Time to diabetic retinopathy and its prognostic factors among adults with type 2 diabetes mellitus in Johor, Malaysia from 2015 to 2019: a retrospective cohort study using surveillance data

Time to diabetic retinopathy and its prognostic factors among adults with type 2 diabetes mellitus in Johor, Malaysia from 2015 to 2019: a retrospective cohort study using surveillance data | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Time to diabetic retinopathy and its prognostic factors among adults with type 2 diabetes mellitus in Johor, Malaysia from 2015 to 2019: a retrospective cohort study using surveillance data Muhammad Muaz Shahriman Teruna, Tajul Rosli Razak, Siti Munira Yasin, and 9 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9556443/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background Diabetic retinopathy is a major microvascular complication of type 2 diabetes mellitus and remains a leading cause of preventable visual impairment worldwide. Understanding the time to onset of diabetic retinopathy and its prognostic factors is essential to optimise screening strategies and guide early intervention. This study aimed to determine the time to development of diabetic retinopathy and identify its associated prognostic factors among adults with type 2 diabetes mellitus in Johor, Malaysia. Methods A retrospective cohort study was conducted using secondary data from the National Diabetes Registry of Johor from 2015 to 2019. Adults aged 18 years and above with type 2 diabetes mellitus and no diabetic retinopathy at baseline were included. Time-to-event was defined as the duration from the date of type 2 diabetes mellitus diagnosis to the first diagnosis of diabetic retinopathy. All variables were categorised and analysed using survival analysis techniques. Kaplan–Meier methods were used to estimate diabetic retinopathy-free survival, with differences assessed using the log-rank test. Cox proportional hazards regression analyses were performed to identify independent prognostic factors. Results A total of 47,953 patients were included, of whom 6,402 (13.3%) developed diabetic retinopathy during follow-up. The overall median time to diabetic retinopathy was approximately 75 months. Significant differences in diabetic retinopathy-free survival were observed across several variables (p < 0.05). In the multivariable Cox regression model, duration of diabetes greater than 10 years (AHR = 1.96, 95% CI: 1.79–2.14), hypertension (AHR = 1.20, 95% CI: 1.10–1.31), dyslipidaemia (AHR = 1.25, 95% CI: 1.16–1.34), high waist circumference (AHR = 1.08, 95% CI: 1.02–1.14), positive urine protein (AHR = 1.09, 95% CI: 1.04–1.15), poor glycaemic control (AHR = 1.11, 95% CI: 1.03–1.20), and complications such as nephropathy (AHR = 1.78, 95% CI: 1.69–1.88) and diabetic foot ulcer (AHR = 1.92, 95% CI: 1.67–2.20) were independently associated with an increased risk of diabetic retinopathy. Ethnicity also remained significant, with Chinese and Indian patients demonstrating higher risk compared to Malays. Conclusions Diabetic retinopathy develops within a relatively short duration following type 2 diabetes mellitus diagnosis and is influenced by a combination of metabolic, clinical, and complication-related factors. Early risk stratification and integrated management of modifiable risk factors are essential to delay the onset of diabetic retinopathy. These findings provide important real-world evidence to support targeted screening and public health strategies in Malaysia. Diabetic retinopathy Type 2 diabetes mellitus Time-to-event Prognostic factors Figures Figure 1 Figure 2 Background Time to diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) plays a crucial role in understanding the disease's progression and its impact on public health. DR, a microvascular complication of diabetes, remains one of the leading causes of blindness worldwide among the diabetic population, particularly in individuals with T2DM [ 1 ]. DR is defined as damage to the retinal blood vessels due to hyperglycaemia and typically manifests in stages, including non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) [ 2 ]. NPDR is characterized by the presence of