Table 4.
Hazard Ratios (95% CI) of Cardiovascular Outcomes According to HbA1c Categories
| No. Events | HbA1c in mmol/mol (%) | P Trend | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| <48 (<6.5) | 48 to <58 (6.5 to <7.5) | 58 to <69 (7.5 to <8.5) | ≥69 (≥8.5) | |||||||
| HR | 95% CI | HR | 95% CI | HR | 95% CI | HR | 95% CI | |||
| CV mortality | 3355 | |||||||||
| Model 1a | 1.00 | ··· | 0.80 | 0.72, 0.88 | 0.79 | 0.70, 0.90 | 0.73 | 0.62, 0.85 | <0.001 | |
| Model 2b | 1.00 | ··· | 0.84 | 0.76, 0.93 | 0.91 | 0.80, 1.03 | 0.93 | 0.79, 1.09 | 0.57 | |
| Model 3c | 1.00 | ··· | 0.85 | 0.77, 0.94 | 0.92 | 0.81, 1.05 | 0.92 | 0.78, 1.08 | 0.45 | |
| Model 4d | 1.00 | ··· | 1.03 | 0.93, 1.15 | 1.16 | 1.02, 1.32 | 1.18 | 1.01, 1.37 | 0.01 | |
| Nonfatal MI | 2445 | |||||||||
| Model 1a | 1.00 | ··· | 1.03 | 0.93, 1.14 | 1.03 | 0.90, 1.17 | 0.99 | 0.87, 1.13 | 0.89 | |
| Model 2b | 1.00 | ··· | 1.07 | 0.97, 1.19 | 1.13 | 0.99, 1.29 | 1.19 | 1.04, 1.35 | 0.009 | |
| Model 3c | 1.00 | ··· | 1.07 | 0.97, 1.19 | 1.13 | 0.99, 1.29 | 1.16 | 1.01, 1.33 | 0.02 | |
| Model 4d | 1.00 | ··· | 1.10 | 0.99, 1.22 | 1.16 | 1.01, 1.33 | 1.15 | 1.01, 1.32 | 0.05 | |
| Fatal or nonfatal MI | 2754 | |||||||||
| Model 1a | 1.00 | ··· | 0.99 | 0.90, 1.09 | 0.98 | 0.85, 1.12 | 1.00 | 0.87, 1.16 | 0.99 | |
| Model 2b | 1.00 | ··· | 1.03 | 0.94, 1.13 | 1.08 | 0.94, 1.23 | 1.20 | 1.04, 1.39 | 0.01 | |
| Model 3c | 1.00 | ··· | 1.03 | 0.94, 1.13 | 1.08 | 0.94, 1.23 | 1.18 | 1.02, 1.37 | 0.02 | |
| Model 4d | 1.00 | ··· | 1.08 | 0.98, 1.19 | 1.13 | 0.98, 1.29 | 1.20 | 1.02, 1.41 | 0.02 | |
| Stroke | 1257 | |||||||||
| Model 1a | 1.00 | ··· | 1.03 | 0.88, 1.21 | 0.88 | 0.71, 1.07 | 1.00 | 0.82, 1.22 | 0.65 | |
| Model 2b | 1.00 | ··· | 1.07 | 0.91, 1.25 | 0.95 | 0.77, 1.16 | 1.14 | 0.93, 1.41 | 0.44 | |
| Model 3c | 1.00 | ··· | 1.10 | 0.94, 1.28 | 0.98 | 0.80, 1.21 | 1.17 | 0.95, 1.44 | 0.32 | |
| Model 4d | 1.00 | ··· | 1.13 | 0.96, 1.33 | 1.00 | 0.81, 1.23 | 1.13 | 0.92, 1.38 | 0.50 | |
| PAD | 266 | |||||||||
| Model 1a | 1.00 | ··· | 0.95 | 0.70, 1.30 | 1.05 | 0.72, 1.53 | 0.88 | 0.57, 1.36 | 0.67 | |
| Model 2b | 1.00 | ··· | 0.98 | 0.72, 1.33 | 1.12 | 0.77, 1.64 | 0.98 | 0.63, 1.51 | 0.93 | |
| Model 3c | 1.00 | ··· | 0.97 | 0.71, 1.32 | 1.14 | 0.78, 1.66 | 0.94 | 0.61, 1.48 | 0.99 | |
| Model 4d | 1.00 | ··· | 1.02 | 0.74, 1.39 | 1.21 | 0.82, 1.78 | 1.01 | 0.62, 1.64 | 0.80 | |
| All‐cause mortality | 8709 | |||||||||
| Model 1a | 1.00 | ··· | 0.73 | 0.69, 0.77 | 0.64 | 0.59, 0.69 | 0.57 | 0.51, 0.63 | <0.001 | |
| Model 2b | 1.00 | ··· | 0.77 | 0.73, 0.81 | 0.74 | 0.68, 0.80 | 0.75 | 0.67, 0.83 | <0.001 | |
| Model 3c | 1.00 | ··· | 0.79 | 0.74, 0.83 | 0.77 | 0.71, 0.83 | 0.75 | 0.68, 0.83 | <0.001 | |
| Model 4d | 1.00 | ··· | 1.00 | 0.94, 1.06 | 1.01 | 0.93, 1.10 | 1.00 | 0.91, 1.10 | 0.96 | |
CV indicates cardiovascular; ESRD, end‐stage renal disease; HbA1c, glycated hemoglobin; HR, hazard ratio; MI, myocardial infarction; PAD, peripheral arterial disease; SES, socioeconomic status.
Model 1 adjusted for year of ESRD incidence.
Model 2 adjust for year of ESRD incidence in addition to census division (a marker for location), demographic variables such as age, sex, race/ethnicity, Medicare/Medicaid dual eligibility, and area‐level geocoded SES variables such as median rent, median household income, percentage living below poverty, percentage unemployed, and percentage with less than high school education.
Model 3 adjusted for variables in model 2, baseline body mass index, estimated glomerular filtration rate, and preexisting comorbidities including heart failure, arrhythmias, coronary artery disease, other cardiac disease, peripheral arterial disease, hypertension, chronic obstructive pulmonary disease, current tobacco use, cancer, and alcohol dependence.
Model 4 adjusted for variables in model 3 and laboratory variables such as albumin, normalized protein catabolic rate, hemoglobin, platelet count, white blood cell count, ferritin, mean arterial pressure, pulse pressure, serum calcium, serum phosphorus, parathyroid hormone, and predialysis weight.