Joint Effect of Diabetes and Opiate Use on All-Cause and Cause-Specific Mortality: The Golestan Cohort Study

Joint Effect of Diabetes and Opiate Use on All-Cause and Cause-Specific Mortality: The Golestan Cohort Study Publisher Pubmed

Nalini M^{1, 2} ; Khoshnia M³ ; Kamangar F⁴ ; Sharafkhah M¹ ; Poustchi H⁵ ; Pourshams A¹ ; Roshandel G³ ; Gharavi S¹ ; Zahedi M⁶ ; Norouzi A³ ; Sotoudeh M¹ ; Nikmanesh A^{7, 8} ; Brennan P⁹ ; Boffetta P^{10, 11} Show All Authors

Nalini M^{1, 2}
Khoshnia M³
Kamangar F⁴
Sharafkhah M¹
Poustchi H⁵
Pourshams A¹
Roshandel G³
Gharavi S¹
Zahedi M⁶
Norouzi A³
Sotoudeh M¹
Nikmanesh A^{7, 8}
Brennan P⁹
Boffetta P^{10, 11}
Dawsey SM¹²
Abnet CC¹²
Malekzadeh R¹
Etemadi A^{1, 12}

Show Affiliations

1. Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
2. Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
3. Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran
4. Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, United States
5. Liver and Pancreaticobilliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
6. Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
7. Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
8. Sasan Alborz Research Center, Masoud Clinic, Tehran, Iran
9. Section of Genetics, International Agency for Research on Cancer, Lyon, France
10. Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
11. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
12. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States

Source: International Journal of Epidemiology Published:2021

Abstract

Background: Many diabetic individuals use prescription and non-prescription opioids and opiates. We aimed to investigate the joint effect of diabetes and opiate use on all-cause and cause-specific mortality. Methods: Golestan Cohort study is a prospective population-based study in Iran. A total of 50 045 people-aged 40-75, 28 811 women, 8487 opiate users, 3548 diabetic patients-were followed during a median of 11.1 years, with over 99% success follow-up. Hazard ratio and 95% confidence intervals (HRs, 95% CIs), and preventable death attributable to each risk factor, were calculated. Results: After 533 309 person-years, 7060 deaths occurred: 4178 (10.8%) of non-diabetic non-opiate users, 757 (25.3%) diabetic non-users, 1906 (24.0%) non-diabetic opiate users and 219 (39.8%) diabetic opiate users. Compared with non-diabetic non-users, HRs (95% CIs) for all-cause mortality were 2.17 (2.00-2.35) in diabetic non-opiate users, 1.63 (1.53-1.74) in non-diabetic opiate users and 2.76 (2.40-3.17) in diabetic opiate users. Among those who both had diabetes and used opiates, 63.8% (95% CI: 58.3%-68.5%) of all deaths were attributable to these risk factors, compared with 53.9% (95% CI: 50%-57.4%) in people who only had diabetes and 38.7% (95% CI: 34.6%-42.5%) in non-diabetic opiate users. Diabetes was more strongly associated with cardiovascular than cancer mortality. The risk of early mortality in known cases of diabetes did not depend on whether they started opiate use before or after their diagnosis. Conclusions: Using opiates is detrimental to the health of diabetic patients. Public awareness about the health effects of opiates, and improvement of diabetes care especially among individuals with or at risk of opiate use, are necessary. © 2020 Published by Oxford University Press on behalf of the International Epidemiological Association 2020. This work is written by US Government employees and is in the public domain in the US.

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Reza Malekzadeh (89)

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Style	Citing Format
MLA	Nalini M, et al.. "Joint Effect of Diabetes and Opiate Use on All-Cause and Cause-Specific Mortality: The Golestan Cohort Study." International Journal of Epidemiology, vol. 50, no. 1, 2021, pp. 314-324.
APA	Nalini M, Khoshnia M, Kamangar F, Sharafkhah M, Poustchi H, Pourshams A, Roshandel G, Gharavi S, Zahedi M, Norouzi A, Sotoudeh M, Nikmanesh A, Brennan P, Boffetta P, Dawsey SM, Abnet CC, Malekzadeh R, Etemadi A (2021). Joint Effect of Diabetes and Opiate Use on All-Cause and Cause-Specific Mortality: The Golestan Cohort Study. International Journal of Epidemiology, 50(1), 314-324.
Chicago	Nalini M, Khoshnia M, Kamangar F, Sharafkhah M, Poustchi H, Pourshams A, Roshandel G, et al.. "Joint Effect of Diabetes and Opiate Use on All-Cause and Cause-Specific Mortality: The Golestan Cohort Study." International Journal of Epidemiology 50, no. 1 (2021): 314-324.
Harvard	Nalini M et al. (2021) 'Joint Effect of Diabetes and Opiate Use on All-Cause and Cause-Specific Mortality: The Golestan Cohort Study', International Journal of Epidemiology, 50(1), pp. 314-324.
Vancouver	Nalini M, Khoshnia M, Kamangar F, Sharafkhah M, Poustchi H, Pourshams A, et al.. Joint Effect of Diabetes and Opiate Use on All-Cause and Cause-Specific Mortality: The Golestan Cohort Study. International Journal of Epidemiology. 2021;50(1):314-324.
BibTex	@article{ author = {Nalini M and Khoshnia M and Kamangar F and Sharafkhah M and Poustchi H and Pourshams A and Roshandel G and Gharavi S and Zahedi M and Norouzi A and Sotoudeh M and Nikmanesh A and Brennan P and Boffetta P and Dawsey SM and Abnet CC and Malekzadeh R and Etemadi A}, title = {Joint Effect of Diabetes and Opiate Use on All-Cause and Cause-Specific Mortality: The Golestan Cohort Study}, journal = {International Journal of Epidemiology}, volume = {50}, number = {1}, pages = {314-324}, year = {2021} }
RIS	TY - JOUR AU - Nalini M AU - Khoshnia M AU - Kamangar F AU - Sharafkhah M AU - Poustchi H AU - Pourshams A AU - Roshandel G AU - Gharavi S AU - Zahedi M AU - Norouzi A AU - Sotoudeh M AU - Nikmanesh A AU - Brennan P AU - Boffetta P AU - Dawsey SM AU - Abnet CC AU - Malekzadeh R AU - Etemadi A TI - Joint Effect of Diabetes and Opiate Use on All-Cause and Cause-Specific Mortality: The Golestan Cohort Study JO - International Journal of Epidemiology VL - 50 IS - 1 SP - 314 EP - 324 PY - 2021 ER -

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