microaneurysms, haemorrhages, and hard exudates, reflecting pathological changes such as retinal leakage and vessel blockage. In contrast, PDR involves the growth of new, fragile blood vessels known as neovascularization on the retina, posing an increased risk of significant vision loss due to potential bleeding. The global prevalence of T2DM has become a pressing public health issue, which increased across various demographics and regions. Current estimates indicate that approximately 463 million adults suffer from T2DM globally, which constitutes about one in eleven adults and represents a significant rise over the past decades [ 3 ]. Projections by the International Diabetes Federation (IDF) suggest that these figures could escalate to nearly 700 million by the year 2045 [ 4 ]. This upward trend is particularly alarming in developing countries, where dietary transitions, urbanization, and sedentary lifestyles intensify the risk of developing diabetes. Apart from that, the prevalence rates of DR among individuals with T2DM have been reported to range from approximately 15% to nearly 50% globally. For example, a study conducted in Pakistan identified a prevalence of 15% among newly diagnosed T2DM patients [ 5 ]. In another study, a prevalence of 40.1% was reported among T2DM patients [ 6 ]. Additionally, findings from a South African cohort indicated a prevalence of 35.3%, particularly among older patients [ 7 ]. Furthermore, it is noted that the prevalence can be as high as 60% in individuals with a longer duration of diabetes, emphasizing that duration is a critical risk factor, as indicated by studies from the Wisconsin Epidemiologic Study of Diabetic Retinopathy, where the incidence of DR escalates significantly with prolonged diabetes duration [ 8 ]. Time-to-event analysis can be employed to evaluate the time until the onset of DR in relation to modifiable risk factors, providing insights into patient management practices that can enhance outcomes. Such analyses may involve the use of Cox proportional hazards models to determine the relationship between survival time and predictors such as fasting blood sugar, glycated haemoglobin (HbA1c) levels, and the presence of concomitant diabetic complications [ 9 ]. Moreover, using the Kaplan-Meier method allows researchers to visualize the incidence of DR over time, associating extended durations of diabetes with increased risks of DR. Findings suggest that longer durations of diabetes significantly correlate with adverse outcomes in various diabetic complications, including DR [ 10 ]. Despite the growing burden of DR, there remains a critical gap in locally contextualised evidence on the temporal progression to DR and its prognostic determinants within Malaysian populations, particularly using surveillance data. Understanding the timing and predictors of DR onset is essential to optimise early detection, allocate healthcare resources efficiently, and reduce preventable visual impairment [ 11 ]. Furthermore, time-to-event analysis approaches provide firmer framework for identifying high-risk individuals compared to conventional methods [ 12 ]. Therefore, this study is justified to bridge the existing evidence gap by utilising longitudinal registry data to generate population-specific insights. The aim of this study is to determine the time to DR and to identify its prognostic factors among adults with T2DM in Johor, Malaysia, from 2015 to 2019 using surveillance data. Methods Study design and setting A retrospective cohort study was conducted encompassing all adult T2DM patients registered in Johor National Diabetes Registry (NDR) from 1st January 2015 to 31st December 2019. Johor is a state of Malaysia situated on the southern coast of Peninsular Malaysia, covering a land area of 19,166 km² which recorded an approximate population of 4.0 million individuals in the year 2019 [ 13 ]. The state is divided into ten administrative districts, namely Johor Bahru (the capital district), Kulai, Batu Pahat, Kluang, Muar, Tangkak, Segamat, Kota Tinggi, Pontian, and Mersing (listed in descending order based on their respective population and urbanisation level) [ 13 ]. Data source The NDR records