Cardiovascular Disease, Cancer, and Mortality Among People With Type 2 Diabetes and Alcoholic or Nonalcoholic Fatty Liver Disease Hospital Admission

Sarah H Wild; Jeremy J Walker; Joanne R Morling; David A McAllister; Helen M Colhoun; Bassam Farran; Stuart McGurnaghan; Rory McCrimmon; Stephanie H Read; Naveed Sattar; Christopher D Byrne; Scottish Diabetes Research Network Epidemiology Group

doi:10.2337/dc17-1590

Cardiovascular Disease, Cancer, and Mortality Among People With Type 2 Diabetes and Alcoholic or Nonalcoholic Fatty Liver Disease Hospital Admission

Sarah H Wild (Lead / Corresponding author), Jeremy J Walker, Joanne R Morling, David A McAllister, Helen M Colhoun, Bassam Farran, Stuart McGurnaghan, Rory McCrimmon, Stephanie H Read, Naveed Sattar, Christopher D Byrne, Scottish Diabetes Research Network Epidemiology Group

Research output: Contribution to journal › Article › peer-review

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Abstract

Objective: To describe associations between alcoholic liver disease (ALD) or nonalcoholic fatty liver disease (NAFLD) hospital admission and cardiovascular disease (CVD), cancer, and mortality in people with type 2 diabetes mellitus (T2DM).

Research Design and Methods: We performed a retrospective cohort study by using linked population-based routine data from diabetes registry, hospital, cancer, and death records for people ages 40-89 years diagnosed with T2DM in Scotland between 2004 and 2013 who had one or more hospital admission records. Liver disease and outcomes were identified by using ICD-9 and -10 codes. We estimated hazard ratios (HRs) from Cox proportional hazards regression models, adjusting for key risk factors.

Results: A total of 134,368 people with T2DM (1,707 with ALD and 1,452 with NAFLD) were studied, with a mean follow-up of 4.3 years for CVD and 4.7 years for mortality. Among those with ALD, NAFLD, or without liver disease hospital records 378, 320, and 21,873 CVD events; 268, 176, and 15,101 cancers; and 724, 221, and 16,203 deaths were reported, respectively. For ALD and NAFLD, respectively, adjusted HRs (95% CIs) compared with the group with no record of liver disease were 1.59 (1.43, 1.76) and 1.70 (1.52, 1.90) for CVD, 40.3 (28.8, 56.5) and 19.12 (11.71, 31.2) for hepatocellular carcinoma (HCC), 1.28 (1.12, 1.47) and 1.10 (0.94, 1.29) for non-HCC cancer, and 4.86 (4.50, 5.24) and 1.60 (1.40, 1.83) for all-cause mortality.

Conclusions: Hospital records of ALD or NAFLD are associated to varying degrees with an increased risk of CVD, cancer, and mortality among people with T2DM.

Original language	English
Article number	dc171590
Pages (from-to)	341-347
Number of pages	7
Journal	Diabetes Care
Volume	41
Issue number	2
Early online date	22 Nov 2017
DOIs	https://doi.org/10.2337/dc17-1590
Publication status	Published - Feb 2018

Keywords

Adult
Aged
Aged, 80 and over
Carcinoma, Hepatocellular/complications
Cardiovascular Diseases/epidemiology
Diabetes Complications/epidemiology
Diabetes Mellitus, Type 2/complications
Female
Hospitalization/statistics & numerical data
Humans
Liver Diseases, Alcoholic/complications
Liver Neoplasms/complications
Male
Middle Aged
Mortality
Neoplasms/epidemiology
Non-alcoholic Fatty Liver Disease/complications
Patient Admission/statistics & numerical data
Retrospective Studies
Risk Factors
Scotland/epidemiology

ASJC Scopus subject areas

Advanced and Specialised Nursing
Internal Medicine
Endocrinology, Diabetes and Metabolism

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.2337/dc17-1590

Author Accepted Manuscript
This is an author-created, uncopyedited electronic version of an article accepted for publication in Diabetes Care. The American Diabetes Association (ADA), publisher of Diabetes Care, is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version will be available in a future issue of Diabetes Care in print and online at http://care.diabetesjournals.org.
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McCrimmon, Rory
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Wild, S. H., Walker, J. J., Morling, J. R., McAllister, D. A., Colhoun, H. M., Farran, B., McGurnaghan, S., McCrimmon, R., Read, S. H., Sattar, N., Byrne, C. D., & Scottish Diabetes Research Network Epidemiology Group (2018). Cardiovascular Disease, Cancer, and Mortality Among People With Type 2 Diabetes and Alcoholic or Nonalcoholic Fatty Liver Disease Hospital Admission. Diabetes Care, 41(2), 341-347. Article dc171590. https://doi.org/10.2337/dc17-1590

