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Standl, E.* ; Balletshofer, B.* ; Dahl, B.* ; Weichenhain, B.* ; Stiegler, H.* ; Hörmann, A. ; Holle, R.

Predictors of 10-year macrovascular and overall mortality in patients with NIDDM: The Munich General Practitioner Project.

Diabetologia 39, 1540-1545 (1996)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
The 10-year follow-up of the Munich General Practitioner Project was designed as a long-term prospective study to evaluate factors predicting macrovascular and overall mortality in a random cohort of non-insulin-dependent diabetic (NIDDM) patients. Of the original 290 patients (103 males, 187 females, median age 65 years) 92.5% could be assessed, 103 subjects had died, 58 from macrovascular causes. In an univariate analysis of baseline data, deceased patients, and especially those who died from macrovascular causes had significantly higher fasting blood glucose, HbA1c, von Willebrand-factor protein, urine albumin excretion, and serum beta 2-microglobulin, were significantly older, exhibited significantly more ischaemic heart disease (abnormal ECG Minnesota codes), carotid artery and peripheral vascular disease (both determined by ultrasound-Doppler), and had significantly inferior knowledge about diabetes and its treatment. No significant differences were seen for gender, blood pressure, smoking, total cholesterol, triglycerides, HDL-cholesterol, or the use of antidiabetic, antihypertensive or coronary drugs. In a multiple logistic regression analysis, the risk factors for macrovascular death were age, HbA1c and von Willebrand-factor protein. When baseline macrovascular disease was taken into account, carotid artery disease was also a determinant. The main variables from the metabolic syndrome (blood pressure, dyslipidaemia, body mass index) did not enter a multiple logistic regression analysis. The data suggest that age and haemoglobin A1c are major determinants, and that in addition von Willebrand-factor associated endothelial damage is a risk factor for macrovascular mortality in NIDDM patients.
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Publication type Article: Journal article
Document type Scientific Article
Keywords non-insulin-dependent diabetes mellitus; mortality; macrovascular mortality; von Willebrand factor; urine albumin excretion; HbA(1c); blood pressure; lipids; DEPENDENT DIABETES-MELLITUS; CORONARY-HEART-DISEASE; RISK-FACTORS; CARDIOVASCULAR-DISEASE; INTERVENTION TRIAL; RANDOM COHORT; MICROALBUMINURIA; FRAMINGHAM
ISSN (print) / ISBN 0012-186X
e-ISSN 1432-0428
Journal Diabetologia
Quellenangaben Volume: 39, Issue: 12, Pages: 1540-1545 Article Number: , Supplement: ,
Publisher Springer
Publishing Place Berlin ; Heidelberg [u.a.]
Reviewing status Peer reviewed
Institute(s) Department for Medical Information Systems (MEDIS)
Institute of Health Economics and Health Care Management (IGM)