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1Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
3Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
4Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Copyright © 2020 Korean Endocrine Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST
No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS
Conception or design: S.H.L., K.H., M.K.K. Acquisition, analysis, or interpretation of data: S.H.L., K.H., H.S.K., J.H.C., K.H.Y., M.K.K. Drafting the work or revising: S.H.L., M.K.K. Final approval of the manuscript: S.H.L., K.H., H.S.K., J.H.C., K.H.Y., M.K.K.
Model 1: Adjusted for age and sex; Model 2: Adjusted for age, sex, smoking, regular exercise, body mass index, chronic kidney disease, duration of diabetes, numbers of anti-diabetic medication, fasting blood glucose, systolic blood pressure, total cholesterol, and atrial fibrillation.
BMI, body mass index; FBG, fasting blood glucose; SBP, systolic blood pressure.
Characteristic | Development cohort (n=891,095) | Validation cohort (n=381,897) | ||||
---|---|---|---|---|---|---|
|
| |||||
MI (−) | MI (+) | P value | MI (−) | MI (+) | P value | |
Number | 873,635 | 17,460 | 374,548 | 7,349 | ||
| ||||||
Age, yr | <0.0001 | <0.0001 | ||||
40–49 | 248,957 (28.5) | 3,292 (18.9) | 106,452 (28.4) | 1,359 (18.5) | ||
50–59 | 407,974 (46.7) | 8,179 (46.8) | 175,093 (46.8) | 3,519 (47.9) | ||
60–64 | 216,704 (24.8) | 5,989 (34.3) | 93,003 (24.8) | 2,471 (33.6) | ||
| ||||||
Sex | <0.0001 | <0.0001 | ||||
Male | 558,919 (64.0) | 12,300 (70.5) | 239,500 (63.9) | 5,324 (72.5) | ||
Female | 314,716 (36.0) | 5,160 (29.5) | 135,048 (36.1) | 2,025 (27.5) | ||
| ||||||
Smoking status | <0.0001 | <0.0001 | ||||
Current | 251,445 (28.8) | 6,811 (39.0) | 107,852 (28.8) | 2,866 (39.0) | ||
| ||||||
Regular exercise | <0.0001 | <0.0001 | ||||
Yes | 462,446 (52.9) | 8,236 (47.2) | 197,412 (52.7) | 3,505 (47.7) | ||
| ||||||
BMI, kg/m2 | <0.0001 | 0.0008 | ||||
<18.5 | 9,559 (1.1) | 272 (1.6) | 4,174 (1.1) | 116 (1.6) | ||
18.5–23 | 204,207 (23.4) | 4,235 (24.3) | 87,438 (23.3) | 1,689 (23.0) | ||
≥23 | 659,869 (75.5) | 12,953 (74.2) | 282,936 (75.5) | 5,544 (75.4) | ||
| ||||||
Chronic kidney disease | <0.0001 | <0.0001 | ||||
Yes | 57,407 (6.6) | 2,171 (12.4) | 24,636 (6.6) | 895 (12.2) | ||
| ||||||
Duration of diabetes, yr | <0.0001 | <0.0001 | ||||
≥5 | 261,606 (29.9) | 7,332 (42.0) | 112,894 (30.1) | 3,123 (42.5) | ||
| ||||||
No. of anti-diabetic medication | <0.0001 | <0.0001 | ||||
≥2 or insulin | 401,728 (46.0) | 10,127 (58.0) | 172,378 (46.0) | 4,274 (58.2) | ||
| ||||||
FBG, mg/dL | <0.0001 | <0.0001 | ||||
