Prediction of all-cause mortality in a patient population with hypertension and type 2 DM by using traditional risk factors and serum-phosphate,-calcium and-magnesium

• Published in: Acta diabetologica Vol. 44; no. 3; pp. 138 - 143
• Main Authors: Håglin, L, Törnkvist, B, Bäckman, L
• Format: Journal Article
• Language: English
• Published: Germany Springer Nature B.V 01.09.2007
• Subjects: All-cause mortality - Calcium - Magnesium - Metabolic syndrome - Phosphate - Sex; Calcium; Calcium - blood; Dermatologi och venerologi, klinisk genetik, invärtesmedicin; Dermatology and venerology,clinical genetics, internal medicine; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - mortality; Diabetic Angiopathies - blood; Diabetic Angiopathies - mortality; Diabetologi; Diabetology; Female; Gender; Humans; Hypertension; Hypertension - blood; Hypertension - mortality; Internal medicine; Invärtesmedicin; Life Style; Magnesium; Magnesium - blood; Male; MEDICIN; MEDICINE; Metabolism; Mortality; Myocardial Ischemia - mortality; Obesity - blood; Obesity - mortality; Phosphates - blood; Regression analysis; Risk Factors; Survival Analysis; Survivors
• ISSN: 0940-5429; 1432-5233
• DOI: 10.1007/s00592-007-0254-6

The aim of this study is to investigate whether the prediction of all-cause mortality from traditional risk factors is improved by adding electrolytes (serum-phosphate (S-P), serum-calcium (S-Ca) and serum-magnesium (S-Mg)) in a Cox regression. The study uses an 18-year follow-up of patients (n=2504) referred by physicians in primary health care and hospitals to the Vindeln Patient Education (VPE) Center, mainly with a diagnosis of hypertension (HT), type 2 diabetes mellitus (DM) and/or obesity. Cox regression, with the latest registered value and baseline values for risk factors, was used to study all-cause mortality in men and women. 221 out of 1096 men and 157 out of 1408 women died during the 18-year follow-up (20% and 11% respectively). The Cox regression analysis reveals that high blood glucose (B-Glu) and low S-Mg were significantly associated with increased all-cause mortality in the whole patient population as well as in men and women separately. Among women, type 2 DM and systolic blood pressure (SBP) and among men, high S-Ca, S-P, S-urate and body mass index (BMI) were the main predictors of all-cause mortality. There is significantly improved prediction of all-cause mortality with electrolytes added to the traditional risk factors. High B-Glu and low S-Mg in both men and women, and high S-Ca and S-P in men, are significantly associated with all-cause mortality. The metabolic disturbance in this high-risk group of patients can be more fully understood if ionic imbalance is included in the prediction of mortatlity.