provided by the Non-Communicable Disease (NCD) Unit of Johor State Health Department was used. The personal information, sociodemographic and clinical characteristics, complications, as well as treatment details of patients with T2DM in Johor, were documented and stored in NDR, which is the online diabetes surveillance registry established by the Ministry of Health (MOH). The NCD units in each district carried out the data collection and recording process at district level, with oversight provided by the NCD unit at the state level. The State Health Department has access to the data of all patients with T2DM registered within their respective state. In order to maintain patients’ anonymity, all identifying information, including the patient’s name, identification card number, contact number, and residential address were requested to be removed. Participants This retrospective cohort study included adult patients aged 18 years and above with a confirmed diagnosis of T2DM who were registered in the National Diabetes Registry in Johor between 1st January 2015 and 31st December 2019, and who had no evidence of DR at baseline assessment. Patients were required to have complete baseline information on key sociodemographic and clinical variables, such as age, gender, duration of diabetes, glycaemic control, and comorbidities. Individuals were excluded if they had pre-existing DR at baseline, had missing or incomplete data on outcome status or follow-up duration that precluded time-to-event analysis. Additionally, patients with duplicate entries, or those who were lost to follow-up immediately after baseline without any subsequent assessment were excluded to ensure the validity and reliability of the time-to-event analysis. Variables The independent variables in this study were divided according to four domains namely sociodemographic, clinical, medication, and complication. Sociodemographic comprised a range of sociodemographic characteristics such as age, gender, and ethnicity. Clinical variables encompassed comorbidities, complications, diabetes-related factors such as duration of diabetes, glycaemic control measured by HbA1c, body mass index (BMI), mean arterial pressure (MAP) status, waist circumference, urine microalbumin, urine protein, and lipid profile parameters. In addition, treatment-related variables, including the use of antidiabetic medications such as insulin and oral hypoglycaemic agents, were included to reflect real-world management. These variables were selected based on established literature as potential prognostic factors influencing the development of DR and were analysed to determine their association with time to event. The primary outcome of this study was the development of DR, defined as the first documented diagnosis of DR during the follow-up period based on retinal screening records within the registry. Time-to-event was calculated as the duration (in months) from the baseline date which is the date of T2DM diagnosis to the date of diagnosis of DR. Participants who did not develop DR during the study period were treated as censored observations at their last recorded follow-up. This outcome measure aligns with survival analysis methodology, allowing for estimation of DR-free survival and identification of prognostic factors associated with earlier onset of the condition. In term of the independent variables in this study, the BMI was classified into four categories, namely underweight (< 18.5 kg/m²), normal (18.5–22.9 kg/m²), overweight (23.0–27.4 kg/m²), and obese (≥ 27.5 kg/m²), reflecting the degree of body fatness and obesity status among participants [ 14 ]. Waist circumference was categorised into normal and high-risk groups using sex-specific cut-off points, whereby values > 90 cm for men and > 80 cm for women were considered high, indicating central obesity and increased cardiometabolic risk [ 14 ]. Glycaemic control was assessed using glycated haemoglobin (HbA1c), which was divided into good control (< 7%), intermediate control (7% to < 8%), and poor control (≥ 8%), representing the long-term level of blood glucose control [ 15 ]. Lipid profile parameters included high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol, and triglycerides (TG). HDL levels were categorised into low and normal according to sex-specific thresholds, where lower HDL levels indicated poorer protective lipid status [ 14 ]. LDL was classified into normal (≤ 2.6 mmol/L) and high (> 2.6 mmol/L), reflecting the level of atherogenic cholesterol [ 14 ]. Total cholesterol was grouped into normal ( 1.7 mmol/L), both representing abnormalities in lipid metabolism that may contribute to vascular complications among patients with diabetes mellitus [ 14 ]. Sample size and sampling method The minimum sample size for this study was estimated using the single population proportion formula, \(\:n=\frac{{Z}^{2}P(1-P)}{{d}^{2}}\) , where Z represents the standard normal deviate at a 95% confidence level (1.96), P is the estimated prevalence of DR, and d is the margin of error set at 0.05. The prevalence of DR was taken as 36.8% based on a recent study done at Sabah, Malaysia which reported that approximately 36.8% of patients with T2DM had DR [ 16 ]. Substituting these values yielded a minimum required sample size of approximately 358 participants. After adjusting for an additional 20% to account for incomplete or missing data, the final minimum sample size was estimated to be 430 participants. The sampling method used in this study was universal sampling of secondary data in the Johor NDR database. Statistical analyses All statistical analyses were conducted using IBM SPSS version 30. All variables, including those originally continuous, were categorised and summarised using frequencies and percentages. The Kaplan–Meier method was employed to estimate DR-free survival probabilities over time, and to illustrate the distribution of time to DR across different categories of independent variables. The log-rank test was used to determine whether there were statistically significant differences in the time to development of DR across categories of each independent variable by comparing the survival distributions between groups, and a p-value of less than 0.05 was considered statistically significant. To identify prognostic factors associated with the development of DR, Cox proportional hazards regression analyses were performed. Initially, simple (univariable) Cox regression was conducted to estimate crude hazard ratios (HRs), 95% confidence intervals (CIs), and corresponding p-values for each independent variable. Variables with a p-value of less than 0.05 in the univariable analysis were subsequently included in the multiple Cox proportional hazards model to obtain adjusted HRs while controlling for potential confounders. The Cox proportional hazards assumption was evaluated, and no significant violations were observed. The final model was assessed for multicollinearity and interaction effects where appropriate, ensuring the validity of the findings. Results Study population and participant selection A total of 50,457 adults with T2DM were initially identified from the Johor NDR database between 2015 and 2019. After removing 1,056 duplicate records, 49,401 patients remained. Further exclusions were applied to ensure data completeness for time-to-event analysis, including cases with missing outcome data, missing date of DR diagnosis, and incomplete key clinical variables such as BMI, blood pressure (BP), and HbA1c. Following these exclusions, a final sample of 47,953 patients was included in the study. This selection process ensured that only individuals with complete and reliable data were analysed to accurately estimate the time-to-DR development and its associated prognostic factors (figure 1). Characteristics of the study population Table 1 presents the characteristics of adults with T2DM, of whom 6,402 (13.3%) developed DR while 41,551 (86.7%) were censored during the follow-up period. In term of sociodemographic, the cohort was predominantly older, with the majority aged ≥60 years (57.4%), followed by those aged 50–59 years (28.2%). A higher proportion of DR cases was observed among older age groups, particularly those aged ≥60 years (68.7%). Males constituted a larger proportion of the study population (61.7%) and also had a slightly higher proportion of DR cases (62.2%) compared to females. In terms of ethnicity, Malays represented the majority (71.4%), followed by Chinese (20.4%) and Indians (7.8%), with DR cases distributed proportionately across these groups. With regard to clinical characteristics, most participants had comorbid hypertension (83.7%) and dyslipidaemia (78.8%), both of which were more prevalent among those who developed DR (90.1% and 85.8%, respectively). The majority of patients had a diabetes duration of ≤10 years (77.3%), although a notable proportion of DR cases still occurred within this group (88.7%). In terms of metabolic indicators, more than half of the participants had high waist circumference (55.6%), and glycaemic control was largely suboptimal, with the largest proportion classified under intermediate control (46.4%), followed by poor control (33.7%). Patients with DR tended to have a higher proportion of intermediate glycaemic control (53.1%). Additionally, a greater proportion of DR cases was observed among those with positive urine protein (37.8%), suggesting a link with microvascular complications. Regarding medication and complications, most patients were on metformin therapy (81.1%), although a relatively higher proportion of DR cases was observed among those not receiving metformin (26.5%). Insulin use was common (69.0%), but a higher proportion of DR cases was noted among those not on insulin (47.9%). In terms of diabetes-related complications, nephropathy was notably more prevalent among patients with DR, alongside higher proportions of ischaemic heart disease (IHD) and diabetic foot ulcer (DFU). Overall, the findings highlight that DR occurrence was more frequent among older individuals, those with longer disease duration, poorer metabolic profiles, and the presence of comorbidities and complications. Overall median time-to-DR The Kaplan–Meier analysis demonstrated that the overall median time-to-DR among adults with T2DM was approximately 75 months (figure 2), indicating that half of the study population remained free of DR for about six years following diagnosis. The survival curve showed a gradual decline over time, reflecting a progressive increase in the cumulative incidence of DR as the duration of diabetes increased. This pattern suggests that the risk of developing DR accumulates steadily with longer disease duration, highlighting the importance of early and continuous screening, particularly within the first decade after diagnosis of T2DM. Table 1 Characteristic of adults with T2DM and DR in Johor from 2015 to 2019 Independent Variables Complication Outcome Total Patients (N = 47,953) Censored (n = 41,551) Diabetic retinopathy (n = 6,402) n (%) n (%) n (%) A) Sociodemographic Age (years) < 30 197 (0.5) 10 (0.2) 207 (0.4) 30 - 39 1271 (3.1) 100 (1.6) 1371 (2.9) 40 - 49 4855 (11.7) 451 (7.0) 5306 (11.1) 50 - 59 12099 (29.1) 1442 (22.5) 13541 (28.2) ≥ 60 23129 (55.7) 4399 (68.7) 27528 (57.4) Gender Female 15941 (38.4) 2421 (37.8) 18362 (38.3) Male 25610 (61.6) 3981 (62.2) 29591 (61.7) Ethnic Malay 29842 (71.8) 4398 (68.7) 34240 (71.4) Chinese 8377 (20.2) 1429 (22.3) 9806 (20.4) Indian 3181 (7.6) 560 (8.7) 3741 (7.8) Others 151 (0.4) 15 (0.3) 166 (0.4) B) Clinical Hypertension No 7185 (17.3) 633 (9.9) 7818 (16.3) Yes 34366 (82.7) 5769 (0.901) 40135 (83.7) Dyslipidaemia No 9261 (22.3) 908 (14.2) 10169 (21.2) Yes 32290 (77.7) 5494 (85.8) 37784 (78.8) MAP Normal 25299 (60.8) 4002 (62.5) 29301 (61.1) Low 25 (0.1) 6 (0.1) 31 (0.1) High 16227 (39.1) 2394 (37.4) 18621 (38.8) Duration of diabetes ≤ 10 years 31405 (75.6) 5676 (88.7) 37081 (77.3) > 10 years 10146 (24.4) 726 (11.3) 10872 (22.7) BMI Normal 20154 (48.5) 2857 (44.6) 23011 (48.0) Underweight 14714 (35.4) 2414 (37.7) 17128 (35.7) Overweight 6011 (14.5) 988 (15.4) 6999 (14.6) Obese 672 (1.6) 143 (2.3) 815 (1.7) Waist circumference Normal 18561 (44.7) 2737 (42.8) 21298 (44.4) High 22990 (55.3) 3665 (57.2) 26655 (55.6) Urine microalbumin Negative 31050 (74.7) 4739 (74.0) 35789 (74.6) Positive 10501 (25.3) 1663 (26.0) 12164 (25.4) Urine protein Negative 29119 (70.1) 3982 (62.2) 33101 (69.0) Positive 12432 (29.9) 2420 (37.8) 14852 (31.0) HbA1c Good control 8393 (20.2) 1147 (17.9) 9540 (19.9) Intermediate