<100 | 70,407 (8.1) | 1,701 (9.7) | 30,108 (8.0) | 765 (10.4) | ||
100–140 | 415,280 (47.5) | 7,074 (40.5) | 178,335 (47.6) | 3,004 (40.9) | ||
140–160 | 164,414 (18.8) | 2,990 (17.1) | 70,556 (18.8) | 1,220 (16.6) | ||
160–180 | 79,768 (9.1) | 1,722 (9.9) | 34,087 (9.1) | 706 (9.6) | ||
≥180 | 143,766 (16.5) | 3,973 (22.8) | 61,462 (16.4) | 1,654 (22.5) | ||
| ||||||
SBP, mm Hg | <0.0001 | <0.0001 | ||||
<130 | 437,693 (50.1) | 7,942 (45.5) | 188,024 (50.2) | 3,340 (45.5) | ||
130–140 | 259,144 (29.7) | 5,229 (30.0) | 110,947 (29.6) | 2,184 (29.7) | ||
140–150 | 90,379 (10.4) | 2,064 (11.8) | 38,401 (10.3) | 857 (11.7) | ||
150–160 | 51,886 (5.9) | 1,241 (7.1) | 22,365 (6.0) | 547 (7.4) | ||
≥160 | 34,533 (4.0) | 984 (5.6) | 14,811 (4.0) | 421 (5.7) | ||
| ||||||
Total cholesterol, mg/dL | <.0001 | <0.0001 | ||||
<160 | 156,649 (17.9) | 2,866 (16.4) | 67,804 (18.1) | 1,210 (16.5) | ||
160–200 | 323,364 (37.0) | 5,900 (33.8) | 138,613 (37.0) | 2,507 (34.1) | ||
200–240 | 263,924 (30.2) | 5,425 (31.1) | 112,479 (30.0) | 2,203 (30.0) | ||
≥240 | 129,698 (14.9) | 3,269 (18.7) | 55,652 (14.9) | 1,429 (19.4) | ||
| ||||||
Atrial fibrillation | <0.0001 | <0.0001 | ||||
Yes | 5,263 (0.6) | 196 (1.1) | 2,359 (0.6) | 100 (1.4) |
Variable | Number | No. of events | Incidence rate,/1,000 person-yr | Model 1 | Model 2 |
---|---|---|---|---|---|
Age, yr | |||||
40–49 | 252,249 | 3,292 | 1.86 | 1 (reference) | 1 (reference) |
50–59 | 416,153 | 8,179 | 2.75 | 1.52 (1.46–1.59) | 1.50 (1.44–1.56) |
60–64 | 222,693 | 5,989 | 3.71 | 2.11 (2.02–2.20) | 1.98 (1.89–2.07) |
| |||||
Sex | |||||
Male | 571,219 | 12,300 | 3.03 | 1 (reference) | 1 (reference) |
Female | 319,876 | 5,160 | 2.24 | 0.68 (0.66–0.70) | 0.76 (0.73–0.78) |
| |||||
Smoking status | |||||
Non/Ex | 632,839 | 10,649 | 2.35 | 1 (reference) | 1 (reference) |
Current | 258,256 | 6,811 | 3.75 | 1.69 (1.63–1.75) | 1.65 (1.59–1.71) |
| |||||
Regular exercise | |||||
No | 420,413 | 9,224 | 3.08 | 1 (reference) | 1 (reference) |
Yes | 470,682 | 8,236 | 2.45 | 0.78 (0.76–0.81) | 0.82 (0.80–0.84) |
| |||||
BMI, kg/m2 | |||||
<18.5 | 9,831 | 272 | 3.94 | 1 (reference) | 1 (reference) |
18.5–23 | 208,442 | 4,235 | 2.84 | 0.72 (0.64–0.81) | 0.75 (0.67–0.85) |
≥23 | 672,822 | 12,953 | 2.70 | 0.69 (0.61–0.78) | 0.75 (0.66–0.84) |
| |||||
Chronic kidney disease | |||||
No | 831,517 | 15,289 | 2.58 | 1 (reference) | 1 (reference) |
Yes | 59,578 | 2,171 | 5.02 | 1.77 (1.69–1.85) | 1.68 (1.61–1.76) |
| |||||
Duration of diabetes, yr | |||||
<5 | 622,157 | 10,128 | 2.30 | 1 (reference) | 1 (reference) |
≥5 | 268,938 | 7,332 | 3.75 | 1.49 (1.45–1.54) | 1.31 (1.26–1.36) |
| |||||
No. of anti-diabetic medication | |||||
