What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiovascular Disease (n=24013). Intervention: Diabetes vs. Normal glucose category. Primary outcome: Cardiovascular disease (CVD) incidents (Third cohort: 2000-2003) (HR 2.59, 95% CI 1.77-3.81).

What question did this study set out to answer?

To assess whether the impact and population burden of diabetes on cardiovascular disease risk have increased over recent decades in middle-aged Japanese residents.

January 1, 2016Circulation JournalOpen Access

Diabetes Trend and Impact on Risk of Cardiovascular Disease in Middle-Aged Japanese People – The CIRCS Study –

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Key result

Diabetes significantly increased the risk of cardiovascular disease in middle-aged Japanese individuals, with the multivariable-adjusted hazard ratio rising from 1.40 in 1992-1995 to 2.59 in the 2000-2003 cohort.

Why the study?

Does the presence of diabetes increase the risk of cardiovascular disease in middle-aged Japanese people over time?

Population

24,013 Japanese residents aged 40-69 years across three cohorts

Comparison

Diabetes vs No diabetes

Design

Cohort

Follow-up

median 10 years

Authors

MHMina Hayama‐TeradaTeradata (United Kingdom)IMIsao MurakiPreventive Cardiology HIHironori ImanoPreventive Cardiology

Discussion

Member takes

Implication

May signal rising diabetes-related CVD burden in Japanese adults; hypothesis-generating for evolving risk profiles and needs prospective validation.

Key Points

To assess whether the impact and population burden of diabetes on cardiovascular disease risk have increased over recent decades in middle-aged Japanese residents.
Prospective cohort analysis across three baseline periods: 1992–1995 (n=8,744), 1996–1999 (n=7,996), and 2000–2003 (n=7,273) with a median follow-up of 10 years in participants aged 40–69 years.
Diabetes was defined as fasting serum glucose ≥7.0 mmol/L, non-fasting glucose ≥11.1 mmol/L, or baseline anti-diabetic medication use.
Multivariable Cox proportional hazards models adjusted for traditional cardiovascular risk factors to estimate hazard ratios and population attributable fractions.
Incident cardiovascular disease occurred in 277 participants in the first cohort, 214 in the second cohort, and 190 in the third cohort.
Multivariable-adjusted hazard ratios for cardiovascular disease in individuals with diabetes rose progressively: HR 1.40 (95% CI, 0.91–2.14) in 1992–1995, HR 1.93 (95% CI, 1.25–3.00) in 1996–1999, and HR 2.59 (95% CI, 1.77–3.81) in 2000–2003.
The population attributable fraction of cardiovascular disease due to diabetes increased across the cohorts from 2.8% to 5.6% and 12.4%.

Study Design

Type

Cohort (n=24,013)

Multicenter

Yes

Structured PICO

Does the presence of diabetes increase the risk of cardiovascular disease in middle-aged Japanese people over time?

Population

24,013 Japanese residents aged 40-69 years without a history of cardiovascular disease were divided into three cohorts from 1992 to 2003 and followed for a median of 10 years to assess the impact of diabetes on cardiovascular risk.

Exposure

Diabetes (defined as fasting serum glucose ≥7.0 mmol/L, non-fasting serum glucose ≥11.1 mmol/L, or anti-diabetic treatment)

Comparator

No diabetes

Outcome

Cardiovascular disease (CVD) incidentshard clinical

Main Result

Hazard Ratio: 2.59 (95% CI 1.77–3.81)

Absolute Event Rate: 6.96% vs 2.14%

The burden of cardiovascular disease attributable to diabetes in middle-aged Japanese people has significantly increased since the early 1990s.

Limitations

Criteria for the diagnosis of diabetes were updated in 1999, which may have affected prevalence estimates.
Relied on a single glucose measurement without glycated hemoglobin or oral glucose tolerance tests.
Did not require the presence of symptoms for the definition of diabetes, potentially identifying false positives.
Increasing chance of early CVD detection due to the increased proportion of treated diabetes patients.
Results may not be generalizable to other ethnic groups.

Cite This Study

Hayama‐Terada et al. (2016) conducted a cohort in Cardiovascular Disease (n=24,013). Diabetes vs. Normal glucose category was evaluated on Cardiovascular disease (CVD) incidents (Third cohort: 2000-2003) (HR 2.59, 95% CI 1.77-3.81). Diabetes significantly increased the risk of cardiovascular disease in middle-aged Japanese individuals, with the multivariable-adjusted hazard ratio rising from 1.40 in 1992-1995 to 2.59 in the 2000-2003 cohort.

synapsesocial.com/papers/6a95027dcd304312aafa5e92 https://doi.org/10.1253/circj.cj-16-0549

Topics

Women and heart disease

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Implication

May signal rising diabetes-related CVD burden in Japanese adults; hypothesis-generating for evolving risk profiles and needs prospective validation.

Diabetes Trend and Impact on Risk of Cardiovascular Disease in Middle-Aged Japanese People – The CIRCS Study –

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Diabetes Trend and Impact on Risk of Cardiovascular Disease in Middle-Aged Japanese People – The CIRCS Study –

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider