LIPID BUT NOT GLYCEMIC PARAMETERS PREDICT TOTAL MORTALITY FROM TYPE-2DIABETES-MELLITUS IN CANTERBURY, NEW-ZEALAND

A cohort of 447 subjects with Type 2 diabetes mellitus (208 male, 239 female; age range 30-82, median 62 years; and of predominantly Europea n origin) was characterized in a clinic survey in 1989. Individual sta tus (dead or alive) at 1 June 1995 was ascertained. Mortality rates we re compared with the general New Zealand population by calculating sta ndardized mortality ratios (SMR) and the hazard ratio (HR) of prognost ic factors evaluated with Cox's proportional hazards model. At 6 years , 289 subjects were confirmed as alive and 133 as dead; only 25 were u ntraceable. Six-year survival for the cohort was 70 % (95 % CI 66-74). SMR was 2.53 (95 % CI 1.99-2.68) for the female cohort and 2.03 (95 % CI 1.60-2.59) for the male cohort. Factors assessed at baseline (1989 ) that were independently prognostic of total mortality included age, male sex, pre-existing coronary artery disease (CAD) (HR 2.2, 95 % CI 1.5-3.3) and plasma cholesterol (HR for 1.4 mmol l(-1) change: 1.49, 9 5 % CI 1.2-1.9). HDL-cholesterol was protective in women (HR for 0.4 m mol l(-1) change: 0.72, 95 % CI 0.51-1.00) but not men. Glycated haemo globin was not a significant predictor of total mortality. Predictors of CAD mortality (in those subjects free of CAD in 1989) included plas ma cholesterol (HR for 1.4 mmol l(-1) change: 1.86 95 % CI 1.20-2.89), glycated haemoglobin (HR for 1.8 % change: 1.9 95 % CI 1.04-3.47), ma le sex, peripheral vascular disease, and smoking. There is therefore i ncreased mortality in Type 2 diabetic subjects in Canterbury, New Zeal and. HDL-cholesterol is protective against total mortality in females. (C) 1998 John Wiley & Sons, Ltd.