Background
Methods
Data source
Study design
Ascertainment and duration of type 2 diabetes
Estimated glomerular filtration rate
Myocardial infarction ascertainment
Ischemic stroke ascertainment
Data collection
Statistical analysis
Results
Baseline characteristics and comorbidities
eGFR category (mL/min)
| ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Overall (N = 57,946)
|
15–29 (n = 972)
|
30–44 (n = 4326)
|
45–59 (n = 12,614)
|
≥ 60 (n = 40,034)
| ||||||
Number
|
%
|
Number
|
%
|
Number
|
%
|
Number
|
%
|
Number
|
%
| |
Sex | ||||||||||
Men | 32,117 | 55.4 | 315 | 32.4 | 1654 | 38.2 | 5434 | 43.1 | 24,714 | 61.7 |
Women | 25,829 | 44.6 | 657 | 67.6 | 2672 | 61.8 | 7180 | 56.9 | 15,320 | 38.3 |
Age at start date (years) | ||||||||||
20–39 | 1269 | 2.2 | 0 | 0.0 | 3 | 0.1 | 30 | 0.2 | 1236 | 3.1 |
40–49 | 4454 | 7.7 | 8 | 0.8 | 27 | 0.6 | 187 | 1.5 | 4232 | 10.6 |
50–59 | 10,729 | 18.5 | 37 | 3.8 | 175 | 4.0 | 1067 | 8.5 | 9450 | 23.6 |
60–69 | 17,889 | 30.9 | 196 | 20.2 | 883 | 20.4 | 3623 | 28.7 | 13,187 | 32.9 |
70–79 | 16,933 | 29.2 | 378 | 38.9 | 1882 | 43.5 | 5303 | 42.0 | 9370 | 23.4 |
80–89 | 6672 | 11.5 | 353 | 36.3 | 1356 | 31.3 | 2404 | 19.1 | 2559 | 6.4 |
Smoking status | ||||||||||
Non-smoker | 30,175 | 52.1 | 561 | 57.7 | 2441 | 56.4 | 7028 | 55.7 | 20,145 | 50.3 |
Current | 10,128 | 17.5 | 104 | 10.7 | 533 | 12.3 | 1671 | 13.2 | 7820 | 19.5 |
Former | 15,011 | 25.9 | 240 | 24.7 | 1105 | 25.5 | 3367 | 26.7 | 10,299 | 25.7 |
Unknown | 2632 | 4.5 | 67 | 6.9 | 247 | 5.7 | 548 | 4.3 | 1770 | 4.4 |
BMI (kg/m2) | ||||||||||
15–19 | 915 | 1.6 | 18 | 1.9 | 84 | 1.9 | 234 | 1.9 | 579 | 1.4 |
20–24 | 9546 | 16.5 | 174 | 17.9 | 818 | 18.9 | 2223 | 17.6 | 6331 | 15.8 |
25–29 | 21,011 | 36.3 | 297 | 30.6 | 1521 | 35.2 | 4757 | 37.7 | 14,436 | 36.1 |
≥ 30 | 22,959 | 39.6 | 362 | 37.2 | 1487 | 34.4 | 4529 | 35.9 | 16,581 | 41.4 |
Unknown | 3515 | 6.1 | 121 | 12.4 | 416 | 9.6 | 871 | 6.9 | 2,107 | 5.3 |
Number of drugs | ||||||||||
≤1 | 15,007 | 25.9 | 107 | 11.0 | 626 | 14.5 | 2708 | 21.5 | 11,566 | 28.9 |
2–4 | 20,458 | 35.3 | 224 | 23.0 | 1185 | 27.4 | 4121 | 32.7 | 14,928 | 37.3 |
5–9 | 18,680 | 32.2 | 461 | 47.4 | 1920 | 44.4 | 4748 | 37.6 | 11,551 | 28.9 |
10–14 | 3335 | 5.8 | 158 | 16.3 | 513 | 11.9 | 906 | 7.2 | 1758 | 4.4 |
≥15 | 466 | 0.8 | 22 | 2.3 | 82 | 1.9 | 131 | 1.0 | 231 | 0.6 |
Duration of diabetes (years) | ||||||||||
<1 | 2848 | 4.9 | 26 | 2.7 | 138 | 3.2 | 557 | 4.4 | 2127 | 5.3 |
1–4 | 23,201 | 40.0 | 208 | 21.4 | 1311 | 30.3 | 4545 | 36.0 | 17,137 | 42.8 |
5–9 | 17,123 | 29.5 | 298 | 30.7 | 1271 | 29.4 | 3786 | 30.0 | 11,768 | 29.4 |
10–14 | 8503 | 14.7 | 184 | 18.9 | 824 | 19.0 | 2095 | 16.6 | 5400 | 13.5 |
≥15 | 6271 | 10.8 | 256 | 26.3 | 782 | 18.1 | 1631 | 12.9 | 3602 | 9.0 |
HbA1c (%) | ||||||||||
<7.00 | 19,382 | 33.4 | 272 | 28.0 | 1463 | 33.8 | 4480 | 35.5 | 13,167 | 32.9 |
7.00–7.99 | 12,823 | 22.1 | 203 | 20.9 | 964 | 22.3 | 2922 | 23.2 | 8734 | 21.8 |
8.00–8.99 | 7221 | 12.5 | 111 | 11.4 | 480 | 11.1 | 1565 | 12.4 | 5065 | 12.7 |
9.00–9.99 | 4634 | 8.0 | 66 | 6.8 | 302 | 7.0 | 877 | 7.0 | 3389 | 8.5 |
