Abstract
ABSTRACT
Objective
To investigate the association between the cardiometabolic risk factors cluster (CRFC) and all‐cause mortality in type 2 diabetes (T2D).
Methods
Data from the Zhejiang Rural T2D Cohort (2016–2024) included 10,310 participants. Four cardiometabolic risk factors (CRFs) were evaluated: central obesity, elevated blood pressure, high triglycerides (TG), and low high‐density lipoprotein cholesterol (HDL‐C). After adjusting for confounders, multivariate Cox regression models were constructed to estimate hazard ratios (HRs). A Total CRFs Score (TCRFS), weighted by regression coefficients of individual CRFs, was stratified into four groups based on quartiles (
Results
Participants had a mean age of 63.54 ± 9.77 years, with the most prevalent CRFs being elevated blood pressure (86.97%), followed by elevated TG (41.21%), low HDL‐C (38.71%), and central obesity (32.96%). Over a mean 8.12 ± 1.71 years of follow‐up, 1,770 deaths occurred (death density: 211.21/10,000 person‐years). No single CRF, except for TG, showed a significant association with all‐cause mortality, whereas the TCRFS was a significant predictor (HR = 2.719, 95%CI (1.360, 5.437),
p
= 0.005). Furthermore, participants in the highest TCRFS quartile (≥P75) had a significantly higher mortality risk compared to those in the lowest quartile (P
= 0.013).
Conclusion
CRFC is significantly associated with increased all‐cause mortality risk in T2D patients. Early comprehensive assessment and intervention for cardiometabolic risk factors may reduce mortality in this population.