Table 2.
Outcomes of insulin users and matched nonusers with diabetes and compensated liver cirrhosis
| Outcomes | Non-insulin users (n = 4094) | Insulin users (n = 2047) | Crude HR (95% CI) | p value | Adjusted HRa (95% CI) | p value | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| Events | PY | IR | Events | PY | IR | |||||
| All-cause mortality | 979 | 24,075 | 4.07 | 627 | 11,866 | 5.28 | 1.33 (1.21˗1.48) | < 0.0001 | 1.31 (1.18˗1.45) | < 0.0001 |
| HCC | 700 | 22,490 | 3.11 | 402 | 10,921 | 3.68 | 1.17 (1.03˗1.32) | 0.01 | 1.18 (1.05˗1.34) | 0.007 |
| MACE | 512 | 22,227 | 2.30 | 339 | 10,738 | 3.16 | 1.37 (1.19˗1.57) | < 0.0001 | 1.41 (1.23˗1.62) | < 0.0001 |
| Stroke | 300 | 23,086 | 1.30 | 186 | 11,285 | 1.65 | 1.28 (1.07˗1.54) | 0.007 | 1.31 (1.09˗1.58) | 0.004 |
| Ischemic heart disease | 198 | 23,277 | 0.85 | 128 | 11,394 | 1.12 | 1.31 (1.05˗1.64) | 0.02 | 1.36 (1.09˗1.71) | 0.006 |
| Heart failure | 125 | 23,649 | 0.53 | 128 | 11,507 | 1.11 | 2.11 (1.65˗2.71) | < 0.0001 | 2.18 (1.70˗2.80) | < 0.0001 |
| Decompensated cirrhosis | 642 | 22,865 | 2.81 | 465 | 10,890 | 4.27 | 1.50 (1.33˗1.69) | < 0.0001 | 1.53 (1.35˗1.72) | < 0.0001 |
| Variceal bleeding | 41 | 23,986 | 0.17 | 38 | 11,767 | 0.32 | 1.83 (1.18˗2.85) | 0.007 | 1.81 (1.16˗2.83) | 0.009 |
| Hepatic ascites | 407 | 23,381 | 1.74 | 327 | 11,196 | 2.92 | 1.66 (1.43˗1.92) | < 0.0001 | 1.68 (1.45˗1.95) | < 0.0001 |
| Hepatic encephalopathy | 351 | 23,577 | 1.49 | 281 | 11,380 | 2.47 | 1.64 (1.40˗1.91) | < 0.0001 | 1.63 (1.39˗1.91) | < 0.0001 |
| Jaundice | 102 | 23,848 | 0.43 | 45 | 11,757 | 0.38 | 0.88 (0.62˗1.25) | 0.49 | 0.90 (0.63˗1.29) | 0.58 |
| Hepatic failure | 493 | 23,363 | 2.11 | 388 | 11,230 | 3.46 | 1.62 (1.42˗1.85) | < 0.0001 | 1.26 (1.42˗1.86) | < 0.0001 |
| Hypoglycemia | 68 | 23,893 | 0.28 | 107 | 11,576 | 0.92 | 3.26 (2.40˗4.42) | < 0.0001 | 3.33 (2.45˗4.53) | < 0.0001 |
PY, person-years; IR, incidence rate, per 100 person-years; HR, hazard ratio; CI, confidence interval; HCC, hepatocellular carcinoma; MACE, major adverse cardiac event, including stroke, ischemic heart disease, and heart failure
aAdjusted for age, sex, index year, age of diabetes mellitus diagnosis, DM duration (years), antihypertensive drugs (ACE inhibitors, ARBs, β-blockers, calcium-channel blockers, diuretics, other antihypertensive), antidiabetic drugs (metformin, sulfonylureas, meglitinides, TZD, α-glucosidase inhibitor, DPP-4 inhibitors), statin, and aspirin, CCI (0, 1, ≥ 2), DCSI score (0, 1, ≥ 2), HBV and HCV