10.00–10.99 | 2497 | 4.3 | 44 | 4.5 | 142 | 3.3 | 433 | 3.4 | 1878 | 4.7 |
≥11 | 2301 | 4.0 | 43 | 4.4 | 134 | 3.1 | 409 | 3.2 | 1715 | 4.3 |
Missing | 9088 | 15.7 | 233 | 24.0 | 841 | 19.4 | 1928 | 15.3 | 6086 | 15.2 |
PCP visits | ||||||||||
0–4 | 8018 | 13.8 | 87 | 9.0 | 471 | 10.9 | 1508 | 12.0 | 5952 | 14.9 |
5–9 | 17,371 | 30.0 | 229 | 23.6 | 1120 | 25.9 | 3640 | 28.9 | 12,382 | 30.9 |
10–19 | 23,024 | 39.7 | 355 | 36.5 | 1717 | 39.7 | 5228 | 41.4 | 15,724 | 39.3 |
≥20 | 9533 | 16.5 | 301 | 31.0 | 1018 | 23.5 | 2238 | 17.7 | 5976 | 14.9 |
Referrals | ||||||||||
0–4 | 50,987 | 88.0 | 750 | 77.2 | 3634 | 84.0 | 10,976 | 87.0 | 35,627 | 89.0 |
5–9 | 5525 | 9.5 | 162 | 16.7 | 513 | 11.9 | 1287 | 10.2 | 3563 | 8.9 |
10–19 | 1315 | 2.3 | 55 | 5.7 | 162 | 3.7 | 325 | 2.6 | 773 | 1.9 |
≥20 | 119 | 0.2 | 5 | 0.5 | 17 | 0.4 | 26 | 0.2 | 71 | 0.2 |
Hospitalizations | ||||||||||
None | 52,092 | 89.9 | 735 | 75.6 | 3676 | 85.0 | 11,206 | 88.8 | 36,475 | 91.1 |
1–2 | 5013 | 8.7 | 176 | 18.1 | 524 | 12.1 | 1190 | 9.4 | 3123 | 7.8 |
≥3 | 841 | 1.5 | 61 | 6.3 | 126 | 2.9 | 218 | 1.7 | 436 | 1.1 |
Townsend deprivation index | ||||||||||
1 (least deprived) | 11,719 | 20.2 | 146 | 15.0 | 752 | 17.4 | 2445 | 19.4 | 8376 | 20.9 |
2 | 11,797 | 20.4 | 173 | 17.8 | 811 | 18.7 | 2515 | 19.9 | 8298 | 20.7 |
3 | 11,672 | 20.1 | 214 | 22.0 | 884 | 20.4 | 2586 | 20.5 | 7988 | 20.0 |
4 | 11,548 | 19.9 | 223 | 22.9 | 958 | 22.1 | 2486 | 19.7 | 7881 | 19.7 |
5 (most deprived) | 8203 | 14.2 | 155 | 15.9 | 682 | 15.8 | 1875 | 14.9 | 5491 | 13.7 |
Unknown | 3007 | 5.2 | 61 | 6.3 | 239 | 5.5 | 707 | 5.6 | 2000 | 5.0 |
Practice location | ||||||||||
Urban | 38,467 | 66.4 | 628 | 64.6 | 2862 | 66.2 | 8,443 | 66.9 | 26,534 | 66.3 |
Town | 6335 | 10.9 | 114 | 11.7 | 476 | 11.0 | 1,207 | 9.6 | 4,538 | 11.3 |
Rural | 3373 | 5.8 | 55 | 5.7 | 239 | 5.5 | 703 | 5.6 | 2,376 | 5.9 |
Unknown | 9771 | 16.9 | 175 | 18.0 | 749 | 17.3 | 2,261 | 17.9 | 6,586 | 16.5 |
eGFR category (mL/min)
| ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Overall (
N
= 57,946)
|
15–29 (n = 972)
|
30–44 (n = 4326)
|
45–59 (n = 12,614)
|
≥60 (n = 40,034)
| ||||||
Number
|
%
|
Number
|
%
|
Number
|
%
|
Number
|
%
|
Number
|
%
| |
MI | 5581 | 9.6 | 196 | 20.2 | 729 | 16.9 | 1499 | 11.9 | 3157 | 7.9 |
IS/TIA | 5675 | 9.8 | 207 | 21.3 | 774 | 17.9 | 1677 | 13.3 | 3017 | 7.5 |
COPD | 2651 | 4.6 | 85 | 8.7 | 279 | 6.4 | 725 | 5.7 | 1562 | 3.9 |
Thyroid disease | 4932 | 8.5 | 145 | 14.9 | 595 | 13.8 | 1441 | 11.4 | 2751 | 6.9 |
Hypertension | 32,752 | 56.5 | 664 | 68.3 | 2931 | 67.8 | 8197 | 65.0 | 20,960 | 52.4 |
Renal hypertension | 29 | 0.1 | 4 | 0.4 | 7 | 0.2 | 6 | 0.0 | 12 | 0.0 |
Hyperlipidemia | 3998 | 6.9 | 323 | 33.2 | 891 | 20.6 | 1342 | 10.6 | 1442 | 3.6 |
DVT | 3429 | 5.9 | 106 | 10.9 | 373 | 8.6 | 933 | 7.4 | 2017 | 5.0 |
PAD | 3695 | 6.4 | 158 | 16.3 | 554 | 12.8 | 1026 | 8.1 | 1957 | 4.9 |
Anemia | 3561 | 6.1 | 178 | 18.3 | 539 | 12.5 | 949 | 7.5 | 1895 | 4.7 |
Atrial fibrillation | 3494 | 6.0 | 67 | 6.9 | 265 | 6.1 | 742 | 5.9 | 2420 | 6.0 |
Heart failure | 4011 | 6.9 | 73 | 7.5 | 313 | 7.2 | 853 | 6.8 | 2772 | 6.9 |
Peptic ulcer disease | 3676 | 6.3 | 89 | 9.2 | 354 | 8.2 | 880 | 7.0 | 2353 | 5.9 |
Chronic liver disease | 685 | 1.2 | 10 | 1.0 | 47 | 1.1 | 134 | 1.1 | 494 | 1.2 |
Gout | 3599 | 6.2 | 134 | 13.8 | 480 | 11.1 | 876 | 6.9 | 2109 | 5.3 |
Osteoporosis | 1253 | 2.2 | 37 | 3.8 | 148 | 3.4 | 386 | 3.1 | 682 | 1.7 |
Cancer | 5295 | 9.1 | 119 | 12.2 | 620 | 14.3 | 1434 | 11.4 | 3122 | 7.8 |
Anxiety | 6171 | 10.6 | 122 | 12.6 | 453 | 10.5 | 1354 | 10.7 | 4242 | 10.6 |
GERD | 6152 | 10.6 | 121 | 12.4 | 546 | 12.6 | 1493 | 11.8 | 3992 | 10.0 |
Incidences of death, myocardial infarction and stroke
Mortality
Incidence of myocardial infarction
Incidence of ischemic stroke and transient ischemic attack
Cox regression analyses
Death
|
MI
|
IS/TIA
| |
---|---|---|---|
HR
a
(95% CI)
|
HR
a
(95% CI)
|
HR
a
(95% CI)
| |
eGFR calculated with the MDRD study equation, mL/min | |||
15–29 | 2.79 (2.57–3.03) | 2.34 (1.90–2.88) | 1.78 (1.44–2.19) |
30–59 | 1.38 (1.33-1.43) | 1.37 (1.27-1.48) | 1.13 (1.05-1.22) |
30–44 | 1.83 (1.74–1.92) | 1.75 (1.56–1.97) | 1.27 (1.13–1.43) |
45–59 | 1.25 (1.20–1.30) | 1.27 (1.17–1.38) | 1.09 (1.01–1.18) |
≥60 | 1 (−) | 1 (−) | 1 (−) |
eGFR calculated with the CKD-EPI equation, mL/min | |||
15–29 | 2.79 (2.59–2.99) | 2.21 (1.83–2.66) | 1.73 (1.44–2.09) |
30–59 | 1.41 (1.36-1.46) | 1.38 (1.28-1.49) | 1.20 (1.12-1.29) |
30–44 | 1.75 (1.67–1.84) | 1.72 (1.54–1.92) | 1.28 (1.15–1.43) |
45–59 | 1.29 (1.24–1.34) | 1.27 (1.17–1.38) | 1.19 (1.09–1.27) |
≥60 | 1 (−) | 1 (−) | 1 (−) |
Non-death
|
Death
|
eGFR category
| |||||
---|---|---|---|---|---|---|---|
n = 41,368
|
n = 16,578
|
Overall
|
15–29 mL/min
|
30–44 mL/min
|
45–59 mL/min
|
≥60 mL/min
| |
Number (%)
|
Number (%)
|
HR
a
(95% CI)
|
HR
b
(95% CI)
|
HR
b
(95% CI)
|
HR
b
(95% CI)
|
HR
b
(95% CI)
| |
Sex | |||||||
Men | 22,752 (55.0) | 9365 (56.5) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
Women | 18,616 (45.0) | 7213 (43.5) | 0.80 (0.77–0.82) | 1.03 (0.87–1.21) | 0.77 (0.71–0.84) | 0.79 (0.75–0.84) | 0.78 (0.74–0.82) |
Age at start date (years) | |||||||
20–49 | 5428 (13.1) | 295 (1.8) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
50–74 | 29,403 (71.1) | 8669 (52.3) | 3.90 (3.47–4.39) | 0.60 (0.25–1.48) | 2.62 (1.24–5.54) | 2.43 (1.62–3.63) | 3.75 (3.30–4.25) |
≥75 | 6537 (15.8) | 7614 (45.9) | 11.24 (9.97–12.67) | 0.97 (0.40–2.40) | 5.12 (2.43–10.80) | 6.40 (4.27–9.58) | 13.01 (11.42–14.83) |
Duration of diabetes (years) | |||||||
<5 | 20,135 (48.7) | 5914 (35.7) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
5–9 | 12,134 (26.3) | 4989 (30.1) | 1.16 (1.12–1.21) | 1.07 (0.87–1.32) | 1.14 (1.03–1.27) | 1.14 (1.06–1.22) | 1.17 (1.11–1.23) |
10–14 | 5497 (13.3) | 3006 (18.1) | 1.32 (1.26–1.38) | 1.12 (0.88–1.42) | 1.26 (1.12–1.41) | 1.26 (1.16–1.37) | 1.35 (1.27–1.44) |
≥15 | 3602 (8.7) | 2669 (16.1) | 1.50 (1.43–1.57) | 1.30 (1.04–1.62) | 1.38 (1.22–1.55) | 1.46 (1.34–1.60) | 1.53 (1.43–1.64) |
BMI (kg/m2) | |||||||
15–19 | 477 (1.2) | 438 (2.6) | 1.51 (1.36–1.66) | 1.12 (0.63–2.00) | 1.30 (0.98–1.73) | 1.53 (1.27–1.84) | 1.56 (1.37–1.79) |