@article{c6ebf4b766fe47d0b93d3bec8380218b,

title = "Cardiovascular Disease, Cancer, and Mortality Among People With Type 2 Diabetes and Alcoholic or Nonalcoholic Fatty Liver Disease Hospital Admission",

abstract = "Objective: To describe associations between alcoholic liver disease (ALD) or nonalcoholic fatty liver disease (NAFLD) hospital admission and cardiovascular disease (CVD), cancer, and mortality in people with type 2 diabetes mellitus (T2DM).Research Design and Methods: We performed a retrospective cohort study by using linked population-based routine data from diabetes registry, hospital, cancer, and death records for people ages 40-89 years diagnosed with T2DM in Scotland between 2004 and 2013 who had one or more hospital admission records. Liver disease and outcomes were identified by using ICD-9 and -10 codes. We estimated hazard ratios (HRs) from Cox proportional hazards regression models, adjusting for key risk factors.Results: A total of 134,368 people with T2DM (1,707 with ALD and 1,452 with NAFLD) were studied, with a mean follow-up of 4.3 years for CVD and 4.7 years for mortality. Among those with ALD, NAFLD, or without liver disease hospital records 378, 320, and 21,873 CVD events; 268, 176, and 15,101 cancers; and 724, 221, and 16,203 deaths were reported, respectively. For ALD and NAFLD, respectively, adjusted HRs (95% CIs) compared with the group with no record of liver disease were 1.59 (1.43, 1.76) and 1.70 (1.52, 1.90) for CVD, 40.3 (28.8, 56.5) and 19.12 (11.71, 31.2) for hepatocellular carcinoma (HCC), 1.28 (1.12, 1.47) and 1.10 (0.94, 1.29) for non-HCC cancer, and 4.86 (4.50, 5.24) and 1.60 (1.40, 1.83) for all-cause mortality.Conclusions: Hospital records of ALD or NAFLD are associated to varying degrees with an increased risk of CVD, cancer, and mortality among people with T2DM.",

keywords = "Adult, Aged, Aged, 80 and over, Carcinoma, Hepatocellular/complications, Cardiovascular Diseases/epidemiology, Diabetes Complications/epidemiology, Diabetes Mellitus, Type 2/complications, Female, Hospitalization/statistics & numerical data, Humans, Liver Diseases, Alcoholic/complications, Liver Neoplasms/complications, Male, Middle Aged, Mortality, Neoplasms/epidemiology, Non-alcoholic Fatty Liver Disease/complications, Patient Admission/statistics & numerical data, Retrospective Studies, Risk Factors, Scotland/epidemiology",

author = "Wild, {Sarah H} and Walker, {Jeremy J} and Morling, {Joanne R} and McAllister, {David A} and Colhoun, {Helen M} and Bassam Farran and Stuart McGurnaghan and Rory McCrimmon and Read, {Stephanie H} and Naveed Sattar and Byrne, {Christopher D} and {Scottish Diabetes Research Network Epidemiology Group}",

note = "Data linkage was funded by the Scottish Government through the Scottish Diabetes Group.",

year = "2018",

month = feb,

doi = "10.2337/dc17-1590",

language = "English",

volume = "41",

pages = "341--347",

journal = "Diabetes Care",

issn = "0149-5992",

publisher = "American Diabetes Association Inc.",

number = "2",

}

Wild, SH, Walker, JJ, Morling, JR, McAllister, DA, Colhoun, HM, Farran, B, McGurnaghan, S, McCrimmon, R, Read, SH, Sattar, N, Byrne, CD & Scottish Diabetes Research Network Epidemiology Group 2018, 'Cardiovascular Disease, Cancer, and Mortality Among People With Type 2 Diabetes and Alcoholic or Nonalcoholic Fatty Liver Disease Hospital Admission', Diabetes Care, vol. 41, no. 2, dc171590, pp. 341-347. https://doi.org/10.2337/dc17-1590

Cardiovascular Disease, Cancer, and Mortality Among People With Type 2 Diabetes and Alcoholic or Nonalcoholic Fatty Liver Disease Hospital Admission. / Wild, Sarah H (Lead / Corresponding author); Walker, Jeremy J; Morling, Joanne R et al.
In: Diabetes Care, Vol. 41, No. 2, dc171590, 02.2018, p. 341-347.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Cardiovascular Disease, Cancer, and Mortality Among People With Type 2 Diabetes and Alcoholic or Nonalcoholic Fatty Liver Disease Hospital Admission

AU - Wild, Sarah H

AU - Walker, Jeremy J

AU - Morling, Joanne R

AU - McAllister, David A

AU - Colhoun, Helen M

AU - Farran, Bassam

AU - McGurnaghan, Stuart

AU - McCrimmon, Rory

AU - Read, Stephanie H

AU - Sattar, Naveed

AU - Byrne, Christopher D

AU - Scottish Diabetes Research Network Epidemiology Group

N1 - Data linkage was funded by the Scottish Government through the Scottish Diabetes Group.

