Oxidative Medicine and Cellular Longevity

Research Article

Association of Serum Homocysteine with Cardiovascular and All-Cause Mortality in Adults with Diabetes: A Prospective Cohort Study

Table 3

HR (95% CI) associated with Hcy for all-cause, cardiovascular, and cancer mortality in adults with diabetes.


All-cause deaths	Doubling in Hcy	value	Q1 ()	Q2 ()	Q3 ()	Q4 ()	for trend

Mortality rate per 1000 person-years	34.2 (31.5-37.3)		14.0 (11.1-18.0)	26.3 (21.9-31.7)	39.4 (33.8-46)	81.3 (71.2-93)
Unadjusted model	2.38 (1.88-3.00)^#	<0.001	1 (ref.)	1.93 (1.42-2.63)	2.98 (2.24-3.97)	6.46 (4.82-8.66)	<0.001
Model 1	1.77 (1.44-2.17)	<0.001	1 (ref.)	1.29 (0.94-1.77)	1.63 (1.28-2.07)	2.90 (2.19-3.84)	<0.001
Model 2	1.61 (1.34-1.92)	<0.001	1 (ref.)	1.13 (0.82-1.57)	1.39 (1.03-1.88)	2.33 (1.64-3.30)	<0.001
Cardiovascular deaths
Mortality rate per 1000 person-years	8.3 (11.4-11.4)		4.0 (2.5-6.6)	8.2 (6.1-11.4)	9.6 (7.1-13.1)	24.3 (19-31.5)
Unadjusted	2.52 (1.91-3.33)	<0.001	1 (ref.)	2.15 (1.23-3.74)	2.61 (1.44-4.73)	7.00 (4.05-12.12)	<0.001
Model 1	1.82 (1.34-2.48)	<0.001	1 (ref.)	1.30 (0.75-2.26)	1.20 (0.66-2.17)	2.51 (1.34-4.69)	0.007
Model 2	1.53 (1.08-2.16)	0.018	1 (ref.)	1.25 (0.74-2.12)	1.10 (0.65-1.88)	2.24 (1.22-4.10)	0.017
Cancer-related deaths
Mortality rate per 1000 person-years	5.2 (4.2-6.5)		2.4 (1.4-4.5)	4.9 (3.1-8.0)	5.5 (3.6-8.8)	11.0 (7.9-15.7)
Unadjusted	1.93 (1.50-2.49)	<0.001	1 (ref.)	2.02 (0.92-4.44)	2.27 (1.06-4.85)	4.60 (2.40-8.83)	<0.001
Model 1	1.35 (0.99-1.83)	0.056	1 (ref.)	1.38 (0.6-3.13)	1.26 (0.55-2.88)	2.12 (1.07-4.2)	0.030
Model 2	1.50 (0.94-2.40)	0.087	1 (ref.)	0.96 (0.40-2.35)	0.92 (0.35-2.39)	2.05 (0.90-4.69)	0.096

Weighted mortality was expressed as a rate per 1000 person-years of follow-up and 95% CI. ^#HR (95% CI) was estimated by weighted Cox regression analyses. Model 1 was adjusted for age and sex (). Model 2 was additionally adjusted for race/ethnicity, smoking, BMI, hypertension, cancer, CVD, TC/HDL-C ratio, lipid-lowering agents, antiplatelet, vitamin B12, eGFR, HbA1c, metformin, duration of diabetes, UACR, ACEI/ARBs, and diabetic complications ().