20–24 | 6127 (14.8) | 3419 (20.6) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
25–29 | 15,249 (36.9) | 5762 (34.8) | 0.78 (0.75–0.82) | 0.72 (0.57–0.90) | 0.82 (0.73–0.92) | 0.79 (0.73–0.86) | 0.78 (0.73–0.83) |
≥30 | 17,577 (42.5) | 5382 (32.5) | 0.82 (0.78–0.85) | 0.64 (0.51–0.81) | 0.80 (0.71–0.90) | 0.85 (0.78–0.92) | 0.82 (0.77–0.87) |
Unknown | 1938 (4.7) | 1577 (9.5) | 1.43 (1.34–1.52) | 1.17 (0.88–1.55) | 1.32 (1.13–1.54) | 1.54 (1.37–1.72) | 1.42 (1.30–1.56) |
Smoking status | |||||||
Non–smoker | 21,930 (53.0) | 8245 (49.7) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
Current | 6819 (16.5) | 3309 (20.0) | 1.50 (1.44–1.57) | 1.09 (0.84–1.40) | 1.33 (1.18–1.50) | 1.60 (1.48–1.74) | 1.54 (1.46–1.63) |
Former | 10,815 (26.1) | 4196 (25.3) | 1.07 (1.03–1.12) | 1.04 (0.86–1.25) | 1.00 (0.91–1.11) | 1.09 (1.02–1.17) | 1.08 (1.03–1.14) |
Unknown | 1804 (4.4) | 828 (5.0) | 0.95 (0.88–1.02) | 1.06 (0.78–1.45) | 0.88 (0.73–1.06) | 1.00 (0.86–1.15) | 0.91 (0.82–1.01) |
Number of medications | |||||||
0–1 | 11,963 (28.9) | 3044 (18.4) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
2–4 | 15,169 (36.7) | 5289 (31.9) | 1.21 (1.15–1.26) | 0.90 (0.67–1.20) | 1.07 (0.94–1.23) | 1.19 (1.09–1.30) | 1.22 (1.16–1.30) |
5–9 | 12,235 (29.6) | 6445 (38.9) | 1.45 (1.39–1.52) | 1.02 (0.79–1.32) | 1.15 (1.01–1.31) | 1.39 (1.27–1.51) | 1.53 (1.44–1.63) |
≥10 | 2001 (4.8) | 1800 (10.9) | 2.03 (1.91–2.16) | 1.03 (0.76–1.39) | 1.67 (1.43–1.96) | 2.01 (1.79–2.26) | 2.18 (1.99–2.38) |
HbA1c (%) | |||||||
<7.00 | 14,151 (34.2) | 5231 (31.6) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
7.00–7.99 | 9363 (22.6) | 3460 (20.9) | 1.01 (0.97–1.05) | 1.29 (1.03–1.61) | 1.04 (0.92–1.16) | 0.98 (0.91–1.06) | 1.01 (0.95–1.07) |
8.00–8.99 | 5333 (12.9) | 1888 (11.4) | 0.97 (0.92–1.02) | 1.02 (0.77–1.36) | 1.12 (0.97–1.29) | 0.96 (0.87–1.07) | 0.95 (0.88–1.02) |
9.00–9.99 | 3319 (8.0) | 1315 (7.9) | 1.14 (1.07–1.21) | 1.40 (1.01–1.92) | 1.24 (1.05–1.46) | 1.18 (1.04–1.32) | 1.11 (1.02–1.20) |
≥10.00 | 3363 (8.1) | 1435 (8.7) | 1.35 (1.27–1.43) | 1.23 (0.92–1.65) | 1.46 (1.23–1.73) | 1.43 (1.27–1.60) | 1.31 (1.21–1.42) |
Missing | 5839 (14.1) | 3249 (19.6) | 1.24 (1.19–1.30) | 1.35 (1.09–1.67) | 1.38 (1.23–1.54) | 1.19 (1.09–1.30) | 1.23 (1.16–1.31) |
Comorbiditiesc
| |||||||
Hypertension | 23,223 (56.1) | 9529 (57.5) | 0.87 (0.84–0.90) | 0.68 (0.58–0.81) | 0.76 (0.70–0.83) | 0.85 (0.80–0.90) | 0.91 (0.87–0.95) |
Hyperlipidemia | 1343 (3.2) | 2655 (16.0) | 2.04 (1.95–2.13) | 1.68 (1.42–1.98) | 1.76 (1.59–1.93) | 2.13 (1.97–2.31) | 2.33 (2.16–2.51) |
History of MI | 3033 (7.3) | 2548 (15.4) | 1.14 (1.09–1.19) | 1.14 (0.94–1.39) | 1.14 (1.02–1.27) | 1.09 (1.00–1.19) | 1.20 (1.12–1.28) |
History of IS/TIA | 2776 (6.7) | 2899 (17.5) | 1.51 (1.45–1.57) | 1.12 (0.93–1.36) | 1.39 (1.26–1.54) | 1.46 (1.36–1.57) | 1.67 (1.57–1.77) |
History of IHDd
| 6146 (14.9) | 4052 (24.4) | 1.02 (0.98–1.06) | 1.10 (0.93–1.30) | 0.92 (0.84–1.02) | 1.01 (0.94–1.08) | 1.03 (0.97–1.09) |
COPD | 1075 (2.6) | 1576 (9.5) | 1.77 (1.68–1.87) | 1.55 (1.20–2.01) | 1.32 (1.14–1.54) | 1.65 (1.49–1.83) | 1.95 (1.81–2.10) |
