Table 3.
Risk Factors for DR Incidence and Progression in the MESA
| DR Incidence | DR Progression | |||
|---|---|---|---|---|
| Risk Factors | RR (95% CI)* | RR (95% CI)† | RR (95% CI)* | RR (95% CI)† |
| Age, per year | 0.98 (0.96 – 1.01) | 0.99 (0.97 – 1.02) | 0.95 (0.91 – 0.99) | 0.99 (0.94 – 1.04) |
| Gender, female | 1.19 (0.78 – 1.82) | 1.05 (0.67 – 1.63) | 0.67 (0.31 – 1.45) | 0.44 (0.17 – 1.09) |
| Ethnicity | ||||
| White | Reference | Reference | Reference | Reference |
| Chinese | 1.24 (0.64 – 2.40) | 1.21 (0.63 – 2.34) | 1.91 (0.31 – 11.85) | 1.13 (0.23 – 5.51) |
| African American | 0.72 (0.39 – 1.33) | 0.56 (0.30 – 1.07) | 2.33 (0.57 – 9.60) | 1.86 (0.49 – 7.11) |
| Hispanic | 1.16 (0.68 – 2.00) | 0.91 (0.52 – 1.57) | 1.56 (0.35 – 6.94) | 1.11 (0.25 – 5.03) |
| Diabetes duration, per year | 0.98 (0.94 – 1.03) | 0.94 (0.88 – 1.00) | ||
| Education | ||||
| College or higher | Reference | Reference | ||
| High school or lower | 1.32 (0.87 – 2.02) | 1.03 (0.48 – 2.18) | ||
| Total household income | ||||
| >$50,000 | Reference | Reference | ||
| $25,000 to $50,000 | 1.67 (0.94 – 2.97) | 0.80 (0.33 – 1.96) | ||
| <$25,000 | 1.71 (0.98 – 3.00) | 0.88 (0.35 – 2.20) | ||
| Cigarette smoker, current | 1.47 (0.82 – 2.62) | 1.88 (0.80 – 4.41) | ||
| Body mass index, per unit | 1.02 (0.99 – 1.05) | 1.00 (0.94 – 1.06) | ||
| Hip-to-waist ratio, per 0.1 unit | 1.00 (0.74 – 1.33) | 1.09 (0.75 – 1.58) | ||
| Physical activity, per hour/week | 1.00 (1.00 – 1.00) | 1.00 (1.00 – 1.01) | ||
| Hypertension | 0.78 (0.51 – 1.18) | 0.49 (0.23 – 1.01) | ||
| Hypertension medications | ||||
| Diuretics | 1.44 (0.91 – 2.26) | 1.78 (0.83 – 3.79) | ||
| Angiotensin 2 antagonists | 1.10 (0.49 – 2.47) | 0.98 (0.37 – 2.62) | ||
| ACE inhibitor | 0.83 (0.52 – 1.34) | 0.90 (0.42 – 1.94) | ||
| Systolic blood pressure, per 10 mmHg | 1.11 (1.01 – 1.22) | 1.14 (1.04 – 1.25) | 0.85 (0.72 – 1.01) | |
| Diastolic blood pressure, per 10 mmHg | 1.09 (0.90 – 1.32) | 1.08 (0.79 – 1.46) | ||
| Insulin use | 1.62 (0.76 – 3.47) | 0.84 (0.31 – 2.27) | ||
| HbA1c, per % | 1.32 (1.19 – 1.45) | 1.28 (1.16 – 1.41) | 1.29 (1.13 – 1.47) | 1.20 (1.00 – 1.43) |
| Total cholesterol, per mmol/L | 1.00 (1.00 – 1.01) | 1.01 (1.00 – 1.02) | ||
| HDL cholesterol, per mmol/L | 1.00 (0.98 – 1.02) | 0.98 (0.95 – 1.01) | ||
| LDL cholesterol, per mmol/L | 1.00 (0.99 – 1.01) | 1.02 (1.01 – 1.03) | 1.01 (1.00 – 1.03) | |
| Statin use | 0.77 (0.48 – 1.23) | 0.83 (0.38 – 1.81) | ||
| Homocysteine | 0.91 (0.84 – 0.98) | 0.93 (0.85 – 1.00) | 1.05 (0.94 – 1.18) | |
| C-reactive protein | 1.00 (0.97 – 1.03) | 1.02 (0.95 – 1.09) | ||
| Proteinuria | 1.27 (0.78 – 2.06) | 0.76 (0.32 – 1.81) | ||
| Internal carotid IMT, mm | 0.85 (0.60 – 1.19) | 0.79 (0.41 – 1.52) | ||
| Z-score maximum IMT | 0.94 (0.74 – 1.19) | 0.85 (0.57 – 1.26) | ||
DR = diabetic retinopathy; MESA = Multi-Ethnic Study of Atherosclerosis; HbA1c = glycosylated hemoglobin; HDL = high-density lipid; LDL = low-density lipid; IMT = intima-media thickness; ACE = angiotensin converting enzyme
*
Univariate unadjusted relative Risk (RR) and 95% confidence interval (CI);
†
Multivariate adjusted RR (95% CI)
Systolic blood pressure and hypertension were evaluated in separate multivariable models due to high collinearity.