EW , Pavkov ME , Arffman M , Balicer R , Baviera M , Boersma-van Dam E , Brinks R , Carstensen B , Chan JCN , Cheng YJ , Fosse-Edorh S , Fuentes S , Gardiner H , Gulseth HL , Gurevicius R , Ha KH , Hoyer A , Jermendy G , Kautzky-Willer A , Keskimäki I , Kim DJ , Kiss Z , Klimek P , Leventer-Roberts M , Lin CY , Lopez-Doriga Ruiz P , Luk AOY , Ma S , Mata-Cases M , Mauricio D , McGurnaghan S , Imamura T , Paul SK , Peeters A , Pildava S , Porath A , Robitaille C , Roncaglioni MC , Sugiyama T , Wang KL , Wild SH , Yekutiel N , Shaw JE , Magliano DJ . Lancet Diabetes Endocrinol 2022 10 (11) 795-803 BACKGROUND: Diabetes is a major public health issue. Because lifetime risk, life expectancy, and years of life lost are meaningful metrics for clinical decision making, we aimed to estimate these measures for type 2 diabetes in the high-income setting. METHODS: For this multinational, population-based study, we sourced data from 24 databases for 23 jurisdictions (either whole countries or regions of a country): Australia; Austria; Canada; Denmark; Finland; France; Germany; Hong Kong; Hungary; Israel; Italy; Japan; Latvia; Lithuania; the Netherlands; Norway; Scotland; Singapore; South Korea; Spain; Taiwan; the UK; and the USA. Our main outcomes were lifetime risk of type 2 diabetes, life expectancy in people with and without type 2 diabetes, and years of life lost to type 2 diabetes. We modelled the incidence and mortality of type 2 diabetes in people with and without type 2 diabetes in sex-stratified, age-adjusted, and calendar year-adjusted Poisson models for each jurisdiction. Using incidence and mortality, we constructed life tables for people of both sexes aged 20-100 years for each jurisdiction and at two timepoints 5 years apart in the period 2005-19 where possible. Life expectancy from a given age was computed as the area under the survival curves and lifetime lost was calculated as the difference between the expected lifetime of people with versus without type 2 diabetes at a given age. Lifetime risk was calculated as the proportion of each cohort who developed type 2 diabetes between the ages of 20 years and 100 years. We estimated 95% CIs using parametric bootstrapping. FINDINGS: Across all study cohorts from the 23 jurisdictions (total person-years 1 577 234 194), there were 5 119 585 incident cases of type 2 diabetes, 4 007 064 deaths in those with type 2 diabetes, and 11 854 043 deaths in those without type 2 diabetes. The lifetime risk of type 2 diabetes ranged from 16·3% (95% CI 15·6-17·0) for Scottish women to 59·6% (58·5-60·8) for Singaporean men. Lifetime risk declined with time in 11 of the 15 jurisdictions for which two timepoints were studied. Among people with type 2 diabetes, the highest life expectancies were found for both sexes in Japan in 2017-18, where life expectancy at age 20 years was 59·2 years (95% CI 59·2-59·3) for men and 64·1 years (64·0-64·2) for women. The lowest life expectancy at age 20 years with type 2 diabetes was observed in 2013-14 in Lithuania (43·7 years [42·7-44·6]) for men and in 2010-11 in Latvia (54·2 years [53·4-54·9]) for women. Life expectancy in people with type 2 diabetes increased with time for both sexes in all jurisdictions, except for Spain and Scotland. The life expectancy gap between those with and without type 2 diabetes declined substantially in Latvia from 2010-11 to 2015-16 and in the USA from 2009-10 to 2014-15. Years of life lost to type 2 diabetes ranged from 2·5 years (Latvia; 2015-16) to 12·9 years (Israel Clalit Health Services; 2015-16) for 20-year-old men and from 3·1 years (Finland; 2011-12) to 11·2 years (Israel Clalit Health Services; 2010-11 and 2015-16) for 20-year-old women. With time, the expected number of years of life lost to type 2 diabetes decreased in some jurisdictions and increased in others. The greatest decrease in years of life lost to type 2 diabetes occurred in the USA between 2009-10 and 2014-15 for 20-year-old men (a decrease of 2·7 years). INTERPRETATION: Despite declining lifetime risk and improvements in life expectancy for those with type 2 diabetes in many high-income jurisdictions, the burden of type 2 diabetes remains substantial. Public health strategies might benefit from tailored approaches to continue to improve health outcomes for people with diabetes. FUNDING: US Centers for Disease Control and Prevention and Diabetes Australia. |
Trends in all-cause mortality among people with diagnosed diabetes in high-income settings: a multicountry analysis of aggregate data