Thyroid disease | 3418 (8.3) | 1514 (9.1) | 0.92 (0.87–0.97) | 0.97 (0.77–1.21) | 0.89 (0.79–1.01) | 0.98 (0.90–1.08) | 0.90 (0.83–0.98) |
DVT | 2138 (5.2) | 1291 (7.8) | 1.12 (1.06–1.19) | 0.97 (0.76–1.23) | 1.10 (0.96–1.27) | 1.04 (0.94–1.15) | 1.17 (1.08–1.27) |
PAD | 1742 (4.2) | 1953 (11.8) | 1.35 (1.28–1.42) | 1.01 (0.82–1.24) | 1.19 (1.06–1.33) | 1.41 (1.29–1.55) | 1.44 (1.34–1.55) |
Anemia | 2097 (5.1) | 1464 (8.8) | 1.24 (1.17–1.31) | 1.05 (0.86–1.28) | 1.26 (1.12–1.41) | 1.23 (1.11–1.36) | 1.29 (1.18–1.40) |
Atrial fibrillation | 2483 (6.0) | 1011 (6.1) | 1.01 (0.95–1.07) | 1.04 (0.76–1.41) | 0.98 (0.83–1.16) | 1.05 (0.93–1.18) | 1.00 (0.91–1.09) |
Heart failure | 2850 (6.9) | 1161 (7.0) | 1.02 (0.96–1.08) | 1.07 (0.79–1.44) | 1.03 (0.88–1.20) | 1.04 (0.93–1.17) | 0.99 (0.91–1.08) |
Gout | 2370 (5.7) | 1229 (7.4) | 0.98 (0.92–1.04) | 0.95 (0.76–1.19) | 0.98 (0.86–1.12) | 0.99 (0.88–1.10) | 1.00 (0.92–1.10) |
Cancer | 2948 (7.1) | 2347 (14.2) | 1.49 (1.42–1.55) | 1.50 (1.20–1.88) | 1.19 (1.07–1.34) | 1.34 (1.23–1.45) | 1.67 (1.57–1.78) |
Non–MI
|
MI
|
eGFR category
| |||||
---|---|---|---|---|---|---|---|
n = 54,511
|
n = 3435
|
Overall
|
15–29 mL/min
|
30–44 mL/min
|
45–59 mL/min
|
≥60 mL/min
| |
Number (%)
|
Number (%)
|
HR
a
(95% CI)
|
HR
b
(95% CI)
|
HR
b
(95% CI)
|
HR
b
(95% CI)
|
HR
b
(95% CI)
| |
Sex | |||||||
Men | 29,966 (55.0) | 2151 (62.6) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
Women | 25,545 (45.0) | 1284 (37.4) | 0.71 (0.66–0.77) | 1.15 (0.74–1.78) | 0.90 (0.73–1.11) | 0.78 (0.68–0.90) | 0.62 (0.56–0.69) |
Age at start date (years) | |||||||
20–49 | 5573 (10.2) | 150 (4.4) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
50–74 | 35,880 (65.8) | 2192 (63.8) | 1.73 (1.46–2.05) | 0.39 (0.05–2.96) | 1.27 (0.31–5.17) | 1.04 (0.57–1.91) | 1.75 (1.46–2.10) |
≥75 | 13,058 (24.0) | 1093 (31.8) | 2.99 (2.49–3.59) | 0.44 (0.06–3.35) | 1.77 (0.44–7.22) | 1.76 (0.96–3.23) | 3.26 (2.66–4.00) |
Duration of diabetes (years) | |||||||
<5 | 24,828 (45.6) | 1221 (35.6) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
5–9 | 16,112 (29.6) | 1011 (29.4) | 1.14 (1.05–1.24) | 0.55 (0.29–1.03) | 1.04 (0.81–1.34) | 1.20 (1.01–1.42) | 1.15 (1.04–1.28) |
10–14 | 7845 (14.4) | 658 (19.2) | 1.43 (1.30–1.58) | 1.41 (0.79–2.52) | 0.98 (0.73–1.31) | 1.62 (1.34–1.95) | 1.44 (1.27–1.63) |
≥15 | 5726 (10.5) | 545 (15.9) | 1.54 (1.39–1.71) | 1.41 (0.81–2.46) | 1.44 (1.09–1.89) | 1.69 (1.38–2.06) | 1.47 (1.28–1.70) |
BMI (kg/m2) | |||||||
15–19 | 863 (1.6) | 52 (1.5) | 1.25 (0.94–1.66) | – | 0.73 (0.27–2.01) | 1.12 (0.65–1.94) | 1.50 (1.05–2.13) |
20–24 | 8999 (16.5) | 547 (15.9) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
25–29 | 19,633 (36.0) | 1378 (40.1) | 1.08 (0.98–1.19) | 1.12 (0.64–1.98) | 1.20 (0.91–1.59) | 1.05 (0.87–1.27) | 1.06 (0.93–1.21) |
≥30 | 21,713 (39.8) | 1246 (36.3) | 1.01 (0.91–1.12) | 0.67 (0.37–1.22) | 0.90 (0.67–1.22) | 0.99 (0.81–1.22) | 1.05 (0.91–1.20) |
Unknown | 3303 (6.1) | 212 (6.2) | 1.22 (1.04–1.44) | 0.45 (0.16–1.24) | 0.95 (0.60–1.48) | 1.38 (1.02–1.87) | 1.27 (1.01–1.59) |
Smoking status | |||||||
