TY - JOUR
T1 - Incidence of stroke and its association with glycemic control and lifestyle in Japanese patients with type 2 diabetes mellitus
T2 - The Fukuoka diabetes registry
AU - Iwase, Masanori
AU - Komorita, Yuji
AU - Ohkuma, Toshiaki
AU - Fujii, Hiroki
AU - Ide, Hitoshi
AU - Yoshinari, Masahito
AU - Oku, Yutaro
AU - Higashi, Taiki
AU - Nakamura, Udai
AU - Kitazono, Takanari
N1 - Funding Information:
The authors thank Drs. Dongchon Kang, Shuzo Kumagai, Toshiaru Ninomiya, Yoichiro Hirakawa, Shinako Ogata-Kaizu, Tamaki Jodai-Kitamura, Akiko Sumi, Ai Murao-Kimura, Ayaka Oshiro (Kyushu University), Satoshi Sasaki (The University of Tokyo), Yasushi Okada (Kyushu Medical Center), Nobutaka Tsutsu, Nobuhiro Sasaki (Fukuoka Red Cross Hospital), Kiyohide Nunoi, Yuichi Sato, Yuji Uchizono, Kaori Itoh (St. Mary's Hospital), Hirofumi Imoto (Steel Memorial Yawata Hospital), Daisuke Gotoh, Mina Matsuo (Kyushu Central Hospital), Sakae Nohara, Ayako Tsutsumi (Fukuoka Higashi Medical Center), Yasuhiro Idewaki (Hakujyuji Hospital), Masae Minami (Clinic Minami Masae), Miya Wada (Wada Miya Naika Clinic), Yoshifumi Yokomizo (Yokomizo Naika Clinic), Masanori Kikuchi, Yohei Kikuchi (Kikuchi Naika Clinic), Riku Nomiyama (Suzuki Naika Clinic), Shin Nakamura (Nakamura Naika Clinic), Kenji Tashiro (Oshima Eye Hospital), Mototaka Yoshinari (Yoshinari Naika Clinic), Kojiro Ichikawa (Fukutsu Naika Clinic), Yutaka Kiyohara, Teruo Omae (Hisayama Research Institute for Lifestyle Diseases). The authors also thank clinical research coordinators Chiho Ohba (Hisayama Research Institute for Lifestyle Diseases), Yoko Nishioka (Kyushu University) as well as those in the administration office: Tomoko Matake (Hisayama Research Institute for Lifestyle Diseases) and Junko Ishimatsu (Kyushu University). This work was supported in part by The Japan Society for the Promotion of Science KAKENHI from the Ministry of Education, Culture, Sports, Science and Technology of Japan (grant numbers 23249037 and 23659353 to M.I. 16 K00861 to H.F. 19 K24229 to T.O. 20 K19663 to Y.K.), the Junior Scientist Development Grant supported by the Japan Diabetes Society (to T.O. and Y.K.), a grant from the Japan Diabetes Foundation (to T.O.), and the Japan Heart Foundation and Astellas/Pfizer Grant for Research on Atherosclerosis Update (to T.O.), the Lilly Research Grant Program for Bone & Mineral Research (to Y.K.). The Kyushu University Institutional Review Board (approval number 290). All participants provided their written informed consent to take part. The authors declare that no potential conflicts of interest relevant to this article exist. M.I. was responsible for the study concept and design, and drafted the manuscript. M.I. Y.K. and H.F. conducted the analysis. T.O. H.I. M.Y. Y.O. T. H. U.N. and T.K. interpreted the data and contributed to the discussion. All authors participated in critically revising the manuscript and approved the final version. M.I. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for integrity of the data and accuracy of the data analysis.
Funding Information:
This work was supported in part by The Japan Society for the Promotion of Science KAKENHI from the Ministry of Education, Culture, Sports, Science and Technology of Japan (grant numbers 23249037 and 23659353 to M.I., 16 K00861 to H.F., 19 K24229 to T.O., 20 K19663 to Y.K.), the Junior Scientist Development Grant supported by the Japan Diabetes Society (to T.O. and Y.K.), a grant from the Japan Diabetes Foundation (to T.O.), and the Japan Heart Foundation and Astellas/Pfizer Grant for Research on Atherosclerosis Update (to T.O.), the Lilly Research Grant Program for Bone & Mineral Research (to Y.K.).
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2021/2
Y1 - 2021/2
N2 - Aims: We prospectively investigated the incidence of stroke and its subtypes, risk factors and prognosis in Japanese patients with type 2 diabetes. Methods: A total of 4,875 participants with type 2 diabetes (mean age 65.4 years, male 57%, previous stroke 10%) were investigated for the development of stroke for 5 years. Risk factors were evaluated using multivariable adjusted Cox proportional models. Results: The incidence rates per 1,000 person-years were 6.7 for new-onset stroke (ischemic 5.5, hemorrhagic 1.2) and 22.7 for recurrent stroke (ischemic 18.8, hemorrhagic 3.8), respectively. Ischemic stroke was significantly associated with age, male, reduced regular physical activity, HbA1c, diabetic kidney disease and previous stroke. Lacunar infarction was significantly associated with obesity, reduced regular physical activity, HbA1c and diabetic kidney disease, whereas atherothrombotic stroke was significantly associated with age, reduced intake of dietary fiber, reduced regular physical activity, HbA1c and previous stroke. Recurrent stroke was significantly associated with depressive symptom. Thirty-day and one-year survival was 76% and 64% for hemorrhagic stroke, and 96% and 91% for ischemic stroke, respectively. Conclusions: The current study reemphasized the importance of glycemic control and lifestyle modification such as regular physical exercise for stroke prevention in patients with type 2 diabetes.
AB - Aims: We prospectively investigated the incidence of stroke and its subtypes, risk factors and prognosis in Japanese patients with type 2 diabetes. Methods: A total of 4,875 participants with type 2 diabetes (mean age 65.4 years, male 57%, previous stroke 10%) were investigated for the development of stroke for 5 years. Risk factors were evaluated using multivariable adjusted Cox proportional models. Results: The incidence rates per 1,000 person-years were 6.7 for new-onset stroke (ischemic 5.5, hemorrhagic 1.2) and 22.7 for recurrent stroke (ischemic 18.8, hemorrhagic 3.8), respectively. Ischemic stroke was significantly associated with age, male, reduced regular physical activity, HbA1c, diabetic kidney disease and previous stroke. Lacunar infarction was significantly associated with obesity, reduced regular physical activity, HbA1c and diabetic kidney disease, whereas atherothrombotic stroke was significantly associated with age, reduced intake of dietary fiber, reduced regular physical activity, HbA1c and previous stroke. Recurrent stroke was significantly associated with depressive symptom. Thirty-day and one-year survival was 76% and 64% for hemorrhagic stroke, and 96% and 91% for ischemic stroke, respectively. Conclusions: The current study reemphasized the importance of glycemic control and lifestyle modification such as regular physical exercise for stroke prevention in patients with type 2 diabetes.
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U2 - 10.1016/j.diabres.2020.108518
DO - 10.1016/j.diabres.2020.108518
M3 - Article
C2 - 33096191
AN - SCOPUS:85095939278
SN - 0168-8227
VL - 172
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 108518
ER -
