BACKGROUND Both type 1 and type 2 diabetes are well-established risk factors for cardiovascular disease and early mortality. However, few studies have directly compared the hazards of cardiovascular outcomes and premature death among people with type 1 diabetes to those among people with type 2 diabetes and subjects without diabetes. Furthermore, information about the hazard of cardiovascular disease and early mortality among Asians with type 1 diabetes is sparse, although the clinical and epidemiological characteristics of Asians with type 1 diabetes are unlike those of Europeans. We estimated the hazard of myocardial infarction (MI), hospitalization for heart failure (HF), atrial fibrillation (AF), and mortality during follow-up in Korean adults with type 1 diabetes compared with those without diabetes and those with type 2 diabetes. METHODS We used Korean National Health Insurance Service datasets of preventive health check-ups from 2009 to 2016 in this retrospective longitudinal study. The hazard ratios of MI, HF, AF, and mortality during follow-up were analyzed using the Cox regression analyses according to the presence and type of diabetes in ≥ 20-year-old individuals without baseline cardiovascular disease (N = 20,423,051). The presence and type of diabetes was determined based on the presence of type 1 or type 2 diabetes at baseline. RESULTS During more than 93,300,000 person-years of follow-up, there were 116,649 MIs, 135,532 AF cases, 125,997 hospitalizations for HF, and 344,516 deaths. The fully-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident MI, hospitalized HF, AF, and all-cause death within the mean follow-up of 4.6 years were higher in the type 1 diabetes group than the type 2 diabetes [HR (95% CI) 1.679 (1.490-1.893) for MI; 2.105 (1.901-2.330) for HF; 1.608 (1.411-1.833) for AF; 1.884 (1.762-2.013) for death] and non-diabetes groups [HR (95% CI) 2.411 (2.138-2.718) for MI; 3.024 (2.730-3.350) for HF; 1.748 (1.534-1.993) for AF; 2.874 (2.689-3.073) for death]. CONCLUSIONS In Korea, the presence of diabetes was associated with a higher hazard of cardiovascular disease and all-cause death. Specifically, people with type 1 diabetes had a higher hazard of cardiovascular disease and all-cause mortality compared to people with type 2 diabetes.

中文翻译：

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1型糖尿病的早期死亡和心血管疾病的风险：与2型糖尿病的比较，一项全国性研究。

背景技术1型和2型糖尿病都是心血管疾病和早期死亡的公认危险因素。但是，很少有研究直接比较1型糖尿病患者与2型糖尿病患者和非糖尿病患者的心血管结局和过早死亡的危险。此外，尽管亚洲人患有1型糖尿病的临床和流行病学特征与欧洲人不同，但有关1型糖尿病亚洲人中心血管疾病的危险性和早期死亡的信息很少。我们估计韩国1型糖尿病成年人与无糖尿病和2型糖尿病成年人的心肌梗塞（MI），心力衰竭（HF）住院，心房纤颤（AF）和随访期间的死亡率。方法在这项回顾性纵向研究中，我们使用了2009年至2016年韩国国民健康保险服务中心的预防性健康检查数据集。根据20岁以上无基线心血管疾病的患者的糖尿病的存在和类型，使用Cox回归分析对随访期间MI，HF，AF和死亡率的危险比进行了分析（N = 20,423,051）。根据基线时1型或2型糖尿病的存在来确定糖尿病的存在和类型。结果在超过93,300,000人-年的随访中，有116,649例MI，135,532例AF病例，125,997例HF住院和344,516例死亡。在平均随访4内，事件MI，住院HF，AF和全因死亡的完全调整的危险比（HRs）和95％置信区间（CIs）。1型糖尿病组的6岁高于2型糖尿病[MI的HR（95％CI）1.679（1.490-1.893）]；HF 2.105（1.901-2.330）；AF的1.608（1.411-1.833）；1.884（1.762-2.013）（死亡）和非糖尿病组[HR（95％CI）2.411（2.138-2.718）用于MI；HF为3.024（2.730-3.350）；AF的1.748（1.534-1.993）；2.874（2.689-3.073）的死亡]。结论在韩国，糖尿病的存在与心血管疾病和全因死亡的更高危险性相关。具体而言，与2型糖尿病患者相比，1型糖尿病患者具有更高的心血管疾病危险性和全因死亡率。MI 411（2.138-2.718）；HF为3.024（2.730-3.350）；AF的1.748（1.534-1.993）；2.874（2.689-3.073）的死亡]。结论在韩国，糖尿病的存在与心血管疾病和全因死亡的更高危险性相关。具体而言，与2型糖尿病患者相比，1型糖尿病患者具有更高的心血管疾病危险性和全因死亡率。MI 411（2.138-2.718）；HF为3.024（2.730-3.350）；AF的1.748（1.534-1.993）；2.874（2.689-3.073）的死亡]。结论在韩国，糖尿病的存在与心血管疾病和全因死亡的更高危险性相关。具体而言，与2型糖尿病患者相比，1型糖尿病患者具有更高的心血管疾病危险性和全因死亡率。