Non–smoker | 28,484 (52.3) | 1691 (49.2) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
Current | 9427 (17.3) | 701 (20.4) | 1.40 (1.28–1.53) | 0.84 (0.42–1.70) | 1.23 (0.91–1.66) | 1.41 (1.17–1.70) | 1.43 (1.27–1.59) |
Former | 14,116 (25.9) | 895 (26.1) | 0.99 (0.91–1.08) | 0.85 (0.52–1.39) | 0.87 (0.68–1.11) | 1.03 (0.88–1.21) | 1.01 (0.91–1.13) |
Unknown | 2484 (4.6) | 148 (4.3) | 0.98 (0.82–1.17) | 0.74 (0.26–2.14) | 1.22 (0.78–1.91) | 1.12 (0.80–1.56) | 0.89 (0.70–1.12) |
Number of medications | |||||||
0–1 | 14,314 (26.3) | 693 (20.2) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
2–4 | 19,322 (35.4) | 1136 (33.1) | 1.15 (1.05–1.27) | 0.66 (0.31–1.40) | 1.44 (1.02–2.04) | 1.31 (1.08–1.59) | 1.08 (0.96–1.21) |
5–9 | 17,413 (31.9) | 1267 (36.9) | 1.18 (1.07–1.30) | 0.96 (0.51–1.82) | 1.29 (0.93–1.80) | 1.22 (1.01–1.48) | 1.12 (0.99–1.27) |
≥10 | 3462 (6.4) | 339 (9.9) | 1.41 (1.23–1.62) | 0.65 (0.30–1.44) | 1.54 (1.04–2.29) | 1.28 (0.97–1.69) | 1.57 (1.31–1.89) |
HbA1c (%) | |||||||
<7.00 | 18,429 (33.8) | 953 (27.7) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
7.00–7.99 | 12,074 (22.2) | 749 (21.8) | 1.15 (1.05–1.27) | 0.98 (0.54–1.78) | 1.17 (0.90–1.52) | 0.90 (0.74–1.09) | 1.30 (1.14–1.48) |
8.00–8.99 | 6721 (12.3) | 500 (14.6) | 1.33 (1.19–1.49) | 0.83 (0.40–1.70) | 1.23 (0.89–1.71) | 1.22 (0.99–1.51) | 1.45 (1.26–1.68) |
9.00–9.99 | 4310 (7.9) | 324 (9.4) | 1.40 (1.23–1.59) | 1.23 (0.54–2.76) | 1.28 (0.88–1.89) | 1.24 (0.96–1.60) | 1.53 (1.30–1.81) |
≥10.00 | 4468 (8.6) | 330 (9.6) | 1.53 (1.35–1.74) | 0.82 (0.38–1.78) | 0.89 (0.55–1.43) | 1.38 (1.07–1.80) | 1.77 (1.51–2.08) |
Missing | 8509 (15.6) | 579 (16.9) | 1.24 (1.11–1.37) | 1.32 (0.76–2.30) | 0.90 (0.67–1.22) | 1.23 (1.01–1.50) | 1.34 (1.16–1.54) |
Comorbiditiesc
| |||||||
Hypertension | 30,684 (56.3) | 2068 (60.2) | 1.05 (0.98–1.13) | 0.73 (0.46–1.14) | 0.82 (0.67–1.01) | 1.08 (0.94–1.25) | 1.09 (1.00–1.20) |
Hyperlipidemia | 3574 (6.6) | 424 (12.3) | 1.39 (1.25–1.56) | 1.57 (1.02–2.41) | 1.53 (1.21–1.94) | 1.45 (1.20–1.76) | 1.31 (1.09–1.58) |
History of MI | 4778 (8.8) | 803 (23.4) | 1.94 (1.77–2.12) | 2.25 (1.44–3.52) | 1.80 (1.41–2.30) | 1.99 (1.68–2.37) | 1.93 (1.71–2.19) |
History of IS/TIA | 5187 (9.5) | 488 (14.2) | 1.29 (1.17–1.43) | 1.17 (0.71–1.92) | 1.19 (0.92–1.53) | 1.21 (1.01–1.45) | 1.42 (1.24–1.63) |
History of IHDd
| 9021 (16.5) | 1177 (34.3) | 1.66 (1.53–1.80) | 1.35 (0.88–2.08) | 1.34 (1.07–1.68) | 1.57 (1.35–1.83) | 1.81 (1.62–2.02) |
COPD | 2453 (4.5) | 198 (5.8) | 1.17 (1.01–1.35) | 0.83 (0.35–1.96) | 1.13 (0.78–1.66) | 1.08 (0.81–1.43) | 1.24 (1.01–1.52) |
Thyroid disease | 4648 (8.5) | 284 (8.3) | 0.96 (0.85–1.09) | 1.37 (0.80–2.36) | 0.86 (0.64–1.17) | 0.91 (0.73–1.13) | 1.01 (0.84–1.21) |
DVT | 3199 (5.9) | 230 (6.7) | 1.03 (0.90–1.18) | 0.43 (0.19–0.98) | 1.03 (0.73–1.46) | 0.88 (0.68–1.15) | 1.17 (0.97–1.40) |
PAD | 3253 (6.0) | 442 (12.9) | 1.53 (1.38–1.70) | 1.15 (0.70–1.91) | 1.55 (1.20–2.00) | 1.40 (1.14–1.71) | 1.67 (1.45–1.93) |
Anemia | 3310 (6.1) | 251 (7.3) | 1.12 (0.98–1.28) | 1.04 (0.63–1.73) | 0.93 (0.68–1.27) | 1.18 (0.94–1.50) | 1.18 (0.97–1.44) |
