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

**Authors:** Carlos Lederman, Joany Mariño Coronado, Nágila Raquel Teixeira Damasceno, Sabine Schipf, Alfredo José Mansur, Nele Friedrich, Matthias Nauck, Henry Völzke, Marcus Dörr, Davide Di Vece, Christian Templin, Martin Bahls, Till Ittermann, Marcello Ricardo Paulista Markus

PMC · DOI: 10.1038/s41598-026-44015-4 · 2026-03-28

## 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.

## Key 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.

## Linked entities

- **Diseases:** type 2 diabetes (MONDO:0005148)

## Full-text entities

- **Genes:** CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, LPA (lipoprotein(a)) [NCBI Gene 4018] {aka AK38, APOA, LP}
- **Diseases:** Hepatic steatosis (MESH:D005234), smoker (MESH:C000719328), Inflammatory (MESH:D007249), mitochondrial dysfunction (MESH:D028361), diabetes (MESH:D003920), Frailty (MESH:D000073496), CKD-EPI (MESH:D051436), Hypercholesterolemia (MESH:D006937), cardiovascular condition (MESH:D002318), Hypertension (MESH:D006973), death (MESH:D003643), cancer (MESH:D009369), obese (MESH:D009765), Type 2 diabetes (MESH:D003924), chronic diseases (MESH:D002908), stroke (MESH:D020521), myocardial infarction (MESH:D009203)
- **Chemicals:** lipid (MESH:D008055), glucose (MESH:D005947), Triglycerides (MESH:D014280), alcohol (MESH:D000438), cholesterol (MESH:D002784), spirits (-), creatinine (MESH:D003404), TG (MESH:D013866)
- **Species:** Nicotiana tabacum (American tobacco, species) [taxon 4097], Homo sapiens (human, species) [taxon 9606]

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC13035838/full.md

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Source: https://tomesphere.com/paper/PMC13035838