Diabetes and lifetime risk of stroke and subtypes in an urban middle-aged population

Tanvir Chowdhury Turin, Tomonori Okamura, Nahid Rumana, Arfan Raheen Afzal, Makoto Watanabe, Aya Higashiyama, Yoko M. Nakao, Michikazu Nakai, Misa Takegami, Kunihiro Nishimura, Yoshihiro Kokubo, Akira Okayama, Yoshihiro Miyamoto

Research output: Contribution to journalArticle

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Abstract

Aims: Lifetime risk (LTR) is defined as the cumulative probability of developing a disease in one's remaining lifetime from a given index age. The impact of diabetes on the LTR of stroke events in Asians, where stroke incidence is higher than for Westerners, has not been estimated yet. These estimates can be useful for diabetes knowledge translation activities. Methods: All participants who were stroke-free at baseline in the Suita Study, a cohort study of cardiovascular diseases in Japan, were included in the study sample. Age, in years, was used as the time-scale. Age-specific incidence rates were calculated using the person-years method within five-year bands. We estimated the sex- and index-age-specific LTR of first-ever stroke accounting for the competing risk of death. Results: In this cohort study, we followed 5515 participants from 1989 to 2007 for 71,374.23 person-years. At age 40, the LTRs, adjusted for competing risk of death, for all strokes were 15.98% for men without diabetes and 26.64% for men with diabetes. The LTR for stroke was 10.66% higher for men with diabetes than men without diabetes. For women of same index age, the LTR of stroke was 17.29% and 30.72% with diabetes and without diabetes, respectively. The difference in LTR between persons with diabetes and without diabetes was 13.43%. This increased LTR of strokes for persons with diabetes was observed among both men and women across all index ages. Similar results were observed for cerebral infarction stroke subtype. Conclusions: In this urban community-based population we observed that diabetes has a significant effect on the residual LTR of stroke for both men and women of middle age. This knowledge can be used to inform public health education and planning.

Original languageEnglish
JournalJournal of Diabetes and its Complications
DOIs
Publication statusAccepted/In press - 2016 Nov 24

Fingerprint

Stroke
Population
Cohort Studies
Health Planning
Translational Medical Research
Incidence
Cerebral Infarction
Health Education
Japan
Cardiovascular Diseases
Public Health

Keywords

  • Cohort
  • Diabetes
  • Japan
  • Lifetime risk
  • Stroke

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Diabetes and lifetime risk of stroke and subtypes in an urban middle-aged population. / Turin, Tanvir Chowdhury; Okamura, Tomonori; Rumana, Nahid; Afzal, Arfan Raheen; Watanabe, Makoto; Higashiyama, Aya; Nakao, Yoko M.; Nakai, Michikazu; Takegami, Misa; Nishimura, Kunihiro; Kokubo, Yoshihiro; Okayama, Akira; Miyamoto, Yoshihiro.

In: Journal of Diabetes and its Complications, 24.11.2016.

Research output: Contribution to journalArticle

Turin, TC, Okamura, T, Rumana, N, Afzal, AR, Watanabe, M, Higashiyama, A, Nakao, YM, Nakai, M, Takegami, M, Nishimura, K, Kokubo, Y, Okayama, A & Miyamoto, Y 2016, 'Diabetes and lifetime risk of stroke and subtypes in an urban middle-aged population', Journal of Diabetes and its Complications. https://doi.org/10.1016/j.jdiacomp.2017.02.002
Turin, Tanvir Chowdhury ; Okamura, Tomonori ; Rumana, Nahid ; Afzal, Arfan Raheen ; Watanabe, Makoto ; Higashiyama, Aya ; Nakao, Yoko M. ; Nakai, Michikazu ; Takegami, Misa ; Nishimura, Kunihiro ; Kokubo, Yoshihiro ; Okayama, Akira ; Miyamoto, Yoshihiro. / Diabetes and lifetime risk of stroke and subtypes in an urban middle-aged population. In: Journal of Diabetes and its Complications. 2016.
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AU - Turin, Tanvir Chowdhury

AU - Okamura, Tomonori

AU - Rumana, Nahid

AU - Afzal, Arfan Raheen

AU - Watanabe, Makoto

AU - Higashiyama, Aya

AU - Nakao, Yoko M.

AU - Nakai, Michikazu

AU - Takegami, Misa

AU - Nishimura, Kunihiro

AU - Kokubo, Yoshihiro

AU - Okayama, Akira

AU - Miyamoto, Yoshihiro

PY - 2016/11/24

Y1 - 2016/11/24

N2 - Aims: Lifetime risk (LTR) is defined as the cumulative probability of developing a disease in one's remaining lifetime from a given index age. The impact of diabetes on the LTR of stroke events in Asians, where stroke incidence is higher than for Westerners, has not been estimated yet. These estimates can be useful for diabetes knowledge translation activities. Methods: All participants who were stroke-free at baseline in the Suita Study, a cohort study of cardiovascular diseases in Japan, were included in the study sample. Age, in years, was used as the time-scale. Age-specific incidence rates were calculated using the person-years method within five-year bands. We estimated the sex- and index-age-specific LTR of first-ever stroke accounting for the competing risk of death. Results: In this cohort study, we followed 5515 participants from 1989 to 2007 for 71,374.23 person-years. At age 40, the LTRs, adjusted for competing risk of death, for all strokes were 15.98% for men without diabetes and 26.64% for men with diabetes. The LTR for stroke was 10.66% higher for men with diabetes than men without diabetes. For women of same index age, the LTR of stroke was 17.29% and 30.72% with diabetes and without diabetes, respectively. The difference in LTR between persons with diabetes and without diabetes was 13.43%. This increased LTR of strokes for persons with diabetes was observed among both men and women across all index ages. Similar results were observed for cerebral infarction stroke subtype. Conclusions: In this urban community-based population we observed that diabetes has a significant effect on the residual LTR of stroke for both men and women of middle age. This knowledge can be used to inform public health education and planning.

AB - Aims: Lifetime risk (LTR) is defined as the cumulative probability of developing a disease in one's remaining lifetime from a given index age. The impact of diabetes on the LTR of stroke events in Asians, where stroke incidence is higher than for Westerners, has not been estimated yet. These estimates can be useful for diabetes knowledge translation activities. Methods: All participants who were stroke-free at baseline in the Suita Study, a cohort study of cardiovascular diseases in Japan, were included in the study sample. Age, in years, was used as the time-scale. Age-specific incidence rates were calculated using the person-years method within five-year bands. We estimated the sex- and index-age-specific LTR of first-ever stroke accounting for the competing risk of death. Results: In this cohort study, we followed 5515 participants from 1989 to 2007 for 71,374.23 person-years. At age 40, the LTRs, adjusted for competing risk of death, for all strokes were 15.98% for men without diabetes and 26.64% for men with diabetes. The LTR for stroke was 10.66% higher for men with diabetes than men without diabetes. For women of same index age, the LTR of stroke was 17.29% and 30.72% with diabetes and without diabetes, respectively. The difference in LTR between persons with diabetes and without diabetes was 13.43%. This increased LTR of strokes for persons with diabetes was observed among both men and women across all index ages. Similar results were observed for cerebral infarction stroke subtype. Conclusions: In this urban community-based population we observed that diabetes has a significant effect on the residual LTR of stroke for both men and women of middle age. This knowledge can be used to inform public health education and planning.

KW - Cohort

KW - Diabetes

KW - Japan

KW - Lifetime risk

KW - Stroke

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