Atrial fibrillation | 3273 (6.0) | 221 (6.4) | 1.08 (0.95–1.24) | 0.96 (0.41–2.24) | 0.77 (0.49–1.22) | 1.07 (0.81–1.41) | 1.17 (0.99–1.39) |
Heart failure | 3759 (6.9) | 252 (7.3) | 1.06 (0.93–1.21) | 0.83 (0.39–1.79) | 0.59 (0.37–0.95) | 1.02 (0.79–1.32) | 1.21 (1.03–1.42) |
Gout | 3359 (6.2) | 240 (7.0) | 0.93 (0.81–1.06) | 1.25 (0.72–2.20) | 0.81 (0.57–1.13) | 1.17 (0.92–1.49) | 0.83 (0.68–1.01) |
Cancer | 4986 (9.1) | 309 (9.0) | 1.00 (0.89–1.13) | 1.61 (0.92–2.85) | 0.83 (0.60–1.14) | 1.07 (0.87–1.32) | 0.97 (0.82–1.15) |
Non–IS/TIA
|
IS/TIA
|
eGFR category
| |||||
---|---|---|---|---|---|---|---|
n = 54,161
|
n = 3785
|
Overall
|
15–29 mL/min
|
30–44 mL/min
|
45–59 mL/min
|
≥60 mL/min
| |
Number (%)
|
Number (%)
|
HR
a
(95% CI)
|
HR
b
(95% CI)
|
HR
b
(95% CI)
|
HR
b
(95% CI)
|
HR
b
(95% CI)
| |
Sex | |||||||
Men | 30,055 (55.5) | 2062 (54.5) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
Women | 24,106 (44.5) | 1723 (45.5) | 0.95 (0.89–1.02) | 1.52 (0.94–2.46) | 1.07 (0.85–1.33) | 0.91 (0.80–1.04) | 0.93 (0.86–1.02) |
Age at start date (years) | |||||||
20–49 | 5614 (10.4) | 109 (2.9) | 1 (−) | – | – | 1 (−) | 1 (−) |
50–74 | 35,722 (66.0) | 2350 (62.1) | 2.83 (2.32–3.43) | 0.82 (0.53–1.25) | 0.74 (0.60–0.92) | 1.54 (0.80–2.99) | 2.76 (2.25–3.39) |
≥75 | 12,825 (23.7) | 1326 (35.0) | 5.33 (4.35–6.54) | 1 (−) | 1 (−) | 2.69 (1.38–5.24) | 5.95 (4.77–7.42) |
Duration of diabetes (years) | |||||||
<5 | 24,591 (45.4) | 1458 (38.5) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
5–9 | 15,945 (29.4) | 1178 (31.1) | 1.12 (1.04–1.21) | 0.99 (0.58–1.69) | 1.10 (0.85–1.42) | 1.12 (0.96–1.30) | 1.12 (1.01–1.23) |
10–14 | 7874 (14.5) | 629 (16.6) | 1.16 (1.06–1.28) | 0.73 (0.37–1.43) | 1.05 (0.78–1.42) | 1.14 (0.95–1.37) | 1.20 (1.06–1.36) |
≥15 | 5751 (10.6) | 520 (13.7) | 1.27 (1.15–1.41) | 1.26 (0.72–2.22) | 1.35 (1.01–1.82) | 1.15 (0.94–1.41) | 1.29 (1.13–1.48) |
BMI (kg/m2) | |||||||
15–19 | 851 (1.6) | 64 (1.7) | 1.18 (0.91–1.52) | 1.26 (0.29–5.55) | 1.65 (0.82–3.34) | 1.44 (0.89–2.33) | 0.98 (0.69–1.39) |
20–24 | 8894 (16.4) | 652 (17.2) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
25–29 | 19,554 (36.1) | 1457 (38.5) | 1.01 (0.92–1.10) | 0.71 (0.38–1.32) | 1.09 (0.80–1.47) | 1.13 (0.93–1.36) | 0.97 (0.86–1.09) |
≥30 | 21,625 (39.9) | 1334 (35.2) | 0.93 (0.84–1.02) | 0.70 (0.39–1.27) | 1.03 (0.75–1.40) | 1.10 (0.91–1.34) | 0.86 (0.76–0.98) |
Unknown | 3237 (6.0) | 278 (7.3) | 1.24 (1.07–1.43) | 1.31 (0.63–2.69) | 1.45 (0.96–2.18) | 1.40 (1.06–1.85) | 1.11 (0.91–1.36) |
Smoking status | |||||||
Non–smoker | 28,212 (52.1) | 1963 (51.9) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
Current | 9463 (17.5) | 665 (17.6) | 1.19 (1.09–1.30) | 0.74 (0.33–1.65) | 1.20 (0.88–1.64) | 1.13 (0.94–1.37) | 1.24 (1.11–1.38) |
Former | 14,046 (25.9) | 965 (25.5) | 1.03 (0.95–1.11) | 1.09 (0.66–1.81) | 0.80 (0.62–1.04) | 0.91 (0.78–1.07) | 1.12 (1.01–1.24) |
Unknown | 2440 (4.5) | 192 (5.1) | 1.06 (0.91–1.24) | 1.66 (0.81–3.40) | 1.17 (0.75–1.83) | 1.14 (0.85–1.54) | 0.97 (0.79–1.20) |
Number of medications | |||||||