Magliano DJ , Chen L , Carstensen B , Gregg EW , Pavkov ME , Salim A , Andes LJ , Balicer R , Baviera M , Chan JCN , Cheng YJ , Gardiner H , Gulseth HL , Gurevicius R , Ha KH , Jermendy G , Kim DJ , Kiss Z , Leventer-Roberts M , Lin CY , Luk AOY , Ma S , Mata-Cases M , Mauricio D , Nichols GA , Pildava S , Porath A , Read SH , Robitaille C , Roncaglioni MC , Lopez-Doriga Ruiz P , Wang KL , Wild SH , Yekutiel N , Shaw JE . Lancet Diabetes Endocrinol 2022 10 (2) 112-119 BACKGROUND: Population-level trends in mortality among people with diabetes are inadequately described. We aimed to examine the magnitude and trends in excess all-cause mortality in people with diabetes. METHODS: In this retrospective, multicountry analysis, we collected aggregate data from 19 data sources in 16 high-income countries or jurisdictions (in six data sources in Asia, eight in Europe, one from Australia, and four from North America) for the period from Jan 1, 1995, to Dec 31, 2016, (or a subset of this period) on all-cause mortality in people with diagnosed total or type 2 diabetes. We collected data from administrative sources, health insurance records, registries, and a health survey. We estimated excess mortality using the standardised mortality ratio (SMR). FINDINGS: In our dataset, there were approximately 21 million deaths during 0·5 billion person-years of follow-up among people with diagnosed diabetes. 17 of 19 data sources showed decreases in the age-standardised and sex-standardised mortality in people with diabetes, among which the annual percentage change in mortality ranged from -0·5% (95% CI -0·7 to -0·3) in Hungary to -4·2% (-4·3 to -4·1) in Hong Kong. The largest decreases in mortality were observed in east and southeast Asia, with a change of -4·2% (95% CI -4·3 to -4·1) in Hong Kong, -4·0% (-4·8 to -3·2) in South Korea, -3·5% (-4·0 to -3·0) in Taiwan, and -3·6% (-4·2 to -2·9) in Singapore. The annual estimated change in SMR between people with and without diabetes ranged from -3·0% (95% CI -3·0 to -2·9; US Medicare) to 1·6% (1·4 to 1·7; Lombardy, Italy). Among the 17 data sources with decreasing mortality among people with diabetes, we found a significant SMR increase in five data sources, no significant SMR change in four data sources, and a significant SMR decrease in eight data sources. INTERPRETATION: All-cause mortality in diabetes has decreased in most of the high-income countries we assessed. In eight of 19 data sources analysed, mortality decreased more rapidly in people with diabetes than in those without diabetes. Further longevity gains will require continued improvement in prevention and management of diabetes. FUNDING: US Centers for Disease Control and Prevention, Diabetes Australia Research Program, and Victoria State Government Operational Infrastructure Support Program. |
Internationally comparable diagnosis-specific survival probabilities for calculation of the ICD-10-based Injury Severity Score
Gedeborg R , Warner M , Chen LH , Gulliver P , Cryer C , Robitaille Y , Bauer R , Ubeda C , Lauritsen J , Harrison J , Henley G , Langley J . J Trauma Acute Care Surg 2014 76 (2) 358-65 BACKGROUND: The International Statistical Classification of Diseases, 10th Revision (ICD-10)-based Injury Severity Score (ICISS) performs well but requires diagnosis-specific survival probabilities (DSPs), which are empirically derived, for its calculation. The objective was to examine if DSPs based on data pooled from several countries could increase accuracy, precision, utility, and international comparability of DSPs and ICISS. METHODS: Australia, Argentina, Austria, Canada, Denmark, New Zealand, and Sweden provided ICD-10-coded injury hospital discharge data, including in-hospital mortality status. Data from the seven countries were pooled using four different methods to create an international collaborative effort ICISS (ICE-ICISS). The ability of the ICISS to predict mortality using the country-specific DSPs and the pooled DSPs was estimated and compared. RESULTS: The pooled DSPs were based on a total of 3,966,550 observations of injury diagnoses from the seven countries. The proportion of injury diagnoses having at least 100 discharges to calculate the DSP varied from 12% to 48% in the country-specific data set and was 66% in the pooled data set. When compared with using a country's own DSPs for ICISS calculation, the pooled DSPs resulted in somewhat reduced discrimination in predicting mortality (difference in c statistic varied from 0.006 to 0.04). Calibration was generally good when the predicted mortality risk was less than 20%. When Danish and Swedish data were used, ICISS was combined with age and sex in a logistic regression model to predict in-hospital mortality. Including age and sex improved both discrimination and calibration substantially, and the differences from using country-specific or pooled DSPs were minor. CONCLUSION: Pooling data from seven countries generated empirically derived DSPs. These pooled DSPs facilitate international comparisons and enables the use of ICISS in all settings where ICD-10 hospital discharge diagnoses are available. The modest reduction in performance of the ICE-ICISS compared with the country-specific scores is unlikely to outweigh the benefit of internationally comparable Injury Severity Scores possible with pooled data. LEVEL OF EVIDENCE: Prognostic and epidemiological study. Level III. |
The impact of cardiovascular risk-factor profiles on blood pressure control rates in adults from Canada and the United States
