Table 3.
Multivariable‐Adjusted ORs (95% CIs) of Incident Early‐ and Later‐Onset of Diabetes (Versus No Diabetes) According to Each Single Component of the CVH Score
| Separate Model for Each Component* | Mutually Adjusted Model*, † | |||||
|---|---|---|---|---|---|---|
| Individual Components of the CVH Score‡ | Poor (0 points) | Intermediate (1 point) | Ideal (2 points) | Poor (0 points) | Intermediate (1 point) | Ideal (2 points) |
| Early‐onset diabetes (vs no diabetes) | ||||||
| Smoking | 1318 | 258 | 2971 | |||
| Unadjusted cumulative incidence, n (%) | 37 (2.8) | 5 (1.9) | 74 (2.5) | |||
| Multivariable OR (95% CI) | 1.09 (0.71–1.67) | 0.82 (0.32–2.07) | 1.00 (reference) | NS | ||
| Physical activity | 505 | 1384 | 2658 | |||
| Unadjusted cumulative incidence, n (%) | 20 (4.0) | 34 (2.5) | 62 (2.3) | |||
| Multivariable OR (95% CI) | 1.42 (0.81–2.50) | 0.96 (0.62–1.50) | 1.00 (reference) | NS | ||
| Diet quality | 1424 | 1550 | 1573 | |||
| Unadjusted cumulative incidence, n (%) | 53 (3.7) | 40 (2.6) | 23 (1.5) | |||
| Multivariable OR (95% CI) | 1.52 (0.85–2.72) | 1.34 (0.77–2.33) | 1.00 (reference) | NS | ||
| BMI | 517 | 1047 | 2983 | |||
| Unadjusted cumulative incidence, n (%) | 58 (11.2) | 30 (2.9) | 28 (0.9) | |||
| Multivariable OR (95% CI) | 15.68 (9.62–25.55) | 3.41 (2.01–5.78) | 1.00 (reference) | 12.66 (7.65–20.95) | 2.94 (1.72–5.04) | 1.00 (reference) |
| Total cholesterol | 191 | 835 | 3521 | |||
| Unadjusted cumulative incidence, n (%) | 5 (2.6) | 33 (4.0) | 78 (2.2) | |||
| Multivariable OR (95% CI) | 1.26 (0.50–3.18) | 1.89 (1.23–2.89) | 1.00 (reference) | NS | ||
| BP | 55 | 920 | 3572 | |||
| Unadjusted cumulative incidence, n (%) | 5 (9.1) | 45 (4.9) | 66 (1.9) | |||
| Multivariable OR (95% CI) | 7.26 (2.64–20.01) | 3.11 (2.06–4.69) | 1.00 (reference) | 3.55 (1.21–10.44) | 1.94 (1.25–2.99) | 1.00 (reference) |
| Fasting serum glucose | 92 | 4455 | ||||
| Unadjusted cumulative incidence, n (%) | NA (by study design) | 14 (15.2) | 102 (2.3) | NA (by study design) | ||
| Multivariable OR (95% CI) | NA (by study design) | 12.20 (6.40–23.50) | 1.00 (reference) | NA (by study design) | 9.28 (4.64–18.54) | 1.00 (reference) |
| Later‐onset diabetes (vs no diabetes) | ||||||
| Smoking | 1318 | 258 | 2971 | |||
| Unadjusted cumulative incidence, n (%) | 159 (12.1) | 22 (8.5) | 289 (9.7) | |||
| Multivariable OR (95% CI) | 1.16 (0.94–1.44) | 0.85 (0.54–1.33) | 1.00 (reference) | NS | ||
| Physical activity | 505 | 1384 | 2658 | |||
| Unadjusted cumulative incidence, n (%) | 73 (14.5) | 151 (10.9) | 246 (9.3) | |||
| Multivariable OR (95% CI) | 1.34 (0.99–1.81) | 1.13 (0.91–1.41) | 1.00 (reference) | NS | ||
| Diet quality | 1424 | 1550 | 1573 | |||
| Unadjusted cumulative incidence, n (%) | 169 (11.9) | 176 (11.4) | 125 (8.0) | |||
| Multivariable OR (95% CI) | 1.38 (1.05–1.83) | 1.26 (0.98–1.62) | 1.00 (reference) | NS | ||
| BMI | 517 | 1047 | 2983 | |||
| Unadjusted cumulative incidence, n (%) | 126 (24.4) | 149 (14.2) | 195 (6.5) | |||
| Multivariable OR (95% CI) | 4.10 (3.17–5.32) | 2.26 (1.80–2.82) | 1.00 (reference) | 3.57 (2.74–4.65) | 2.13 (1.70–2.67) | 1.00 (reference) |
| Total cholesterol | 191 | 835 | 3521 | |||
| Unadjusted cumulative incidence, n (%) | 23 (12.0) | 106 (12.7) | 341 (9.7) | |||
| Multivariable OR (95% CI) | 1.24 (0.80–1.91) | 1.22 (0.96–1.54) | 1.00 (reference) | NS | ||
| BP | 55 | 920 | 3572 | |||
| Unadjusted cumulative incidence, n (%) | 14 (25.5) | 162 (17.6) | 294 (8.2) | |||
| Multivariable OR (95% CI) | 2.88 (1.51–5.49) | 2.11 (1.70–2.62) | 1.00 (reference) | 2.18 (1.13–4.23) | 1.70 (1.36–2.13) | 1.00 (reference) |
| Fasting serum glucose | 92 | 4455 | ||||
| Unadjusted cumulative incidence, n (%) | NA (by study design) | 14 (15.2) | 456 (10.2) | NA (by study design) | ||
| Multivariable OR (95% CI) | NA (by study design) | 2.10 (1.20–3.70) | 1.00 (reference) | NA (by study design) | 1.65 (0.93–2.95) | 1.00 (reference) |
BMI indicates body mass index; BP, blood pressure; CARDIA, Coronary Artery Risk Development in Young Adults; CVH, cardiovascular health; NA, not available; NS, not significant; and OR, odds ratio.
Multinomial logistic regression was used to model outcome variables of normal, early diabetes, and later diabetes. Model was adjusted for age, race (Black or White race), sex (male or female sex), total energy intake, maximal educational attainment, and parental history of diabetes (yes or no).
The individual components of the CVH score were fitted simultaneously in a stepwise logistic model, and 3 (BMI, BP, and fasting serum glucose) were kept in the best model fit and were statistically significant.
The criteria for poor, intermediate, and ideal in each CVH component were defined as the following: (1) smoking: current smoker, former smoker (quit within ≤12 months), and never smoker or quit within >12 months; (2) physical activity (CARDIA physical activity score): <100, 100–299, and ≥300 exercise units; (3) diet quality (APDQS): tertile 1 (median, 50), tertile 2 (median, 61), and tertile 3 (median, 76); (4) BMI: ≥30, 25–29.9, and <25.5 kg/m2; (5) total cholesterol: ≥240, 200–239 or <200 with medication, and <200 without medication; (6) BP: SBP≥140 mm Hg or DBP≥90 mm Hg, SBP 120–139 mm Hg or DBP 80–89 mm Hg or SBP<120 mm Hg and DBP<80 mm Hg with medication, and SBP<120 mm Hg and DBP<80 mm Hg without medication; (7) fasting serum glucose: ≥126 (NA by study design), 100–125, and <100 mg/dL without medication.