Table 2.
Multivariate Cox proportional hazard models for all‐cause, cancer, vascular, and non‐cancer non‐vascular mortality in association with diabetic retinopathy and diabetic kidney disease
| All‐cause mortality | n with/without outcome | Incidence rate (1,000 person‐years) | Model 1 (266/1902) | Model 2 (266/1902) | Model 3 (266/1902) | Model 4 (266/1902) | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| HR (95% CI) | P‐value | HR (95% CI) | P‐value | HR (95% CI) | P‐value | HR (95% CI) | P‐value | |||
| DR (+) | 88/286 | 17.1 | 1.76 (1.31–2.35) | 0.0002 | 1.65 (1.23–2.22) | 0.001 | ||||
| DKD (+) | 107/422 | 14.3 | 1.49 (1.15–1.93) | 0.003 | 1.38 (1.06–1.80) | 0.016 | ||||
| Categorization into 4 groups | ||||||||||
| DR (–) DKD (–) | 116/1,056 | 6.1 | 1 | |||||||
| DR (–) DKD (+) | 62/294 | 11.9 | 1.53 (1.11–2.10) | 0.010 | ||||||
| DR (+) DKD (–) | 43/158 | 15.1 | 1.87 (1.28–2.72) | 0.001 | ||||||
| DR (+) DKD (+) † | 45/128 | 19.7 | 2.17 (1.48–3.18) | <0.0001 | ||||||
| Cancer mortality | n with/without outcome | Incidence rate (1,000 person‐years) | Model 1 (92/1,888) | Model 2 (92/1,888) | Model 3 (92/1,888) | Model 4 (92/1,888) | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| HR (95% CI) | P‐value | HR (95% CI) | P‐value | HR (95% CI) | P‐value | HR (95% CI) | P‐value | |||
| DR (+) | 24/348 | 4.7 | 1.27 (0.75–2.14) | 0.38 | 1.32 (0.77–2.25) | 0.32 | ||||
| DKD (+) | 24/501 | 3.2 | 0.87 (0.53–1.41) | 0.56 | 0.83 (0.51–1.36) | 0.46 | ||||
| Categorization into 4 groups | ||||||||||
| DR (–) DKD (–) | 52/1,111 | 2.8 | 1 | |||||||
| DR (–) DKD (+) | 16/337 | 3.1 | 1.00 (0.56–1.80) | 0.99 | ||||||
| DR (+) DKD (–) | 16/184 | 5.6 | 1.58 (0.86–2.92) | 0.14 | ||||||
| DR (+) DKD (+) | 8/164 | 3.5 | 0.90 (0.40–1.98) | 0.79 | ||||||
| Vascular mortality | n with/without outcome | Incidence rate (1,000 person‐years) | Model 1 (78/1888) | Model 2 (78/1888) | Model 3 (78/1888) | Model 4 (78/1888) | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| HR (95% CI) | P‐value | HR (95% CI) | P‐value | HR (95% CI) | P‐value | HR (95% CI) | P‐value | |||
| DR (+) | 31/341 | 6.1 | 2.24 (1.32–3.82) | 0.003 | 1.98 (1.15–3.40) | 0.014 | ||||
| DKD (+) | 41/484 | 5.5 | 2.13 (1.33–3.41) | 0.002 | 1.93 (1.20–3.11) | 0.007 | ||||
| Categorization into 4 groups | ||||||||||
| DR (–) DKD (–) | 22/1,141 | 1.2 | 1 | |||||||
| DR (–) DKD (+) | 25/328 | 4.8 | 2.92 (1.61–5.29) | 0.0004 | ||||||
| DR (+) DKD (–) | 15/185 | 5.3 | 3.51 (1.73–7.14) | 0.0005 | ||||||
| DR (+) DKD (+) ‡ | 16/156 | 7.0 | 3.56 (1.73–7.33) | 0.0006 | ||||||
| Non‐cancer non‐vascular mortality | n with/without outcome | Incidence rate (1,000 person‐years) | Model 1 (82/1888) | Model 2 (82/1888) | Model 3 (82/1888) | Model 4 (82/1888) | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| HR (95% CI) | P‐value | HR (95% CI) | P‐value | HR (95% CI) | P‐value | HR (95% CI) | P‐value | |||
| DR (+) | 31/341 | 6.1 | 2.26 (1.35–3.78) | 0.002 | 2.04 (1.21–3.44) | 0.008 | ||||
| DKD (+) | 38/487 | 5.1 | 2.01 (1.27–3.17) | 0.003 | 1.82 (1.15–2.90) | 0.011 | ||||
| Categorization into 4 groups | ||||||||||
| DR (–) DKD (–) | 33/1,130 | 1.8 | 1 | |||||||
| DR (–) DKD (+) | 18/335 | 3.5 | 1.55 (0.85–2.83) | 0.15 | ||||||
| DR (+) DKD (–) | 11/189 | 3.9 | 1.65 (0.80–3.42) | 0.18 | ||||||
| DR (+) DKD (+) § | 20/152 | 8.8 | 3.87 (2.06–7.28) | <0.0001 | ||||||
All models were adjusted for age, sex, duration of diabetes, body mass index, glycated hemoglobin, systolic blood pressure, total cholesterol, high‐density lipoprotein cholesterol, smoking status and alcohol intake at baseline.
CI, confidence interval; DKD, diabetic kidney disease; DR, diabetic retinopathy; HR, hazard ratio.
Biological interaction: relative excess risk as a result of interaction −0.225 (−1.191–0.740); attributable proportion due to interaction −0.104 (−0.567–0.360); synergy index 0.838 (0.397–1.773).
Biological interaction: relative excess risk as a result of interaction −1.869 (−4.890–1.152); attributable proportion due to interaction −0.525 (−1.515–0.465); synergy index 0.578 (0.243–1.373).
Biological interaction: relative excess risk as a result of interaction 1.673 (−0.562–3.908); attributable proportion due to interaction 0.432 (0.012–0.852); synergy index 2.394 (0.666–8.605).