Background
Methods
Participants
CAN evaluation
Data collection
Cardiovascular outcomes
Statistical analysis
Results
Total | CAN progression (−) | CAN progression (+) | P-value | |
---|---|---|---|---|
(N = 578) | (N = 404) | (N = 174) | ||
Women, n (%) | 329 (56.9) | 220 (54.5) | 109 (62.6) | 0.083 |
Age (years) | 58.3 ± 10.3 | 57.1 ± 10.1 | 60.9 ± 10.3 | < 0.001 |
Diabetes duration (years) | 10.1 ± 6.2 | 9.1 ± 5.7 | 12.4 ± 6.7 | < 0.001 |
Body mass index (kg/m2) | 24.7 ± 3.2 | 24.8 ± 3.2 | 24.7 ± 3.4 | 0.710 |
Hypertension, n (%) | 242 (43.8) | 163 (42.2) | 79 (47.6) | 0.284 |
Smoking, n (%) | 124 (21.5) | 93 (23.0) | 31 (17.8) | 0.198 |
Alcohol, n (%) | 138 (23.9) | 105 (26.0) | 33 (19.0) | 0.087 |
Insulin, n (%) | 141 (24.4) | 87 (21.5) | 54 (31.0) | 0.020 |
ACE inhibitor/ARBs, n (%) | 181 (31.3) | 122 (30.2) | 59 (33.9) | 0.433 |
Calcium channel blocker, n (%) | 101 (17.5) | 63 (15.6) | 38 (21.8) | 0.090 |
Aspirin, n (%) | 45 (7.8) | 28 (6.9) | 17 (9.8) | 0.318 |
Statin, n (%) | 65 (11.2) | 44 (10.9) | 21 (12.1) | 0.789 |
FPG (mmol/L) | 8.4 ± 2.9 | 8.3 ± 2.7 | 8.8 ± 3.3 | 0.053 |
eGFR (mL/min/1.73 m2) | 85.6 ± 17.1 | 86.7 ± 16.1 | 83.3 ± 19.0 | 0.040 |
Mean HbA1c (%) | 8.3 ± 1.5 | 8.1 ± 1.5 | 8.8 ± 1.6 | < 0.001 |
SD HbA1c | 1.1 ± 1.0 | 1.1 ± 1.0 | 1.0 ± 1.0 | 0.787 |
Mean HbA1c (mmol/L) | 67.1 ± 16.7 | 65.1 ± 16.0 | 71.5 ± 17.6 | < 0.001 |
Mean total cholesterol (mmol/L) | 4.7 ± 0.9 | 4.7 ± 0.9 | 4.8 ± 0.9 | 0.078 |
Mean triglyceride (mmol/L) | 1.7 ± 1.0 | 1.7 ± 1.0 | 1.7 ± 0.9 | 0.931 |
Mean HDL-cholesterol (mmol/L) | 1.2 ± 0.3 | 1.2 ± 0.3 | 1.1 ± 0.3 | 0.204 |
Mean LDL-cholesterol (mmol/L) | 2.8 ± 0.8 | 2.7 ± 0.8 | 2.9 ± 0.8 | 0.021 |
UAE (mg/day) | 79.8 ± 298.9 | 48.1 ± 191.4 | 153.8 ± 453.3 | 0.004 |
Non-progression | Normal → early | Early → definite | Normal → definite | P-value | |
---|---|---|---|---|---|
(N = 404) | (N = 79) | (N = 65) | (N = 30) | ||
Women, n (%) | 220 (54.5) | 49 (62.0) | 41 (63.1) | 19 (63.3) | 0.341 |
Age (years) | 57.1 ± 10.1 | 59.9 ± 10.0 | 62.0 ± 11.1 | 60.7 ± 8.8 | < 0.001 |
Diabetes duration (years) | 9.1 ± 5.7 | 11.4 ± 6.6 | 14.2 ± 7.1 | 11.5 ± 5.6 | < 0.001 |
Body mass index (kg/m2) | 24.8 ± 3.2 | 24.2 ± 3.4 | 24.7 ± 3.4 | 25.7 ± 2.9 | 0.518 |
Hypertension, n (%) | 163 (42.2) | 35 (46.7) | 31 (50.0) | 13 (44.8) | 0.655 |
Smoking, n (%) | 93 (23.0) | 12 (15.2) | 15 (23.1) | 4 (13.3) | 0.295 |
Alcohol, n (%) | 105 (26.0) | 18 (22.8) | 13 (20.0) | 2 (6.7) | 0.091 |
Insulin, n (%) | 87 (21.5) | 14 (17.7) | 30 (46.2) | 10 (33.3) | < 0.001 |
ACE inhibitor/ARBs, n (%) | 122 (30.2) | 25 (31.6) | 24 (36.9) | 10 (33.3) | 0.742 |
Calcium channel blocker, n (%) | 63 (15.6) | 20 (25.3) | 13 (20.0) | 5 (16.7) | 0.198 |
Aspirin, n (%) | 28 (6.9) | 7 (8.9) | 6 (9.2) | 4 (13.3) | 0.57 |
Statin, n (%) | 44 (10.9) | 9 (11.4) | 8 (12.3) | 4 (13.3) | 0.968 |
FPG (mmol/L) | 8.3 ± 2.7 | 8.4 ± 2.8 | 9.1 ± 4.3 | 9.4 ± 1.5 | 0.006 |
eGFR (mL/min/1.73 m2) | 86.7 ± 16.1 | 84.3 ± 17.7 | 81.1 ± 20.6 | 85.2 ± 18.9 | 0.042 |
Mean HbA1c (%) | 8.1 ± 1.5 | 8.2 ± 1.4 | 9.2 ± 1.6 | 9.2 ± 1.4 | < 0.001 |
SD HbA1c | 1.1 ± 1.0 | 0.7 ± 0.6 | 1.3 ± 1.3 | 1.2 ± 1.1 | 0.285 |
