Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study

Roqayeh Aliyari,1 Ebrahim Hajizadeh,1 Ashraf Aminorroaya,2 Farshad Sharifi,3 Iraj Kazemi,4 Ahmad-Reza Baghestani5 1Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; 2Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Scie...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Aliyari R, Hajizadeh E, Aminorroaya A, Sharifi F, Kazemi I, Baghestani AR
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	t2dm hypertension cad microalbuminuria retinopathy diabetics complications multistate models transition probability Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/5e5dda020ac042819c87cd2b34d021fc
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:5e5dda020ac042819c87cd2b34d021fc
record_format	dspace
spelling	oai:doaj.org-article:5e5dda020ac042819c87cd2b34d021fc2021-12-02T12:11:24ZMultistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study1178-7007https://doaj.org/article/5e5dda020ac042819c87cd2b34d021fc2020-05-01T00:00:00Zhttps://www.dovepress.com/multistate-models-to-predict-development-of-late-complications-of-type-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Roqayeh Aliyari,1 Ebrahim Hajizadeh,1 Ashraf Aminorroaya,2 Farshad Sharifi,3 Iraj Kazemi,4 Ahmad-Reza Baghestani5 1Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; 2Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; 3Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; 4Department of Statistics, Faculty of Sciences, University of Isfahan, Isfahan, Iran; 5Department of Biostatistics, Physiotherapy Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IranCorrespondence: Ebrahim HajizadehDepartment of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 1411713116, IranTel +982182883810Fax +982182884510Email hajizadeh@modares.ac.irAshraf AminorroayaIsfahan Endocrine and Metabolism Research, Isfahan University of Medical Sciences, Isfahan, IranTel +98 313 335 9933Fax +98 313 337 3733Email aminorroaya@med.mui.ac.irBackground: Increase in the prevalence of type 2 diabetic mellitus (T2DM) as a complex disease, its complications, and spread has become a dominant global health threat in recent decades.Objective: The aim of the current study was to investigate the impact of risk factors and transition probability on the development and progression of the late complications of T2DM.Methods: This study was an open cohort one which was conducted at Isfahan Endocrine and Metabolism Research Center (IEMRC). The data were collected from 1993 to 2018. The sample size consisted of 2519 adults diagnosed with type 2 diabetes. We applied the homogeneous multistate models including no complication, retinopathy alone, coronary artery disease (CAD), microalbuminuria, retinopathy and CAD, and the final absorbing mortality states.Results: Based on our results, time-varying hypertension strongly intensified the hazard of transition to mortality in CAD, no complication, CAD and retinopathy, and retinopathy patients by 4.99, 4.09, 3.42, and 2.65 times, respectively. Hypertension seemed to be a potential factor for the transition of microalbuminuria to no complication in diabetic patients. One-unit increase in LDL increased the hazard ratio of transition from CAD, and retinopathy and CAD to mortality by 1.8% and 2.4%, respectively. Moreover, one level increase in time-varying HbA1c increased the hazard ratio of transition to retinopathy and mortality among no complication diabetic patients by 30% and 67%, respectively. One level increase in time-varying HbA1c also intensified the hazard ratio of transition from retinopathy to mortality by 45%. The same level of increase in time-varying HbA1c also intensified the hazard ratio of transition from CAD alone to CAD and retinopathy, and microalbuminuria to retinopathy by 26% and 50%, respectively.Conclusion: In addition to glycemic control, our study indicates that controlling hypertension and hyperlipidemia is more effective in reducing mortality and the diabetic macro- and microvascular complications.Keywords: T2DM, hypertension, CAD, microalbuminuria, retinopathy, diabetics complications, multistate models, transition probabilityAliyari RHajizadeh EAminorroaya ASharifi FKazemi IBaghestani ARDove Medical Pressarticlet2dmhypertensioncadmicroalbuminuriaretinopathydiabetics complicationsmultistate modelstransition probabilitySpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 13, Pp 1863-1872 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	t2dm hypertension cad microalbuminuria retinopathy diabetics complications multistate models transition probability Specialties of internal medicine RC581-951
