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Among 1, 884 participants, 203 developed T2DM during the follow-up. The cumulative incidence rate of T2DM was 10.8%, and the incidence density was 1, 001 per 100, 000 person-years.
Table 1 presents the baseline characteristics of participants with incident T2DM and those without T2DM. Conventional CVRFs, such as age, blood pressure, lipids, WC, BMI, and CRP level, were significantly different between the two groups. Subjects with incident T2DM had higher SBP; DBP; TC, TG, LDL-C, and CRP levels; WC; BMI; and heart rate and lower HDL-C level (all P < 0.05). Moreover, the mean age and rate of drinking in subjects with incident T2DM were also higher than that in those without T2DM (both P < 0.05).
Characteristics With T2DM Without T2DM P Value n 203 1, 681 Age, y 47.71 ± 11.09 43.65 ± 10.90 < 0.0001 Male, % 40.39 37.83 0.4782 SBP, mmHg 133.28 ± 22.18 125.70 ± 21.78 < 0.0001 DBP, mmHg 87.42 ± 12.21 82.87 ± 12.08 < 0.0001 TG, mmol/L 1.27 (0.79, 2.21) 0.90 (0.62, 1.30) < 0.0001 TC, mmol/L 3.81 (3.12, 4.78) 3.51 (2.94, 4.23) 0.0004 HDL-C, mmol/L 1.00 (0.86, 1.22) 1.17 (0.96, 1.38) < 0.0001 LDL-C, mmol/L 2.41 (1.82, 3.15) 2.10 (1.57, 2.74) < 0.0001 Smoker, % 40.89 42.53 0.6536 Drinker, % 37.44 29.63 0.0223 WC, cm 86.42 ± 10.74 79.51 ± 8.76 < 0.0001 BMI, kg/m2 24.23 ± 3.85 22.11 ± 3.23 < 0.0001 Heart rate, beat per minute 78.07 ± 10.68 75.80 ± 11.05 0.0058 CRP (P25, P75, mg/L) 9.40 (4.92, 16.63) 5.43 (3.63, 9.76) < 0.0001 Note. SBP, systolic blood pressure; DBP, diastolic blood pressure; TG, triglycerides; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; WC, waist circumference; BMI, body mass index; CRP, C-reactive protein. Table 1. Baseline Characteristics of 1, 884 Participants with and without T2DM
Table 2 summarizes the unadjusted and adjusted HRs and 95% CI of the risk of T2DM according to the number of CVRF clusters. Compared with those without CVRF, the unadjusted HRs (95% CI) in subjects with 1, 2, and ≥ 3 risk factors were 0.997 (0.620, 1.602), 2.632 (1.711, 4.048), and 4.089 (2.677, 6.245), respectively. After adjusting for age, sex, smoking, drinking, and CRP level, the HRs (95% CI) in subjects with 1, 2, and ≥ 3 factors were 0.932 (0.577, 1.505), 2.257 (1.448, 3.518), and 3.316 (2.119, 5.188), respectively. A positive dose-response relationship is likely to present for T2DM with increasing number of CVRF clusters (P for trend < 0.0001).
Numbers Cases Person-years Unadjusted HR (95% CI) Adjusted HR (95% CI)* 0 31 333.54 1.00 (reference) 1.00 (reference) 1 38 420.18 0.997 (0.620, 1.602) 0.932 (0.577, 1.505) 2 63 674.40 2.632 (1.711, 4.048) 2.257 (1.448, 3.518) ≥ 3 71 727.77 4.089 (2.677, 6.245) 3.316 (2.119, 5.188) P for trend < 0.0001 < 0.0001 Note. *Adjusted for age, gender, smoking, drinking, and CRP. Table 2. Hazard Ratios for T2DM Incidence According to the Number of CVRFs
The clustering of two CVRFs and AUC (95% CI) of each cluster are presented in Table 3. The result showed that the AUC of clustering of fast heart rate and abdominal obesity was 0.701 (0.661, 0.741), which was significantly higher than any other clustering (all P < 0.05).
Clusters AUC 95% CI aFast heart rate + Abdominal obesity 0.701 0.661-0.741 Fast heart rate + General obesity 0.616 0.572-0.660 Fast heart rate + Hypertension 0.625 0.582-0.667 Fast heart rate + Dyslipidemia 0.613 0.568-0.657 Fast heart rate + Family history 0.569 0.526-0.613 Note. AUC, area under curve; CI, confidence interval. aAUC is significantly higher than that of other clusters and P < 0.05. Table 3. The Cluster of two CVRFs and the AUC (95% CI) of Each Cluster
Table 4 presents the clustering of three CVRFs and AUC (95% CI) of each cluster. It is noted that the cluster of fast heart rate with abdominal obesity and other risk factors had significantly higher AUC than other clusters (all P < 0.05). The AUCs (95% CI) were 0.701 (0.661, 0.741), 0.711 (0.671, 0.750), 0.713 (0.673, 0.753), and 0.702 (0.662, 0.741) for the clusters of fast heart rate with abdominal obesity and general obesity, fast heart rate with abdominal obesity and hypertension, fast heart rate with abdominal obesity and dyslipidemia, and fast heart rate with abdominal obesity and family history, respectively.
Clusters AUC 95% CI aFast heart rate + Abdominal obesity + General obesity 0.701 0.661-0.741 aFast heart rate + Abdominal obesity + Hypertension 0.711 0.671-0.750 aFast heart rate + Abdominal obesity + Dyslipidemia 0.713 0.673-0.753 aFast heart rate + Abdominal obesity + Family history 0.702 0.662-0.741 Fast heart rate + General obesity + Hypertension 0.653 0.610-0.696 Fast heart rate + General obesity + Dyslipidemia 0.655 0.611-0.699 Fast heart rate + General obesity + Family history 0.623 0.579-0.667 Fast heart rate + Hypertension + Dyslipidemia 0.651 0.607-0.694 Fast heart rate + Hypertension + Family history 0.629 0.587-0.671 Fast heart rate + Dyslipidemia + Family history 0.624 0.580-0.668 Note. aAUC is significantly higher than that of other clusters and P < 0.05. Table 4. The Cluster of Three CVRFs and the AUC (95% CI) of Each Cluster