Comparison of all-cause mortality risk factors in a population-based cohort study

TL;DR

This study identifies risk factors for all-cause mortality in a German population, highlighting diabetes, inflammation, and lifestyle factors.

Contribution

The study compares sex-specific risk factors for all-cause mortality using a long-term population-based cohort.

Findings

Type 2 diabetes and elevated hs-CRP are significant mortality risk factors for both men and women.

Men have additional risk factors like living alone, smoking, and older age.

The study used a 20-year follow-up to assess long-term mortality risks.

Abstract

All-cause mortality is a population health indicator of the combined impact of biological, behavioral, social, and healthcare-related factors. We used data from 3,803 participants (1,947 women, 51.2%; aged 20 to 81 years) of the population-based Study of Health in Pomerania (SHIP-START-0, 1997–2001), with a median follow-up duration of 20.2 years. Sex-stratified cox proportional hazard models were used to estimate associations between socioeconomic, lifestyle, anthropometric, and cardiovascular risk factors with all-cause mortality. During the 70,982 person-years, 1,029 deaths (641 men and 388 women) were determined as all-cause mortality. In men, type 2 diabetes (hazard ratio [HR] = 1.83 [95% confidence interval {CI}: 1.48 to 2.25; p < 0.001]), living without a partner (HR = 1.78 [95% CI: 1.41 to 2.24; p < 0.001]), being a current smoker (HR = 1.76 [95% CI: 1.41 to 2.20; p < 0.001]), older age (HR per year = 1.10 [95% CI: 1.10 to 1.11; p < 0.001]) and elevated hs-CRP (HR per mmol/l = 1.07 [95% CI: 1.03 to 1.11; p < 0.001]) where significantly associated with increased all-cause mortality. In women, just type 2 diabetes (HR = 1.70 [95% CI: 1.28 to 2.15; p < 0.001]) and elevated hs-CRP (HR per mmol/l = 1.07 [95% CI: 1.03 to 1.12; p < 0.001]) where significantly associated with increased all-cause mortality. Type 2 diabetes and inflammation were linked to higher all-cause mortality in both sexes, whereas being without a partner, current smoking, and older age were significant risk factors specifically for men.

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