ArticleBMJ open diabetes research & care2023
Serum osmolality was non-linearly associated with the risk of all-cause and cardiovascular mortality in patients with diabetes.
Article in BMJ open diabetes research & care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 11 citations in OpenAlex.
- Ultra-low contrast agent dosage in photon-counting CT angiography of the thoracoabdominal aorta.European journal of radiology open · 2026Article
- Plasma Osmolality in Cardiovascular Disease: Association, Mechanisms, and Clinical Meaning.Arquivos brasileiros de cardiologia · 2026Article
- Elevated serum osmolarity is associated with 28-day all-cause mortality in patients with cardiac arrest.World journal of emergency medicine · 2026Article
- Association of Plasma Osmolality with Cardiovascular Disease Risk: Evidence from the National Health and Nutrition Examination Survey Database.Arquivos brasileiros de cardiologia · 2025Article
- Serum Osmolality and Stroke Mortality in the ICU: A U-Shaped Risk Pattern and Its Clinical Implications.Journal of clinical medicine · 2025Article
- The U-shaped relationship between serum osmolality and the risk of sepsis-associated delirium development: a retrospective study.BMC neurology · 2025Article
- The U-shaped relationship between serum osmolality and in-hospital mortality in patients with traumatic brain injury: a retrospective study based on the MIMIC-IV database.European journal of medical research · 2025Article
- Relationship Between Serum Osmolality and Diabetic Foot Ulcers in a US Population With Diabetes: Results From NHANES 1999-2004.International journal of endocrinology · 2025Article
- The J-shaped relationship between serum osmolality and all-cause mortality in critically ill patients with myocardial infarction: a retrospective cohort study.Frontiers in endocrinology · 2025Article
- Association between osmolality trajectories and mortality in patients with sepsis: a group-based trajectory model in large ICU open access databases.Frontiers in medicine · 2025Article
- Association between serum osmolality and deteriorating renal function in patients with acute myocardial infarction: analysis of the MIMIC- IV database.BMC cardiovascular disorders · 2024Article
- Association between serum osmolality and 28-day all-cause mortality in patients with heart failure and reduced ejection fraction: a retrospective cohort study from the MIMIC-IV database.Frontiers in endocrinology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThis study aimed to evaluate the relationship between both low and high osmolarity and the risk of all-cause and cause-specific mortality in diabetic population.
methodsAll participants were included from the National Health and Nutrition Examination Survey 1999-2014. Baseline serum osmolality was determined from laboratory tests and cause of death from national death records. HRs and 95% CIs for all-cause mortality and cardiovascular mortality in diabetes were estimated using Cox proportional regression analysis. The non-linear relationship was explored using restricted cubic splines regression.
resultsAmong 7622 individuals with diabetes, 1983 (12.4%) died during a total of 3.26 thousand person-years of follow-up. Compared with the reference category (281-284 mmol/kg), the multivariable-adjusted HRs and 95% CIs for all-cause mortality were 1.27 (1.16-1.40; p<0.001) in the lowest osmolality category (<201 mmol/kg) and 1.18 (1.09-1.28; p<0.001) in the highest osmolality category (>312 mmol/kg). Restricted cubic splines results showed that serum levels of osmolality had a U-shaped association with the risk of all-cause mortality, and L-shaped relationship with the risk of cardiovascular death.
conclusionsBoth low osmolality and high osmolality were predictive of increased all-cause mortality in patients with diabetes, supporting a U-shaped relationship. Also, a lower serum osmolality increased the risk of cardiovascular mortality.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.