Table 6.
The Association of Log‐Aldosterone by Renin Phenotypes, Renin Phenotypes Alone and Log‐Aldosterone:Renin Ratio With Incident Type 2 Diabetes Mellitus
| (A) Log‐Aldosterone Per 1‐Unit SD (Continuous, n=1453)b | Cox Proportional Hazards Model—Hazards Ratio (95% CI) for Incident Type 2 Diabetes Mellitus | ||||
|---|---|---|---|---|---|
| Total No. Participants/Diabetes Mellitus Cases | Median Aldosterone (pg/mL, IQR) | Unadjusted | Model 1a | Model 2a | |
| “Unsuppressed Renin Phenotype” PRA ≥1.0 μg/L per h | 386/34 | 169 (118, 234) | 1.13 (0.78, 1.63) | 1.31 (0.88, 1.94) | 1.66 (1.08, 2.53) |
| “Indeterminate Renin Phenotype” PRA 0.51 to 0.99 μg/L per h | 389/28 | 130 (99, 182) | 1.05 (0.69, 1.60) | 1.16 (0.74, 1.83) | 1.18 (0.74, 1.88) |
| “Suppressed Renin Phenotype” PRA ≤0.50 μg/L per h | 678/48 | 116 (85, 156) | 1.57 (1.10, 2.25) | 1.74 (1.19, 2.54) | 1.79 (1.21, 2.64) |
| (B) Log‐Aldosterone Per 1‐Unit SD (Continuous, n=1179)b |
Cox Proportional Hazards Model—Hazards Ratio (95% CI) for Incident Type 2 Diabetes Mellitus Excluding Participants Taking ACE‐Inhibitors and Angiotensin Receptor Blockers |
||||
|---|---|---|---|---|---|
| Total No. Participants/Diabetes Mellitus Cases | Median Aldosterone (pg/mL, IQR) | Unadjusted | Model 1a | Model 2a | |
| “Unsuppressed Renin Phenotype” PRA ≥1.0 μg/L per h | 246/14 | 188 (140, 267) | 1.74 (0.95, 3.16) | 2.23 (1.12, 4.43) | ··· |
| “Indeterminate Renin Phenotype” PRA 0.51 to 0.99 μg/L per h | 338/24 | 136 (101, 187) | 0.99 (0.63, 1.43) | 1.12 (0.68, 1.84) | ··· |
| “Suppressed Renin Phenotype” PRA ≤0.50 μg/L per h | 595/42 | 114 (84, 152) | 1.65 (1.12, 2.42) | 2.00 (1.31, 3.06) | ··· |
| (C) Plasma Renin Activity (n=1453)c | Cox Proportional Hazards Model—Hazards Ratio (95% CI) for Incident Type 2 Diabetes Mellitus | ||||
|---|---|---|---|---|---|
| Total No. Participants/Diabetes Mellitus Cases | Median Aldosterone (pg/mL, IQR) | Unadjusted | Model 1a | Model 2a | |
| “Unsuppressed Renin Phenotype” ≥1.0 μg/L per h | 386/34 | 169 (118, 234) | Referent | Referent | Referent |
| “Indeterminate Renin Phenotype” 0.51 to 0.99 μg/L per h | 389/28 | 130 (99, 182) | 0.80 (0.48, 1.32) | 0.79 (0.48, 1.31) | 0.87 (0.52, 1.47) |
| “Suppressed Renin Phenotype” ≤0.50 μg/L per h | 678/48 | 116 (85, 156) | 0.80 (0.52, 1.24) | 0.71 (0.45, 1.12) | 0.79 (0.49, 1.28) |
| (D) Plasma Renin Activity (n=1179)c |
Cox Proportional Hazards Model—Hazards Ratio (95% CI) for Incident Type 2 Diabetes Mellitus Excluding Participants Taking ACE‐Inhibitors and Angiotensin Receptor Blockers |
||||
|---|---|---|---|---|---|
| Total No. Participants/Diabetes Mellitus Cases | Median Aldosterone (pg/mL, IQR) | Unadjusted | Model 1a | Model 2a | |
| “Unsuppressed Renin Phenotype” ≥1.0 μg/L per h | 246/14 | 188 (140, 267) | Referent | Referent | ··· |
| “Indeterminate Renin Phenotype” 0.51 to 0.99 μg/L per h | 338/24 | 136 (101, 187) | 1.24 (0.64, 2.40) | 1.13 (0.58, 2.20) | ··· |
| “Suppressed Renin Phenotype” ≤0.50 μg/L per h | 595/42 | 114 (84, 152) | 1.26 (0.69, 2.31) | 1.04 (0.56, 1.96) | ··· |
| (E) Log‐Aldosterone:Plasma Renin Activity Ratio Per 1‐Unit SD (Continuous)d | Cox Proportional Hazards Model—Hazards Ratio (95% CI) for Incident Type 2 Diabetes Mellitus | ||||
|---|---|---|---|---|---|
| Total No. Participants/Diabetes Mellitus Cases | Median Aldosterone (pg/mL, IQR) | Unadjusted | Model 1a | Model 2a | |
| All participants | 1453/110 | 131 (95, 183) | 0.93 (0.77, 1.12) | 0.91 (0.75, 1.10) | 0.97 (0.79, 1.19) |
| Excluding participants taking ACE‐inhibitors and angiotensin receptor blockers | 1179/80 | 133 (95, 186) | 1.10 (0.85, 1.41) | 1.07 (0.82, 1.40) | ··· |
ACE indicates angiotensin‐converting enzyme inhibitors; CI, confidence interval; IQR, interquartile range.
Model 1: age, education, sex, study site, race, alcohol, physical activity, estimated glomerular filtration rate, systolic blood pressure and waist circumference (cm). Model 2+ACE‐inhibitors and angiotensin receptor blockers.
Hazard ratio for incident type 2 diabetes mellitus with log‐aldosterone standard deviations as a continuous exposure, by renin phenotype.
Hazard ratio for incident type 2 diabetes mellitus by renin phenotype.
Hazard ratio for incident type 2 diabetes mellitus with log‐aldosterone/PRA standard deviations as a continuous exposure.