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Prospective study of cytomegalovirus seropositivity and risk of mortality from diabetes

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Abstract

Cytomegalovirus (CMV) infects 40 % of the world population and has been suggested to be associated with diabetes; however, no prospective study has ever examined diabetes mortality associated with the infection. A cohort of 14,404 non-diabetic adult participants aged 17–90 years from the Third National Health and Nutrition Examination Survey (1988–1994) was prospectively followed for mortality through 2006. CMV immunoglobulin G was measured by enzyme-linked immunosorbent assay and immunofluorescence assay. Diabetes death was assessed with death records from the National Death Index. Cox proportional hazards modeling was used to determine diabetes mortality risk associated with CMV infection, adjusting for socio-demographics, diabetes risk factors, and comorbidities. At baseline, 76.8 % of subjects were CMV seropositive, and after an average follow-up of 13.7 years, diabetes mortality rate per 10,000 person-years was 6.8 (95 % CI 5.7, 8.0). Among seropositive participants, the diabetes death rate (8.4, 95 % CI 7.0, 9.9) was more than four times the rate in seronegative ones (2.0, 95 % CI 1.1, 3.6) (P value for the difference <0.001). In the adjusted Cox proportional hazards analysis, CMV seropositivity more than doubled the risk of diabetes mortality (HR 2.06, 95 % CI 1.05, 4.06). CMV infection may thus predict future mortality from diabetes in non-diabetic people.

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Abbreviations

BMI:

Body mass index

CDC:

Centers for Disease Control and Prevention

CMV:

Cytomegalovirus

CRP:

C-reactive protein

HDL:

High-density lipoprotein

HHV-5:

Human herpes virus 5

HR:

Hazard ratio

ICD:

International classification of diseases

IgG:

Immunoglobulin G

IgM:

Immunoglobulin M

MET:

Metabolic-equivalent task

NCHS:

National Center for Health Statistics

NDI:

National Death Index

NHANES:

National Health and Nutrition Examination Survey

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Conflict of interest

The authors have no conflict of interest to declare.

Human and Animal Rights disclosure

The NHANES was approved by the institutional review boards of the NCHS and CDC.

Informed consent

All participants gave informed consent. This analysis was performed on an anonymous and publicly available dataset and required no further institutional review board approval.

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Authors and Affiliations

  1. Department of Epidemiology, University of Iowa, S161 CPHB 105 River Street, Iowa City, IA, 52242, USA

    Angelico Mendy

  2. Department of Occupational and Environmental Health, Florida International University, Miami, FL, USA

    Janvier Gasana

  3. South Florida Asthma Consortium, Ft. Lauderdale, FL, USA

    Janvier Gasana

  4. Department of Physical Therapy, Florida International University, Miami, FL, USA

    Edgar R. Vieira

  5. Emergency Department, Saint Louis Regional Hospital, Saint Louis, Senegal

    Hamidou Diallo

Authors
  1. Angelico Mendy
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  2. Janvier Gasana
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  3. Edgar R. Vieira
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  4. Hamidou Diallo
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Corresponding author

Correspondence to Angelico Mendy.

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Managed by Massimo Porta.

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Mendy, A., Gasana, J., Vieira, E.R. et al. Prospective study of cytomegalovirus seropositivity and risk of mortality from diabetes. Acta Diabetol 51, 723–729 (2014). https://doi.org/10.1007/s00592-014-0573-3

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  • DOI: https://doi.org/10.1007/s00592-014-0573-3

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