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首页> 外文期刊>BMC Family Practice >Mortality in persons with undetected and diagnosed hypertension, type 2 diabetes, and hypothyroidism, compared with persons without corresponding disease - a prospective cohort study; The HUNT Study, Norway
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Mortality in persons with undetected and diagnosed hypertension, type 2 diabetes, and hypothyroidism, compared with persons without corresponding disease - a prospective cohort study; The HUNT Study, Norway

机译：与未患相应疾病的人相比，患有未被发现和诊断为高血压，2型糖尿病和甲状腺功能低下的人的死亡率-前瞻性队列研究; HUNT研究，挪威

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Suggested strategies in reducing the impact of non-communicable diseases (NCD) are early diagnosing and screening. We have limited proof of benefit of population screening for NCD. Increased mortality in persons with diagnosed NCD has been shown for decades. However, mortality in undetected NCD has barely been studied. This paper explores whether all-cause mortality differed between persons with diagnosed hypothyroidism, type 2 diabetes (T2DM), and hypertension, compared with persons with undetected-, and with persons without the corresponding disease. A prospective cohort study of the general population in Nord-Tr?ndelag, Norway. Persons ≥20?years at baseline 1995–97 were followed until death or June 15, 2016. Cox proportional hazards models were used to compute age and multiple adjusted hazard ratios (HR) with 95% confidence intervals (CI) for the association between disease status and all-cause mortality. The number of participants in the hypothyroidism study was 31,960, in the T2DM study 37,957, and in the hypertension study 63,371. Mortality was increased in persons with diagnosed type 2 diabetes and hypertension, compared to persons without corresponding disease; HR 1.69 (95% CI 1.55–1.84) and HR 1.23 (95% CI 1.09–1.39), respectively. Among persons with undetected T2DM, the HR was 1.21 (95% CI 1.08–1.37), whilst among undetected hypothyroidism and hypertension, mortality was not increased compared with persons without the diseases. Further, the association with mortality was stronger in persons with long duration of T2DM (HR 1.96 (95% CI 1.57–2.44)) and hypertension (HR 1.32 (95% CI 1.17–1.49)), compared with persons with short duration (HR 1.29 (1.09–1.53) and HR 1.16 (1.03-1-30) respectively). Mortality was increased in persons with diagnosed T2DM and hypertension, and in undetected T2DM, compared with persons without the diseases. The strength of the association with mortality in undetected T2DM was however lower compared with persons with diagnosed T2DM, and mortality was not increased in persons with undetected hypothyroidism and hypertension, compared with persons without the diseases. Thus, future research needs to test more thoroughly if early diagnosing of these diseases, such as general population screening, is beneficial for health.
机译：减少非传染性疾病（NCD）影响的建议策略是早期诊断和筛查。对于NCD人群筛查的益处，我们的证据有限。数十年来，已显示出诊断为NCD的人死亡率增加。但是，尚未研究未发现的NCD中的死亡率。本文探讨了诊断为甲状腺功能减退，2型糖尿病（T2DM）和高血压的人与未发现和没有相应疾病的人相比，全因死亡率是否存在差异。挪威Nord-Tr？ndelag地区总人口的前瞻性队列研究。在基线1995-97年≥20岁的人群接受随访，直到死亡或2016年6月15日为止。使用Cox比例风险模型计算年龄和多重调整的风险比（HR），疾病之间的关联度为95％置信区间（CI）状况和全因死亡率。甲状腺功能减退研究的参与者人数为31,960，T2DM研究的参与者为37,957，高血压研究的参与者为63,371。与没有相应疾病的人相比，诊断为2型糖尿病和高血压的人的死亡率增加了。 HR 1.69（95％CI 1.55-1.84）和HR 1.23（95％CI 1.09-1.39）。在未发现T2DM的人群中，HR为1.21（95％CI 1.08–1.37），而在未发现甲状腺功能减退症和高血压的人群中，死亡率没有升高。此外，与持续时间短（HR）的人相比，长期T2DM（HR 1.96（95％CI 1.57–2.44））和高血压（HR 1.32（95％CI 1.17–1.49））患者与死亡率的关联更强。 1.29（1.09–1.53）和HR 1.16（1.03-1-30））。与没有疾病的人相比，被诊断为T2DM和高血压的人以及未发现的T2DM的人的死亡率增加。然而，与未确诊的T2DM患者相比，未发现的T2DM患者与死亡的关联强度较低，与未发现疾病的甲状腺功能减退和高血压患者相比，未发现甲状腺功能减退和高血压患者的死亡率并未增加。因此，未来的研究需要更彻底地测试这些疾病的早期诊断（例如总体人群筛查）是否对健康有益。

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