PY - 2018/2

Y1 - 2018/2

N2 - Objective: To describe associations between alcoholic liver disease (ALD) or nonalcoholic fatty liver disease (NAFLD) hospital admission and cardiovascular disease (CVD), cancer, and mortality in people with type 2 diabetes mellitus (T2DM).Research Design and Methods: We performed a retrospective cohort study by using linked population-based routine data from diabetes registry, hospital, cancer, and death records for people ages 40-89 years diagnosed with T2DM in Scotland between 2004 and 2013 who had one or more hospital admission records. Liver disease and outcomes were identified by using ICD-9 and -10 codes. We estimated hazard ratios (HRs) from Cox proportional hazards regression models, adjusting for key risk factors.Results: A total of 134,368 people with T2DM (1,707 with ALD and 1,452 with NAFLD) were studied, with a mean follow-up of 4.3 years for CVD and 4.7 years for mortality. Among those with ALD, NAFLD, or without liver disease hospital records 378, 320, and 21,873 CVD events; 268, 176, and 15,101 cancers; and 724, 221, and 16,203 deaths were reported, respectively. For ALD and NAFLD, respectively, adjusted HRs (95% CIs) compared with the group with no record of liver disease were 1.59 (1.43, 1.76) and 1.70 (1.52, 1.90) for CVD, 40.3 (28.8, 56.5) and 19.12 (11.71, 31.2) for hepatocellular carcinoma (HCC), 1.28 (1.12, 1.47) and 1.10 (0.94, 1.29) for non-HCC cancer, and 4.86 (4.50, 5.24) and 1.60 (1.40, 1.83) for all-cause mortality.Conclusions: Hospital records of ALD or NAFLD are associated to varying degrees with an increased risk of CVD, cancer, and mortality among people with T2DM.

AB - Objective: To describe associations between alcoholic liver disease (ALD) or nonalcoholic fatty liver disease (NAFLD) hospital admission and cardiovascular disease (CVD), cancer, and mortality in people with type 2 diabetes mellitus (T2DM).Research Design and Methods: We performed a retrospective cohort study by using linked population-based routine data from diabetes registry, hospital, cancer, and death records for people ages 40-89 years diagnosed with T2DM in Scotland between 2004 and 2013 who had one or more hospital admission records. Liver disease and outcomes were identified by using ICD-9 and -10 codes. We estimated hazard ratios (HRs) from Cox proportional hazards regression models, adjusting for key risk factors.Results: A total of 134,368 people with T2DM (1,707 with ALD and 1,452 with NAFLD) were studied, with a mean follow-up of 4.3 years for CVD and 4.7 years for mortality. Among those with ALD, NAFLD, or without liver disease hospital records 378, 320, and 21,873 CVD events; 268, 176, and 15,101 cancers; and 724, 221, and 16,203 deaths were reported, respectively. For ALD and NAFLD, respectively, adjusted HRs (95% CIs) compared with the group with no record of liver disease were 1.59 (1.43, 1.76) and 1.70 (1.52, 1.90) for CVD, 40.3 (28.8, 56.5) and 19.12 (11.71, 31.2) for hepatocellular carcinoma (HCC), 1.28 (1.12, 1.47) and 1.10 (0.94, 1.29) for non-HCC cancer, and 4.86 (4.50, 5.24) and 1.60 (1.40, 1.83) for all-cause mortality.Conclusions: Hospital records of ALD or NAFLD are associated to varying degrees with an increased risk of CVD, cancer, and mortality among people with T2DM.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Carcinoma, Hepatocellular/complications

KW - Cardiovascular Diseases/epidemiology

KW - Diabetes Complications/epidemiology

KW - Diabetes Mellitus, Type 2/complications

KW - Female

KW - Hospitalization/statistics & numerical data

KW - Humans

KW - Liver Diseases, Alcoholic/complications

KW - Liver Neoplasms/complications

KW - Male

KW - Middle Aged

KW - Mortality

KW - Neoplasms/epidemiology

KW - Non-alcoholic Fatty Liver Disease/complications

KW - Patient Admission/statistics & numerical data

KW - Retrospective Studies

KW - Risk Factors

KW - Scotland/epidemiology

U2 - 10.2337/dc17-1590

DO - 10.2337/dc17-1590

M3 - Article

C2 - 29167212

SN - 0149-5992

VL - 41

SP - 341

EP - 347

JO - Diabetes Care

JF - Diabetes Care

IS - 2

M1 - dc171590

ER -

Cardiovascular Disease, Cancer, and Mortality Among People With Type 2 Diabetes and Alcoholic or Nonalcoholic Fatty Liver Disease Hospital Admission

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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