control 18874 (45.4) 3399 (53.1) 22273 (46.4) Poor control 14284 (34.4) 1856 (29.0) 16140 (33.7) Table 1: Continued Independent Variables Complication Outcome Total Patients (N = 47,953) Censored (n = 41,551) Diabetic retinopathy (n = 6,402) n (%) n (%) n (%) Total cholesterol Normal 27450 (66.1) 4051 (63.3) 31501 (65.7) High 14101 (33.9) 2351 (36.7) 16452 (34.3) Triglycerides Normal 15847 (38.1) 2459 (38.4) 18306 (38.2) High 25704 (61.9) 3943 (61.6) 29647 (61.8) HDL Normal 20796 (50.0) 3150 (49.2) 23946 (49.9) Low 20755 (50.0) 3252 (50.8) 24007 (50.1) LDL Normal 17422 (41.9) 2799 (43.7) 20221 (42.2) High 24129 (58.1) 3603 (56.3) 27732 (57.8) C) Medication Metformin Yes 34195 (82.3) 4705 (73.5) 38900 (81.1) No 7356 (17.7) 1697 (26.5) 9053 (18.9) Sulphonylureas Yes 17795 (42.8) 2349 (36.7) 20144 (42.0) No 23756 (57.2) 4053 (63.3) 27809 (58.0) Insulin Yes 29742 (71.6) 3333 (52.1) 33075 (69.0) No 11809 (28.4) 3069 (47.9) 14878 (31.0) D) Complication IHD No 38190 (91.9) 5497 (85.9) 43687 (91.1) Yes 3361 (8.1) 905 (14.1) 4266 (8.9) CeVD No 40949 (98.6) 6233 (97.4) 47182 (98.4) Yes 602 (1.4) 169 (2.6) 771 (1.6) Nephropathy No 32710 (78.7) 3679 (57.5) 36389 (75.9) Yes 8841 (21.3) 2723 (42.5) 11564 (24.1) DFU No 41094 (98.9) 6148 (96.0) 47242 (98.5) Yes 457 (1.1) 254 (4.0) 711 (1.5) Amputation No 41326 (99.5) 6302 (98.4) 47628 (99.3) Yes 225 (0.5) 100 (1.6) 325 (0.7) T2DM, type 2 diabetes mellitus; DR, diabetic retinopathy; HbA1c, glycated haemoglobin; BMI, body mass index; MAP, mean arterial pressure; HDL, high-density lipoprotein; LDL, low-density lipoprotein; IHD, ischaemic heart disease; CeVD, cerebrovascular disease; DFU, diabetic foot ulcer. Median time-to-DR by independent variables Table 2 summarises the median time-to-DR across categories of the independent variables, along with the corresponding log-rank test results. Median time-to-DR tended to increase with age, rising from 61 months among those aged <30 years to 75 months among individuals aged ≥60 years (p<0.001). Males demonstrated a slightly longer median time-to-DR compared to females (77 vs 73 months, p<0.001). Differences were also evident across ethnic groups, with Malays exhibiting a longer median survival (76 months), while comparatively shorter durations were observed among Indians (72 months) and those classified as others (60 months), suggesting potential underlying disparities. With respect to clinical characteristics, patients with hypertension and dyslipidaemia had shorter DR-free survival compared to those without these conditions (p<0.001). Duration of diabetes emerged as one of the most influential factors, where individuals with more than 10 years of disease had a markedly shorter median time-to-DR (46 months) compared to those with ≤10 years (77 months), with strong statistical significance (p<0.001). Glycaemic control also played an important role, as patients with good HbA1c control had a longer median survival time (85 months), whereas those with intermediate and poor control had shorter durations (75 and 73 months, respectively; p<0.001). Additionally, high waist circumference and positive urine protein were associated with reduced time-to-DR, suggesting the impact of metabolic and renal factors on disease progression. In contrast, some variables did not demonstrate significant differences in time-to-DR. These included BMI, urine microalbumin, total cholesterol, triglycerides, and LDL, all of which had p-values greater than 0.05, indicating no statistically significant variation in median survival across their categories. Regarding treatment factors, insulin use showed a significant difference, with those not receiving insulin experiencing a shorter median time-to-DR (72 months vs 76 months, p<0.001), while metformin use showed a modest but statistically significant difference (p=0.008). The presence of diabetes-related complications was consistently associated with shorter DR-free survival. Patients with IHD, CeVD, nephropathy, and DFU exhibited significantly reduced median time-to-DR compared to those without these conditions (all p<0.001). Among these, nephropathy and DFU showed particularly marked reductions, reflecting the interconnected nature of