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Outline
To explore the independent and combined effects of diabetes onset age and disease duration on all-cause and cause-specific mortality.
A total of 5 555 adult patients with diabetes from the National Health and Nutrition Examination Survey (NHANES) database between 1999 and 2018 were included. The associations of age at onset and disease duration of diabetes with all-cause and cause-specific mortality were analyzed using weighted Cox proportional hazards models and restricted cubic spline analysis.
Multivariable analysis showed that diabetic patients with onset age of 60 years or older had lower all-cause mortality, cardiovascular disease mortality, and diabetes-related mortality than those with onset age under 45 years [hazard ratio (HR) and 95% confidence interval (CI): 0.55 (0.46-0.65), 0.65 (0.49-0.88), 0.34 (0.19-0.64),respectively]. Patients with a disease duration of ≥17 years had higher all-cause mortality, cardiovascular disease mortality, and diabetes-related mortality than those with a disease duration of <4 years [HR (95% CI): 1.85 (1.51-2.27), 1.66 (1.22-2.26),4.82 (2.11-8.69), respectively]. Compared with patients with onset age <45 years and disease duration ≥17 years, the subgroups with onset age of 45-<60 years and onset age ≥60 years (both with disease duration of 0-17 years) had a lower mortality risk[HR (95% CI): 0.37 (0.19-0.70), 0.59 (0.40-0.87), 0.72 (0.56-0.93), 0.55 (0.43-0.71), 0.59 (0.46-0.74), 0.72 (0.57-0.90),respectively].
Age at onset and disease duration have non-linear associations with mortality in diabetic patients,and the coexistence of the two factors further increases the risk of mortality.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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