Table 3.
Multivariable-adjusted cancer mortality rates and hazard ratios of cancer mortality and major site-specific cancer mortality by glycated hemoglobin value in non-diabetic participants, and by diabetes in the Atherosclerosis Risk in Communities Study (ARIC), 1990–2006.
| Glycated Hemoglobin, % in Non-Diabetic Participants |
|||||
|---|---|---|---|---|---|
| Women‡ | Total | <5.0 | 5.0–5.6 | ≥5.7 | Diabetes* |
| All Cancer | |||||
| No. of cases | 372 | 33 | 180 | 110 | 49 |
| Person yrs of follow-up | 101,246 | 7,502 | 64,548 | 21,349 | 7,847 |
| Mortality rate† | 391.5 | 501.9 | 297.4 | 547.2 | 601.9 |
| HR (95% CI) 1 | 1.77 (1.22,2.58) |
1.00 (Ref) |
1.81 (1.41,2.32) |
2.25 (1.63,3.13) |
|
| HR (95% CI) 2 | 1.82 (1.25,2.64) |
1.00 (Ref) |
1.58 (1.23,2.05) |
1.96 (1.40,2.76) |
|
| Lung Cancer | |||||
| No. of cases | 105 | 7 | 55 | 31 | 12 |
| Person yrs of follow-up | 101,246 | 7,502 | 64,548 | 21,349 | 7,847 |
| Mortality rate† | 110.9 | 119.0 | 90.7 | 148.4 | 146.6 |
| HR (95% CI) 1 | 1.29 (0.59,2.85) |
1.00 (Ref) |
1.66 (1.04,2.63) |
1.77 (0.94,3.40) |
|
| HR (95% CI) 2 | 1.18 (0.53,2.60) |
1.00 (Ref) |
1.35 (0.83,2.21) |
1.73 (0.88,3.40) |
|
| Post-menopausal Breast Cancer |
|||||
| No. of cases | 40 | 4 | 19 | 8 | 9 |
| Person yrs of follow-up | 86,236 | 5,604 | 53,988 | 19,423 | 7,221 |
| Mortality rate† | 48.1 | 63.4 | 38.2 | 38.6 | 85.7 |
| HR (95% CI) 1 | 2.12 (0.72,6.27) |
1.00 (Ref) |
1.03 (0.44,2.44) |
3.22 (1.40,7.43) |
|
| HR (95% CI) 2 | 2.28 (0.77,6.75) |
1.00 (Ref) |
0.88 (0.37,2.13) |
2.34 (0.97,5.62) |
|
| Colorectal Cancer | |||||
| No. of cases | 29 | 5 | 14 | 6 | 4 |
| Person yrs of follow-up | 101,246 | 7,502 | 64,548 | 21,349 | 7,847 |
| Mortality rate† | 30.6 | 65.2 | 24.6 | 36.3 | 53.2 |
| HR (95% CI) 1 | 3.23 (1.15,9.04) |
1.00 (Ref) |
1.31 (0.48,3.57) |
2.49 (0.79,7.90) |
|
| HR (95% CI) 2 | 3.30 (1.17,9.24) |
1.00 (Ref) |
1.18 (0.43,3.27) |
2.25 (0.68,7.46) |
|
|
Men | |||||
| All Cancer | |||||
| No. of cases | 515 | 32 | 300 | 143 | 40 |
| Person yrs of follow-up | 80,271 | 6,513 | 49,472 | 18,121 | 6,165 |
| Mortality rate† | 641.3 | 602.7 | 649.9 | 728.0 | 595.3 |
| HR (95% CI)1 | 0.88 (0.61,1.27) |
1.00 (Ref) |
1.16 (0.94,1.42) |
0.94 (0.67,1.31) |
|
| HR (95% CI) 2 | 0.97 (0.67,1.40) |
1.00 (Ref) |
1.08 (0.87,1.33) |
0.92 (0.66,1.30) |
|
| All Cancer minus Prostate Cancer |
|||||
| No. of cases | 471 | 27 | 280 | 125 | 39 |
| Person yrs of follow-up | 80,271 | 6,513 | 49,472 | 18,121 | 6,165 |
| Mortality rate† | 584.4 | 515.2 | 601.8 | 647.4 | 583.9 |
| HR (95% CI) 1 | 0.79 (0.53,1.18) |
1.00 (Ref) |
1.11 (0.89,1.37) |
1.00 (0.71,1.40) |
|
| HR (95% CI) 2 | 0.89 (0.60,1.32) |
1.00 (Ref) |
1.01 (0.80,1.26) |
0.92 (0.65,1.30) |
|
| Lung Cancer | |||||
| No. of cases | 182 | 7 | 104 | 60 | 11 |
| Person yrs of follow-up | 80,271 | 6,513 | 49,472 | 18,121 | 6,165 |
| Mortality rate† | 225.7 | 132.8 | 221.1 | 315.1 | 172.3 |
| HR (95% CI) 1 | 0.56 (0.26,1.20) |
1.00 (Ref) |
1.41 (1.02,1.96) |
0.74 (0.39,1.39) |
|
| HR (95% CI) 2 | 0.65 (0.30,1.40) |
1.00 (Ref) |
1.31 (0.94,1.84) |
0.81 (0.43,1.52) |
|
| Colorectal Cancer | |||||
| No. of cases | 46 | 5 | 25 | 10 | 6 |
| Person yrs of follow-up | 80,271 | 6,513 | 49,472 | 18,121 | 6,165 |
| Mortality rate† | 57.2 | 89.0 | 60.4 | 51.7 | 91.6 |
| HR (95% CI) 1 | 1.66 (0.63,4.34) |
1.00 (Ref) |
0.97 (0.46,2.06) |
1.69 (0.68,4.20) |
|
| HR (95% CI) 2 | 1.73 (0.66,4.53) |
1.00 (Ref) |
0.86 (0.40,1.85) |
1.51 (0.59,3.81) |
|
| Prostate Cancer | |||||
| No. of cases | 44 | 5 | 20 | 18 | 1 |
| Person yrs of follow-up | 80,271 | 6,513 | 49,472 | 18,121 | 6,165 |
| Mortality rate† | 56.9 | 87.5 | 48.0 | 80.6 | 11.4 |
| HR (95% CI) 1 | 2.15 (0.80,5.74) |
1.00 (Ref) |
1.81 (0.93,3.51) |
0.29 (0.04,2.18) |
|
| HR (95% CI) 2 | 2.06 (0.77,5.52) |
1.00 (Ref) |
1.65 (0.84,3.25) |
0.25 (0.03,1.91) |
|
Abbreviations: No., number; yrs, years; HR, Hazard Ratio; CI, Confidence Interval
A participant was classified as having diabetes if they self-reported a diagnosis of diabetes and/or were taking medication to treat diabetes at the first or second visits.
The rate per 100,000 women/men is given, standardized to the age and race distribution in the analytic cohort.
The Cox proportional hazards models were adjusted for:
age (continuous) at the second visit, and race/ethnicity (white, black);
covariates in (1) and ARIC study site, education level (less than high school, high school/equivalent, college or above), cigarette smoking status (never, former, current), cigarette-years smoked (continuous), body mass index (continuous), and waist circumference (continuous).
The Cox proportional hazards models for women were also adjusted for post-menopausal hormone use (no, yes).