spellingShingle	t2dm hypertension cad microalbuminuria retinopathy diabetics complications multistate models transition probability Specialties of internal medicine RC581-951 Aliyari R Hajizadeh E Aminorroaya A Sharifi F Kazemi I Baghestani AR Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study
description	Roqayeh Aliyari,1 Ebrahim Hajizadeh,1 Ashraf Aminorroaya,2 Farshad Sharifi,3 Iraj Kazemi,4 Ahmad-Reza Baghestani5 1Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; 2Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; 3Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; 4Department of Statistics, Faculty of Sciences, University of Isfahan, Isfahan, Iran; 5Department of Biostatistics, Physiotherapy Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IranCorrespondence: Ebrahim HajizadehDepartment of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 1411713116, IranTel +982182883810Fax +982182884510Email hajizadeh@modares.ac.irAshraf AminorroayaIsfahan Endocrine and Metabolism Research, Isfahan University of Medical Sciences, Isfahan, IranTel +98 313 335 9933Fax +98 313 337 3733Email aminorroaya@med.mui.ac.irBackground: Increase in the prevalence of type 2 diabetic mellitus (T2DM) as a complex disease, its complications, and spread has become a dominant global health threat in recent decades.Objective: The aim of the current study was to investigate the impact of risk factors and transition probability on the development and progression of the late complications of T2DM.Methods: This study was an open cohort one which was conducted at Isfahan Endocrine and Metabolism Research Center (IEMRC). The data were collected from 1993 to 2018. The sample size consisted of 2519 adults diagnosed with type 2 diabetes. We applied the homogeneous multistate models including no complication, retinopathy alone, coronary artery disease (CAD), microalbuminuria, retinopathy and CAD, and the final absorbing mortality states.Results: Based on our results, time-varying hypertension strongly intensified the hazard of transition to mortality in CAD, no complication, CAD and retinopathy, and retinopathy patients by 4.99, 4.09, 3.42, and 2.65 times, respectively. Hypertension seemed to be a potential factor for the transition of microalbuminuria to no complication in diabetic patients. One-unit increase in LDL increased the hazard ratio of transition from CAD, and retinopathy and CAD to mortality by 1.8% and 2.4%, respectively. Moreover, one level increase in time-varying HbA1c increased the hazard ratio of transition to retinopathy and mortality among no complication diabetic patients by 30% and 67%, respectively. One level increase in time-varying HbA1c also intensified the hazard ratio of transition from retinopathy to mortality by 45%. The same level of increase in time-varying HbA1c also intensified the hazard ratio of transition from CAD alone to CAD and retinopathy, and microalbuminuria to retinopathy by 26% and 50%, respectively.Conclusion: In addition to glycemic control, our study indicates that controlling hypertension and hyperlipidemia is more effective in reducing mortality and the diabetic macro- and microvascular complications.Keywords: T2DM, hypertension, CAD, microalbuminuria, retinopathy, diabetics complications, multistate models, transition probability
format	article
author	Aliyari R Hajizadeh E Aminorroaya A Sharifi F Kazemi I Baghestani AR
author_facet	Aliyari R Hajizadeh E Aminorroaya A Sharifi F Kazemi I Baghestani AR
author_sort	Aliyari R
title	Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study
title_short	Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study
title_full	Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study
title_fullStr	Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study
title_full_unstemmed	Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study
title_sort	multistate models to predict development of late complications of type 2 diabetes in an open cohort study
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/5e5dda020ac042819c87cd2b34d021fc
work_keys_str_mv	AT aliyarir multistatemodelstopredictdevelopmentoflatecomplicationsoftype2diabetesinanopencohortstudy AT hajizadehe multistatemodelstopredictdevelopmentoflatecomplicationsoftype2diabetesinanopencohortstudy AT aminorroayaa multistatemodelstopredictdevelopmentoflatecomplicationsoftype2diabetesinanopencohortstudy AT sharifif multistatemodelstopredictdevelopmentoflatecomplicationsoftype2diabetesinanopencohortstudy AT kazemii multistatemodelstopredictdevelopmentoflatecomplicationsoftype2diabetesinanopencohortstudy AT baghestaniar multistatemodelstopredictdevelopmentoflatecomplicationsoftype2diabetesinanopencohortstudy
_version_	1718394631147749376

Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study

Ejemplares similares