0, 1 | 479,240 | 7,333 | 2.19 | 1 (reference) | 1 (reference) |
≥2 or insulin | 411,855 | 10,127 | 3.37 | 1.46 (1.42–1.51) | 1.30 (1.26–1.35) |
| |||||
FBG, mg/dL | |||||
<100 | 72,108 | 1,701 | 3.24 | 1.30 (1.23–1.37) | 1.19 (1.13–1.25) |
100–140 | 422,354 | 7,074 | 2.36 | 1 (reference) | 1 (reference) |
140–160 | 167,404 | 2,990 | 2.51 | 1.08 (1.03–1.12) | 1.03 (0.98–1.07) |
160–180 | 81,490 | 1,722 | 2.94 | 1.26 (1.20–1.33) | 1.12 (1.06–1.18) |
≥180 | 147,739 | 3,973 | 3.75 | 1.66 (1.60–1.73) | 1.34 (1.29–1.40) |
| |||||
SBP, mm Hg | |||||
<130 | 445,635 | 7,942 | 2.50 | 1 (reference) | 1 (reference) |
130–139 | 264,373 | 5,229 | 2.77 | 1.06 (1.03–1.10) | 1.08 (1.04–1.12) |
140–149 | 92,443 | 2,064 | 3.13 | 1.17 (1.12–1.23) | 1.19 (1.13–1.25) |
150–159 | 53,127 | 1,241 | 3.27 | 1.21 (1.14–1.29) | 1.21 (1.14–1.29) |
≥160 | 35,517 | 984 | 3.87 | 1.44 (1.35–1.54) | 1.39 (1.30–1.49) |
| |||||
Total cholesterol, mg/dL | |||||
<160 | 159,515 | 2,866 | 2.51 | 1 (reference) | 1 (reference) |
160–200 | 329,264 | 5,900 | 2.50 | 1.04 (0.99–1.08) | 1.09 (1.04–1.14) |
200–240 | 269,349 | 5,425 | 2.83 | 1.22 (1.17–1.28) | 1.31 (1.25–1.38) |
≥240 | 132,967 | 3,269 | 3.48 | 1.58 (1.50–1.66) | 1.68 (1.59–1.77) |
| |||||
Atrial fibrillation | |||||
No | 885,636 | 17,264 | 2.73 | 1 (reference) | 1 (reference) |
Yes | 5,459 | 196 | 5.06 | 1.60 (1.39–1.84) | 1.64 (1.42–1.89) |
Variable | Value |
---|---|
Age, yr | |
40–49 | 0 |
50–59 | 59 |
60–64 | 100 |
| |
Sex | |
Male | 41 |
Female | 0 |
| |
Current smoking | |
No | 0 |
Yes | 72 |
| |
Regular exercise | |
No | 30 |
Yes | 0 |
| |
Body mass index, kg/m2 | |
<18.5 | 12 |
18.5–23 | 6 |
≥23.0 | 0 |
| |
Chronic kidney disease | |
No | 0 |
Yes | 78 |
| |
Duration of diabetes | |
<5 | 0 |
≥5 | 41 |
| |
No. of anti-diabetic medication | |
0–1 | 0 |
≥2 or insulin | 39 |
| |
Fasting blood glucose, mg/dL | |
<100 | 26 |
100–139 | 0 |
140–159 | 3 |
160–179 | 15 |
≥180 | 42 |
| |
Systolic blood pressure, mm Hg | |
<130 | 0 |
130–139 | 12 |
140–149 | 26 |
150–159 | 29 |
≥160 | 50 |
| |
Total cholesterol, mg/dL | |
<160 | 0 |
160–199 | 12 |
200–239 | 39 |
≥240 | 75 |
| |
Atrial fibrillation | |
No | 0 |
Yes | 74 |
Values are expressed as number (%). MI, myocardial infarction; BMI, body mass index; FBG, fasting blood glucose; SBP, systolic blood pressure.
Model 1: Adjusted for age and sex; Model 2: Adjusted for age, sex, smoking, regular exercise, body mass index, chronic kidney disease, duration of diabetes, numbers of anti-diabetic medication, fasting blood glucose, systolic blood pressure, total cholesterol, and atrial fibrillation. BMI, body mass index; FBG, fasting blood glucose; SBP, systolic blood pressure.