Table 4. Summary of the Meta-analysis for Cardiovascular Outcomes in Persons With Type 2 Diabetes After Excluding the CHS and BMESa.
| Outcome, DR Type | Model 1b | Model 2c | Model 3d | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Studies, No. | Participants, No. | Events, No. | IRR (95% CI) | Studies, No. | Participants, No. | Events, No. | IRR (95% CI) | Studies, No. | Participants, No. | Events, No. | IRR (95% CI) | |
| First CVD | ||||||||||||
| DME | 6 | 5316 | 852 | 1.63 (1.21-2.19) | 5 | 4404 | 752 | 1.47 (1.04-2.10) | 4 | 2285 | 427 | 1.48 (0.76-2.87) |
| PDR | 5 | 4983 | 861 | 1.27 (1.02-1.59) | 3 | 2863 | 553 | 1.27 (1.00-1.64) | 3 | 2306 | 430 | 1.21 (0.85-1.72) |
| VTDR | 6 | 5779 | 939 | 1.38 (1.15-1.66) | 4 | 3628 | 584 | 1.33 (1.05-1.69) | 4 | 2396 | 451 | 1.26 (0.92-1.73) |
| Fatal CVD | ||||||||||||
| DME | 4 | 3541 | 129 | 3.42 (1.47-7.98) | 4 | 3359 | 123 | 3.86 (1.60-9.30) | 3 | 1937 | 99 | 3.45 (1.29-9.28) |
| PDR | 3 | 2982 | 133 | 1.87 (1.00-3.50) | 3 | 2863 | 125 | 1.80 (0.87-3.70) | 3 | 2036 | 99 | 1.50 (0.56-4.03) |
| VTDR | 4 | 3739 | 137 | 2.47 (1.47-4.13) | 4 | 3739 | 137 | 2.40 (1.36-4.24) | 4 | 2389 | 101 | 2.20 (1.10-4.39) |
| First CHD | ||||||||||||
| DME | 6 | 4682 | 693 | 1.50 (1.09-2.07) | 4 | 3182 | 431 | 1.87 (0.98-3.60) | 4 | 2156 | 359 | 1.45 (0.73-2.88) |
| PDR | 5 | 4313 | 696 | 1.37 (1.08-1.74) | 3 | 2641 | 440 | 1.33 (1.00-1.77) | 3 | 1898 | 132 | 1.20 (0.82-1.76) |
| VTDR | 6 | 5020 | 544 | 1.41 (1.15-1.73) | 4 | 3404 | 467 | 1.41 (1.08-1.84) | 4 | 2256 | 375 | 1.32 (0.94-1.85) |
| Fatal CHD | ||||||||||||
| DME | 4 | 3277 | 113 | 4.22 (1.78-9.98) | 4 | 3167 | 107 | 4.72 (1.93-11.55) | 3 | 1810 | 89 | 3.77 (1.39-10.21) |
| PDR | 3 | 2724 | 117 | 2.07 (1.10-3.88) | 3 | 2531 | 110 | 1.98 (0.96-4.10) | 3 | 1898 | 89 | 1.70 (0.63-4.60) |
| VTDR | 4 | 3480 | 120 | 2.81 (1.67-4.74) | 4 | 3389 | 113 | 2.72 (1.53-4.83) | 3 | 1898 | 89 | 2.47 (1.21-5.06) |
Abbreviations: BMES, Blue Mountains Eye Study; CHS, Cardiovascular Health Study; CHD, coronary heart disease; CVD, cardiovascular disease; DME, diabetic macular edema; DR, diabetic retinopathy; IRR. incidence rate ratio; PDR, proliferative diabetic retinopathy; VTDR, vision-threatening diabetic retinopathy.
Because BMES and CHS had shorter durations of diabetes and shorter follow-up, we performed a sensitivity analysis by excluding the 2 studies.
Model 1: adjusted for age, sex, and race/ethnicity.
Model 2: model 1 additionally adjusted for current smoking, systolic blood pressure, use of hypertension medication, total cholesterol level, and body mass index.
Model 3: model 2 additionally adjusted for duration of diabetes, use of treatment for diabetes, and hemoglobin A1c level.