microvascular and macrovascular complications in accelerating disease progression. Collectively, these findings emphasise that the time-to-DR is shaped by a complex interplay of demographic characteristics, disease burden, metabolic control, and existing complications. Table 2 Median time-to-DR for all independent variables Independent Variables Median time-to-DR Log-rank test Months 95% CI X² (df) p-value A) Sociodemographic Age (years) 27.5 (4) <0.001 < 30 61 44 - 77 30 - 39 63 59 - 66 40 - 49 72 66 - 77 50 - 59 74 70 - 77 ≥ 60 75 73 - 76 Gender 13.1 (1) <0.001 Female 73 70 - 75 Male 77 74 - 79 Ethnic 22.1 (3) <0.001 Malay 76 74 - 77 Chinese 73 69 - 76 Indian 72 66 - 77 Others 60 52 - 67 B) Clinical Hypertension 43.9 (1) <0.001 No 71 65 - 76 Yes 75 73 - 76 Dyslipidaemia 155.7 (1) <0.001 No 77 71 - 82 Yes 74 72 - 75 MAP 6.4 (2) 0.04 Normal 77 74 - 79 Low 131 71 - 190 High 73 70 - 75 Duration of diabetes 205.7 (1) 10 years 46 44 - 47 BMI 4.9 (3) 0.178 Normal 73 70 - 75 Underweight 76 73 - 78 Overweight 78 73 - 82 Obese 81 69 - 92 Waist circumference 9.3 (1) 0.002 Normal 78 75 - 80 High 74 71 - 76 Urine microalbumin 0.2 (1) 0.643 Negative 72 68 - 75 Positive 77 74 - 79 Urine protein 125.8 (1) <0.001 Negative 77 74 - 79 Positive 72 69 - 74 Table 2: Continued Independent Variables Median time-to-DR Log-rank test Months 95% CI X² (df) p-value HbA1c 27.9 (2) <0.001 Good control 85 81 - 88 Intermediate control 75 72 - 77 Poor control 73 70 - 75 Total cholesterol 2.6 (1) 0.104 Normal 75 73 - 76 High 77 74 - 79 Triglycerides 0.009 (1) 0.925 Normal 75 72 - 77 High 76 73 - 78 HDL 32.1 (1) <0.001 Normal 79 76 - 81 Low 73 71 - 74 LDL 0.029 (1) 0.865 Normal 77 74 - 79 High 74 71 - 76 C) Medication Metformin 7.1 (1) 0.008 Yes 75 73 - 76 No 76 73 - 79 Sulphonylureas 2.5 (1) 0.111 Yes 76 73 - 78 No 75 72 - 77 Insulin 157.6 (1) <0.001 Yes 76 73 - 78 No 72 69 - 74 D) Complication IHD 25.7 (1) <0.001 No 75 73 - 76 Yes 72 67 - 76 CeVD 37.6 (1) <0.001 No 76 74 - 77 Yes 60 54 - 65 Nephropathy 279.6 (1) <0.001 No 77 74 - 79 Yes 69 66 - 61 DFU 35.1 (1) <0.001 No 76 74 - 77 Yes 64 57 - 70 Amputation 0.6 (1) 0.413 No 75 73 - 76 Yes 77 68 - 85 DR, diabetic retinopathy; CI, confidence interval; df, degree of freedom; HbA1c, glycated haemoglobin; BMI, body mass index; MAP, mean arterial pressure; HDL, high-density lipoprotein; LDL, low-density lipoprotein; IHD, ischaemic heart disease; CeVD, cerebrovascular disease; DFU, diabetic foot ulcer. Prognostic factors associated with time-to-DR Table 3 summarizes the results of both simple and multiple Cox proportional hazards regression analyses examining the association between various factors and the time-to-DR. In the univariable analysis, several sociodemographic variables appeared to be associated with DR risk. Older age groups and male sex showed increased hazards, and individuals of Indian ethnicity had a higher risk compared to Malays. However, after adjustment in the multivariable model, age and gender were no longer statistically significant, suggesting that their apparent effects were confounded by other clinical and disease-related factors. Ethnicity, on the other hand, remained independently associated with DR, with both Chinese and Indian patients were statistically significant increased risk compared to Malays. Clinical variables such as hypertension and dyslipidaemia remained significant predictors after adjustment, indicating that patients with these comorbidities had a higher hazard of developing DR. Duration of diabetes emerged as a key determinant, with individuals having more than 10 years of disease nearly twice as likely to develop DR compared to those with a shorter duration. Measures reflecting metabolic and renal status also contributed independently in which increased waist circumference and the presence of urine protein were both associated with higher risk. Poor glycaemic control remained a significant predictor in the adjusted model, reinforcing the central role of sustained hyperglycaemia in accelerating microvascular damage. Medication factors further contributed to the overall risk profile. Patients not receiving metformin had a slightly higher hazard of DR, while those not on insulin therapy