McAlister FA , Robitaille C , Gillespie C , Yuan K , Rao DP , Grover S , Dai S , Johansen H , Joffres M , Loustalot F , Campbell N . Can J Cardiol 2013 29 (5) 598-605 BACKGROUND: It is unclear whether blood pressure control varies across the spectrum of atherosclerotic risk. METHODS: We used data from nonpregnant adults who had fasted laboratory samples drawn for the 2007-2009 cycle of the Canadian Health Measures Survey (CHMS) or the 2005-2008 US National Health and Nutrition Examination Survey (NHANES). RESULTS: The 1692 CHMS subjects and 3541 NHANES participants were demographically similar (aged a mean of 45 years), although NHANES participants exhibited higher obesity rates (33.8% vs 22.2%, P < 0.001). Over 80% of CHMS and NHANES subjects with hypertension had at least 1 other cardiovascular risk factor. As the number of atherosclerotic risk factors increased, hypertension prevalence increased, but blood pressure control rates improved (from 48% among hypertensives with no other risk factors in CHMS to 77% among those with 3 or more risk factors, and from 35% to 53% in NHANES). However, the converse was not true: The distribution of Framingham risk scores for those subjects with "controlled hypertension" was nearly identical to the distribution among those adults with uncontrolled hypertension in both CHMS and NHANES and substantially higher than scores in normotensive subjects. CONCLUSIONS: Although control of blood pressure was better in patients with multiple atherosclerotic risk factors, hypertensives with controlled blood pressures exhibited risk-factor profiles similar to those of participants with uncontrolled blood pressures. This suggests the need, in educational messaging and therapy decision making, for an increased focus on total atherosclerotic risk rather than just blood pressure control. |
Does the MTHFR 677C-->T variant affect the Recommended Dietary Allowance for folate in the US population?
Robitaille J , Hamner HC , Cogswell ME , Yang Q . Am J Clin Nutr 2009 89 (4) 1269-73 BACKGROUND: The MTHFR 677C-->T variant is associated with reduced enzyme activity, abnormalities of folate metabolism, and potential increase in folate requirement. The effect of this variant on the Recommended Dietary Allowance (RDA) for folate is unclear. OBJECTIVE: The aim of this study was to assess the effect of the MTHFR 677C-->T polymorphism on the current folate RDA for US adults aged > or =19 y (400 microg/d) by race and ethnicity. DESIGN: We calculated the projected RDA for folate for each racial and ethnic group according to the methods of the Institute of Medicine. We modeled the projected RDA with different hypothetical effect sizes ranging from 5% to 50%. The RDA value was then weighted according to the US prevalence of the TT (or the combined CT/TT) genotype in each racial and ethnic group. RESULTS: The projected RDA ranges were based on TT genotype frequencies and on different effect sizes (5-50%) that ranged from 400 to 421 microg/d for non-Hispanic whites, 401-436 microg/d for Mexican Americans, and 400-402 microg/d for non-Hispanic blacks. CONCLUSIONS: Our findings suggest that the current RDA for folate differs little for non-Hispanic whites, non-Hispanic blacks, and Mexican Americans irrespective of the MTHFR TT genotype, and, from a population perspective, the MTHFR 677C-->T variant does not warrant modifications to the current RDA for dietary folate at this time. |
Maternal nutrient intake and risks for transverse and longitudinal limb deficiencies: data from the National Birth Defects Prevention Study, 1997-2003
Robitaille J , Carmichael SL , Shaw GM , Olney RS , National Birth Defects Prevention Study . Birth Defects Res A Clin Mol Teratol 2009 85 (9) 773-9 BACKGROUND: The association between periconceptional intake of supplements containing folic acid with specific subtypes of limb deficiencies has been inconsistent. The objective was to investigate whether intake of nutrients involved in one-carbon metabolism (folate, vitamin B(6), vitamin B(12), riboflavin, choline, betaine, zinc, and methionine) through diet alone or in combination with a supplement containing folic acid influenced the risk for transverse limb deficiency (TLD) and longitudinal limb deficiency (LLD). METHODS: We analyzed 1997-2003 data from the National Birth Defects Prevention Study and included 324 case infants with TLD, 158 case infants with LLD, and 4982 nonmalformed control infants. A food frequency questionnaire was used to estimate nutrient intakes. Use of supplements containing folic acid 1 month before through 2 months after conception was recorded. RESULTS: Use of a supplement containing folic acid was not associated with LLD or TLD. For nonsupplement users, within (1) the lowest quartile of dietary folate intake or vitamin B(6) intake, adjusted odds ratios (aORs) for LLD were, respectively, 3.86 (95% confidence interval [CI]: 1.08-13.78) and 4.36 (95% CI: 0.93-20.48); and (2) the lowest quartile for riboflavin intake, the aOR for TLD was 2.94 (95% CI: 1.04-8.32). For supplement users within the lowest quartile of folate intake or riboflavin intake, the aORs for TLD were, respectively, 1.52 (95% CI: 0.91-2.54) and 1.54 (95% CI: 1.00-2.37). CONCLUSIONS: TLD and LLD were not associated with supplement use, but TLD was associated with low intakes of riboflavin from diet. |
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