PMID- 33238174
OWN - NLM
STAT- MEDLINE
DCOM- 20210315
LR  - 20221207
IS  - 1872-8227 (Electronic)
IS  - 0168-8227 (Linking)
VI  - 171
DP  - 2021 Jan
TI  - Examining the heterogeneity inexcess risks of coronary heart disease, stroke, 
      dialysis, and lower extremity amputation associated with type 2 diabetes mellitus 
      across demographic subgroups in an Asian population: A population-based matched 
      cohort study.
PG  - 108551
LID - S0168-8227(20)30808-1 [pii]
LID - 10.1016/j.diabres.2020.108551 [doi]
AB  - AIMS: To examine whether the excess risks of coronary heart disease (CHD), 
      stroke, dialysis, and lower extremity amputation (LEA) associated with type 2 
      diabetes mellitus (T2DM) differ across age, sex, and ethnicity in Singapore. 
      METHODS: Using a 10-year administrative data, we matched individuals with T2DM 
      using nearest neighbour matching, to those without, in 1:2 ratio. To examine 
      whether the excess risks were heterogeneous across age, sex, and ethnicity, we 
      generated interaction terms of age, sex, and ethnicity with T2DM status in Cox 
      proportional hazard (PH) models. RESULTS: The main analyses included ~1 million 
      person years, comprising 66,099 and 120,485 individuals with and without T2DM, 
      respectively. The associations of T2DM with CHD and dialysis, split into two time 
      periods to address violation of PH assumption, were higher with older age in 
      short-term but lower with older age in long-term. The association of T2DM with 
      stroke and LEA were lower with older age. The associations of T2DM with CHD and 
      stroke were also consistently higher in women than men. The associations of T2DM 
      with LEA were higher in ethnic Malays than ethnic Chinese. CONCLUSIONS: The 
      excess risks of CHD, stroke, dialysis, and LEA associated with T2DM were 
      heterogeneous across some demographic subgroups.
CI  - Copyright (c) 2020. Published by Elsevier B.V.
FAU - Lim, Ka Keat
AU  - Lim KK
AD  - Programme in Health Services and Systems Research, Duke-NUS Medical School, 
      Singapore, Republic of Singapore; School of Population Health & Environmental 
      Sciences, Faculty of Life Sciences & Medicine, King's College London, London, 
      United Kingdom; National Institute for Health Research (NIHR) Biomedical Research 
      Centre, Guy's and St Thomas' NHS Foundation Trust and King's College London, 
      United Kingdom.
FAU - Lee, Vivian Shu Yi
AU  - Lee VSY
AD  - SingHealth Regional Health System, Singapore Health Services, Singapore, Republic 
      of Singapore.
FAU - Tan, Chuen Seng
AU  - Tan CS
AD  - Saw Swee Hock School of Public Health, National University of Singapore and 
      National University Health System, Singapore, Republic of Singapore.
FAU - Kwan, Yu Heng
AU  - Kwan YH
AD  - Programme in Health Services and Systems Research, Duke-NUS Medical School, 
      Singapore, Republic of Singapore; Department of Rheumatology and Immunology, 
      Singapore General Hospital, Singapore, Republic of Singapore.
FAU - Lim, Zoey Hui Xian
AU  - Lim ZHX
AD  - SingHealth Regional Health System, Singapore Health Services, Singapore, Republic 
      of Singapore.
FAU - Wee, Hwee Lin
AU  - Wee HL
AD  - Saw Swee Hock School of Public Health, National University of Singapore and 
      National University Health System, Singapore, Republic of Singapore; Department 
      of Pharmacy, Faculty of Science, National University of Singapore, Singapore, 
      Republic of Singapore.
FAU - Ostbye, Truls
AU  - Ostbye T
AD  - Programme in Health Services and Systems Research, Duke-NUS Medical School, 
      Singapore, Republic of Singapore.
FAU - Low, Lian Leng
AU  - Low LL
AD  - Department of Family Medicine and Continuing Care, Singapore General Hospital, 
      Singapore, Republic of Singapore; Post Acute and Continuing Care, SingHealth 
      Community Hospitals, Singapore; SingHealth Duke-NUS Family Medicine Academic 
      Clinical Program, Singapore; PULSES Centre Grant, SingHealth Regional Health 
      System, Singapore. Electronic address: low.lian.leng@singhealth.com.sg.
LA  - eng
PT  - Journal Article
DEP - 20201122
PL  - Ireland
TA  - Diabetes Res Clin Pract
JT  - Diabetes research and clinical practice
JID - 8508335
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Amputation, Surgical/*methods
MH  - Asian People
MH  - Cohort Studies
MH  - Coronary Disease/*epidemiology/*etiology
MH  - Diabetes Mellitus, Type 2/*epidemiology/*etiology
MH  - Female
MH  - Humans
MH  - Lower Extremity/*blood supply
MH  - Male
MH  - Middle Aged
MH  - Renal Dialysis/*methods
MH  - Risk Factors
MH  - Young Adult
OTO - NOTNLM
OT  - Amputation
OT  - Chronic kidney disease
OT  - Complications of diabetes mellitus
OT  - Coronary heart disease
OT  - Cox proportional hazards models
OT  - Dialysis
OT  - Stroke
OT  - Type 2 diabetes mellitus
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2020/11/26 06:00
MHDA- 2021/03/16 06:00
CRDT- 2020/11/25 20:05
PHST- 2020/06/28 00:00 [received]
PHST- 2020/10/28 00:00 [revised]
PHST- 2020/11/10 00:00 [accepted]
PHST- 2020/11/26 06:00 [pubmed]
PHST- 2021/03/16 06:00 [medline]
PHST- 2020/11/25 20:05 [entrez]
AID - S0168-8227(20)30808-1 [pii]
AID - 10.1016/j.diabres.2020.108551 [doi]
PST - ppublish
SO  - Diabetes Res Clin Pract. 2021 Jan;171:108551. doi: 10.1016/j.diabres.2020.108551. 
      Epub 2020 Nov 22.