0–1 | 14,249 (26.3) | 758 (20.0) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | 1 (−) |
2–4 | 19,205 (35.5) | 1253 (33.1) | 1.14 (1.04–1.25) | 1.48 (0.68–3.23) | 1.02 (0.72–1.46) | 1.17 (0.97–1.41) | 1.12 (1.00–1.25) |
5–9 | 17,266 (31.9) | 1414 (37.4) | 1.28 (1.16–1.40) | 1.06 (0.51–2.20) | 1.11 (0.80–1.54) | 1.16 (0.97–1.40) | 1.34 (1.20–1.51) |
≥10 | 3441 (6.4) | 360 (9.5) | 1.65 (1.44–1.89) | 1.15 (0.50–2.62) | 1.42 (0.96–2.09) | 1.77 (1.38–2.27) | 1.64 (1.36–1.97) |
HbA1c (%) | |||||||
<7.00 | 18,214 (33.6) | 1168 (30.9) | 1 (−) | 1 (−) | 1 (−) | 1 (−) | |
7.00–7.99 | 12,029 (22.2) | 794 (21.0) | 1.02 (0.93–1.12) | 1.56 (0.89–2.74) | 0.95 (0.72–1.25) | 0.96 (0.81–1.14) | 1.04 (0.92–1.17) |
8.00–8.99 | 6730 (12.4) | 491 (13.0) | 1.12 (1.00–1.24) | 0.72 (0.31–1.63) | 1.17 (0.83–1.63) | 0.93 (0.75–1.15) | 1.22 (1.06–1.39) |
9.00–9.99 | 4297 (7.9) | 337 (8.9) | 1.30 (1.15–1.47) | 1.15 (0.46–2.87) | 1.24 (0.84–1.83) | 1.32 (1.03–1.68) | 1.33 (1.14–1.56) |
≥10.00 | 4474 (8.3) | 324 (8.6) | 1.33 (1.17–1.51) | 1.17 (0.53–2.58) | 0.72 (0.42–1.24) | 1.13 (0.86–1.48) | 1.52 (1.31–1.77) |
Missing | 8417 (15.5) | 671 (17.7) | 1.20 (1.09–1.33) | 1.36 (0.77–2.41) | 0.96 (0.72–1.30) | 1.15 (0.96–1.39) | 1.28 (1.13–1.44) |
Comorbiditiesc
| |||||||
Hypertension | 30,384 (56.1) | 2368 (62.6) | 1.07 (1.00–1.14) | 0.81 (0.52–1.28) | 1.06 (0.84–1.33) | 1.09 (0.95–1.25) | 1.07 (0.98–1.16) |
Hyperlipidemia | 3648 (6.7) | 350 (9.2) | 1.23 (1.09–1.39) | 1.79 (1.15–2.79) | 1.42 (1.10–1.82) | 1.21 (0.98–1.48) | 1.17 (0.96–1.43) |
History of MI | 5134 (9.5) | 447 (11.8) | 0.97 (0.87–1.08) | 1.12 (0.65–1.91) | 0.77 (0.57–1.03) | 1.06 (0.87–1.30) | 0.98 (0.84–1.14) |
History of IS/TIA | 4710 (8.7) | 965 (25.5) | 3.26 (3.02–3.52) | 1.97 (1.25–3.12) | 2.89 (2.33–3.59) | 3.09 (2.68–3.57) | 3.57 (3.22–3.95) |
History of IHDd
| 9308 (17.2) | 890 (23.5) | 1.16 (1.07–1.27) | 0.81 (0.50–1.31) | 1.45 (1.15–1.83) | 1.06 (0.91–1.24) | 1.18 (1.05–1.32) |
COPD | 2458 (4.5) | 193 (5.1) | 1.04 (0.89–1.20) | 1.15 (0.56–2.39) | 0.79 (0.50–1.26) | 1.07 (0.81–1.41) | 1.03 (0.85–1.26) |
Thyroid disease | 4571 (8.4) | 361 (9.5) | 1.01 (0.90–1.13) | 0.72 (0.40–1.31) | 0.97 (0.72–1.29) | 0.99 (0.81–1.21) | 1.07 (0.91–1.25) |
DVT | 3139 (5.8) | 290 (7.7) | 1.15 (1.02–1.29) | 0.67 (0.32–1.39) | 1.50 (1.09–2.07) | 1.30 (1.05–1.60) | 1.02 (0.85–1.21) |
PAD | 3330 (6.1) | 365 (9.6) | 1.22 (1.09–1.36) | 0.96 (0.54–1.68) | 1.35 (1.02–1.77) | 1.36 (1.11–1.67) | 1.15 (0.98–1.35) |
Anemia | 3298 (6.1) | 263 (6.9) | 1.04 (0.92–1.19) | 0.82 (0.47–1.44) | 1.01 (0.74–1.38) | 1.05 (0.83–1.33) | 1.08 (0.90–1.30) |
Atrial fibrillation | 3273 (6.0) | 221 (5.8) | 0.95 (0.83–1.09) | 0.61 (0.22–1.68) | 0.82 (0.52–1.29) | 0.85 (0.63–1.13) | 1.05 (0.89–1.24) |
Heart failure | 3755 (6.9) | 256 (6.8) | 0.97 (0.86–1.11) | 0.76 (0.30–1.91) | 1.08 (0.74–1.57) | 1.06 (0.83–1.34) | 0.95 (0.80–1.12) |
Gout | 3299 (6.1) | 300 (7.9) | 1.17 (1.04–1.32) | 0.86 (0.47–1.59) | 1.15 (0.84–1.59) | 1.34 (1.07–1.66) | 1.11 (0.94–1.32) |
Cancer | 4845 (8.9) | 450 (11.9) | 1.30 (1.18–1.44) | 0.84 (0.42–1.69) | 1.33 (1.01–1.75) | 1.09 (0.90–1.33) | 1.43 (1.25–1.63) |