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Psychiatry"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Individuals with type 2 diabetes mellitus (T2DM) are more vulnerable to social disconnection compared with the general population; however, there are few relevant studies investigating this issue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate whether social isolation or loneliness may be associated with subsequent risk of developing major adverse cardiovascular events, whether these associations vary according to fatal and non\u2010fatal outcomes and how behavioural, psychological and physiological factors mediate these associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This longitudinal analysis included data from 19 360\u00a0individuals with T2DM at baseline (2006\u20132010) from the UK Biobank. Social isolation and loneliness were measured using self\u2010report questionnaires. The study outcomes included the first events of myocardial infarction (MI) or stroke (n=2273) and all\u2010cause (n=2820) or cardiovascular disease\u2010related mortality through linked hospital data or death registries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a median follow\u2010up of 12.4 years (interquartile range (IQR): 11.6\u201313.3 years), participants who were more socially isolated (most social isolation vs least social isolation) experienced increased risks for all\u2010cause (hazard ratio (HR) : 1.33, 95% confidence interval (CI): 1.19 to 1.47) and cardiovascular disease (HR: 1.36, 95% CI: 1.17 to 1.59) mortality but not first MI or stroke. Loneliness (yes vs no) was associated with a greater risk for a composite of incident MI or stroke (HR: 1.37, 95% CI: 1.19 to 1.57) but not mortality. Social isolation was associated with fatal MI and stroke, whereas loneliness was associated with non\u2010fatal MI and stroke. The significant associations of social isolation and loneliness with outcomes were mainly mediated by behavioural factors (mediating proportion: 17.8%\u201328.2% and 17.6%\u201317.8%, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among individuals with T2DM, social isolation and loneliness are associated with a greater risk of developing major adverse cardiovascular events, with differences in both risks stratified according to fatal and non\u2010fatal events and underlying mediating factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/gpsych-2023-101153","type":"journal-article","created":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T09:10:13Z","timestamp":1703668213000},"update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Social isolation, loneliness and subsequent risk of major adverse cardiovascular events among individuals with type 2 diabetes mellitus"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6417-4881","authenticated-orcid":false,"given":"Yannis Yan","family":"Liang","sequence":"first","affiliation":[{"name":"Center for Sleep and Circadian Medicine The Affiliated Brain Hospital of Guangzhou Medical University Guangzhou Guangdong China"},{"name":"Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University Guangzhou Guangdong China"},{"name":"Institute of Psycho\u2010neuroscience The Affiliated Brain Hospital of Guangzhou Medical University Guangzhou Guangdong China"},{"name":"Guangdong Cardiovascular Institute Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilin","family":"Chen","sequence":"additional","affiliation":[{"name":"Center for Sleep and Circadian Medicine The Affiliated Brain Hospital of Guangzhou Medical University Guangzhou Guangdong China"},{"name":"State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science Department of Neurology and National Center for Neurological Disorders Huashan Hospital Fudan University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongliang","family":"Feng","sequence":"additional","affiliation":[{"name":"Center for Sleep and Circadian Medicine The Affiliated Brain Hospital of Guangzhou Medical University Guangzhou Guangdong China"},{"name":"Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University Guangzhou Guangdong 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