INCREASE IN THE MORTALITY ASSOCIATED WITH THE PRESENCE OF DIABETES-MELLITUS IN JAPANESE-BRAZILIANS

Objective As part of a study involving Japanese migrants, living in a developed city in the stare of S. Paulo, Southeastern Brazil, a four-y ear experience of mortality among diabetic and non-diabetic subjects i s described and their respective death rates are compared. In 1993, a cohort of 530 Japanese-Brazilians (236 issei or 1st generation and 294 nisei or 2nd generation) of both both sexes, aged 40 from to 79 years old, were identified. Research design and Method At that time, 91 (17 %) were classified as non-insulin-dependent diabetic subjects (NIDDM), 90 (17%) with impaired glucose tolerance (IGT) and 349 (66%) as norma l, according to WHO criteria. In 1996, families were questioned with a view detecting the deaths wich had occurred among the subjects previo usly studied. This information, in addition to that from death certifi cates was used to record the date and the causes of death. Mortality r ates Soi all causes and for specific causes (circulatory and renal dis eases) were obtained So, the three groups of subjects, by glucose tole rance status. Proportional haz ard regression models were used to comp are the mortality rates, adjusted for several covariables (gender, age , generation, hypertension, dyslipidemia, obesity and serum creatinine ). Results and Conclusions Crude mortality rate ratios for all causes and specific causes, for NIDDM, and normal subjects were 2.95 (95% CI: 1.10 - 7.62) and 4.57 (95% CI: 1.31 - 16.48), respectively. No differ ence was observed between the crude mortality rate ratio for IGT and n ormal subjects. After simultaneous adjustments for the covariates, hig her mortality rates for specific causes were observed among NIDDM than in the normal subjects (mortality rates ratio: 3.86; 95% CI: 1.11 - 1 3.38). These results in Japanese-Brazilians are consistent with previo us reports of increased mortality in other diabetic subjects, thus con firming the adverse effect of this metabolic disturbance on mortality among diabetic subjects.