Mean HbA1c (mmol/L) | 65.1 ± 16.0 | 64.8 ± 16.3 | 76.9 ± 17.3 | 77.4 ± 15.6 | < 0.001 |
Mean total cholesterol (mmol/L) | 4.7 ± 0.9 | 4.7 ± 0.9 | 4.7 ± 0.9 | 5.2 ± 0.8 | 0.009 |
Mean triglyceride (mmol/L) | 1.7 ± 1.0 | 1.7 ± 0.8 | 1.6 ± 0.9 | 1.8 ± 1.1 | 0.971 |
Mean HDL-cholesterol (mmol/L) | 1.2 ± 0.3 | 1.1 ± 0.3 | 1.1 ± 0.3 | 1.2 ± 0.3 | 0.445 |
Mean LDL-cholesterol (mmol/L) | 2.7 ± 0.8 | 2.8 ± 0.8 | 2.8 ± 0.9 | 3.2 ± 0.6 | 0.003 |
UAE (mg/day) | 48.1 ± 191.4 | 142.5 ± 481.0 | 182.7 ± 513.5 | 120.4 ± 137.9 | 0.001 |
Crude HR (95% CI) | P value | Age and sex adjusted HR (95% CI) | P value | Fully adjusted HR (95% CI) | P value | |
---|---|---|---|---|---|---|
Overall risk of CVD
| ||||||
Non-progression of CAN | Reference | Reference | Reference | |||
Progression of CAN | 4.31 (2.49–7.47) | < 0.001 | 3.68 (2.10–6.47) | < 0.001 | 3.32 (1.81–6.14) | < 0.001 |
Non-progression | Reference | Reference | Reference | |||
Normal to early | 2.73 (1.28–5.81) | 0.009 | 2.30 (1.07–4.94) | 0.032 | 2.68 (1.19–6.02) | 0.017 |
Early to definite | 5.18 (2.63–10.20) | < 0.001 | 4.29 (2.12–8.66) | < 0.001 | 3.35 (1.55–7.26) | 0.002 |
Normal to definite | 6.99 (3.19–15.32) | < 0.001 | 6.58 (2.99–14.47) | < 0.001 | 4.91 (2.05–11.77) | < 0.001 |
P for trend | < 0.001 | < 0.001 | 0.001 | |||
Subgroup analysis
| ||||||
Age < 60 years | ||||||
Non-progression of CAN | Reference | Reference | Reference | |||
Progression of CAN | 8.04 (3.01–21.51) | < 0.001 | 8.29 (3.05–22.51) | < 0.001 | 5.49 (1.89–16.00) | 0.001 |
Age ≥ 60 years | ||||||
Non-progression of CAN | Reference | Reference | Reference | |||
Progression of CAN | 2.59 (1.33–5.03) | 0.005 | 2.46 (1.25–4.81) | 0.009 | 2.29 (1.10–4.77) | 0.03 |
Diabetes duration < 10 years | ||||||
Non-progression of CAN | Reference | Reference | Reference | |||
Progression of CAN | 5.37 (2.16–13.38) | < 0.001 | 4.40 (1.73–11.17) | 0.002 | 5.34 (1.81–15.70) | 0.002 |
Diabetes duration ≥ 10 years | ||||||
Non-progression of CAN | Reference | Reference | Reference | |||
Progression of CAN | 3.20 (1.58–6.49) | 0.001 | 3.02 (1.48–6.16) | 0.002 | 2.67 (1.24–5.74) | 0.012 |
BMI < 25 kg/m2 | ||||||
Non-progression of CAN | Reference | Reference | Reference | |||
Progression of CAN | 5.28 (2.43–11.47) | < 0.001 | 4.86 (2.22–10.64) | < 0.001 | 4.87 (2.00–11.90) | 0.001 |
BMI ≥ 25 kg/m2 | ||||||
Non-progression of CAN | Reference | Reference | Reference | |||
Progression of CAN | 3.70 (1.66–8.26) | 0.001 | 2.81 (1.22–6.48) | 0.016 | 3.39 (1.38–8.37) | 0.008 |
Mean HbA1c < 9.0% | ||||||
Non-progression of CAN | Reference | Reference | Reference | |||
Progression of CAN | 3.47 (1.67–7.20) | 0.001 | 2.88 (1.35–6.16) | 0.006 | 3.16 (1.41–7.10) | 0.005 |
Mean HbA1c < 9.0% | ||||||
Non-progression of CAN | Reference | Reference | Reference | |||
Progression of CAN | 4.47 (1.86–10.72) | 0.001 | 3.91 (1.61–0.95) | 0.003 | 5.44 (2.01–14.72) | 0.001 |
Sensitive analysis
| ||||||
Non-progression of CAN | Reference | Reference | Reference | |||
Progression of CAN | 3.41 (1.81–6.43) | < 0.001 | 2.94 (1.54–5.63) | 0.001 | 2.85 (1.40–5.78) | 0.004 |