showed a more pronounced increase in risk. These findings likely reflect differences in disease severity, treatment intensity, and clinical management pathways rather than direct causal effects of the medications themselves. The use of sulphonylureas was not significantly associated with DR in the final model, suggesting a limited independent role after accounting for other variables. The presence of diabetes-related complications demonstrated strong and independent associations with DR. Patients with IHD, CeVD, nephropathy, and DFU had significantly higher hazards of developing DR. These findings highlight the clustering of microvascular and macrovascular complications in patients with more advanced disease. Table 3 Univariable and multivariable analysis of prognostic factors of DR among adults with T2DM in Johor Independent variables Simple Cox proportional hazard regression Multiple Cox proportional hazard regression Regression coefficient (b) Crude HR (95% CI) p-value Regression coefficient (b) Adjusted HR (95% CI) p-value A) Sociodemographic Age (years) < 30 1 ref. 1 ref. 30 - 39 0.391 1.47 (0.77, 2.83) 0.239 0.394 1.48 (0.77, 2.84) 0.235 40 - 49 0.508 1.66 (0.88, 3.11) 0.112 0.352 1.42 (0.76, 2.66) 0.271 50 - 59 0.616 1.85 (0.99 - 3.45) 0.052 0.387 1.47 (0.79, 2.75) 0.224 ≥ 60 0.689 1.99 (1.10, 3.71) 0.03 0.588 1.80 (0.97, 3.36) 0.064 Gender Female 1 ref. 1 ref. Male 0.093 1.09 (1.04, 1.15) <0.001 0.050 1.05 (1.00, 1.11) 0.067 Ethnic Malay 1 ref. 1 ref. Chinese 0.052 1.05 (0.99, 1.12) 0.086 0.112 1.12 (1.05, 1.19) <0.001 Indian 0.205 1.23 (1.12, 1.34) <0.001 0.094 1.10 (1.01, 1.20) 0.041 Others -0.002 0.99 (0.60, 1.65) 0.993 0.123 1.13 (0.68, 1.88) 0.636 B) Clinical Hypertension No 1 ref. 1 ref. Yes 0.278 1.32 (1.21, 1.43) <0.001 0.182 1.20 (1.10, 1.31) <0.001 Dyslipidaemia No 1 ref. 1 ref. Yes 0.445 1.56 (1.45, 1.67) <0.001 0.221 1.25 (1.16, 1.34) 10 years 0.607 1.83 (1.68, 1.99) <0.001 0.673 1.96 (1.79, 2.14) <0.001 Table 3: Continued Independent variables Simple Cox proportional hazard regression Multiple Cox proportional hazard regression Regression coefficient (b) Crude HR (95% CI) p-value Regression coefficient (b) Adjusted HR (95% CI) p-value BMI Normal 1 ref. Underweight 0.003 1.00 (0.95, 1.05) 0.918 Overweight -0.073 0.93 (0.86, 1.00) 0.052 Obese -0.055 0.94 (0.80, 1.12) 0.524 Waist circumference Normal 1 ref. 1 ref. High 0.077 1.08 (1.03, 1.14) 0.002 0.076 1.08 (1.02, 1.14) 0.009 Urine microalbumin Negative 1 ref. Positive 0.013 1.01 (0.95, 1.07) 0.646 Urine protein Negative 1 ref. 1 ref. Positive 0.287 1.33 (1.26, 1.40) <0.001 0.090 1.09 (1.04, 1.15) 0.001 HbA1c Good control 1 ref. 1 ref. Intermediate control -0.073 0.93 (0.86, 1.00) 0.052 0.032 1.03 (0.96, 1.11) 0.363 Poor control 0.094 1.10 (1.03, 1.16) 0.001 0.105 1.11 (1.03, 1.20) 0.006 Total cholesterol Normal 1 ref. High 0.042 1.04 (0.99, 1.09) 0.106 Triglicerides Normal 1 ref. High -0.002 0.99 (0.94, 1.04) 0.926 HDL Normal 1 ref. 1 ref. Low 0.141 1.15 (1.09, 1.21) <0.001 0.020 1.02 (0.97, 1.08) 0.455 LDL Normal 1 ref. High 0.004 1.01 (0.95, 1.05) 0.866 Table 3: Continued Independent variables Simple Cox proportional hazard regression Multiple Cox proportional hazard regression Regression coefficient (b) Crude HR (95% CI) p-value Regression coefficient (b) Adjusted HR (95% CI) p-value C) Medication Metformin Yes 1 ref. 1 ref. No 0.075 1.07 (1.02, 1.14) 0.008 0.068 1.07 (1.01, 1.14) 0.026 Sulphonylureas Yes 1 ref. No -0.041 0.96 (0.91, 1.01) 0.114 Insulin Yes 1 ref. 1 ref. No 0.32 1.37 (1.31, 1.45) <0.001 0.313 1.37 (1.28, 1.46) <0.001 D) Complication IHD No 1 ref. 1 ref. Yes 0.182 1.20 (1.11, 1.28) <0.001 0.264 1.30 (1.21, 1.40) <0.001 CeVD No 1 ref. 1 ref. Yes 0.471 1.60 (1.37, 1.86) <0.001 0.190 1.21 (1.04, 1.41) Nephropathy No 1 ref. 1 ref. Yes 0.435 1.54 (1.46, 1.62) <0.001 0.578 1.78 (1.69, 1.88) <0.001 DFU No 1 ref. 1 ref. Yes 0.375 1.45 (1.28, 1.65) <0.001 0.652 1.92 (1.67, 2.20) <0.001 Amputation No 1 ref. Yes 0.082 1.08 (0.89, 1.32) 0.418 T2DM, type 2 diabetes mellitus; DR, diabetic retinopathy; HR, hazard ratio; CI, confidence interval; ref., reference; HbA1c, glycated haemoglobin; BMI, body mass index; MAP, mean arterial pressure; HDL, high-density lipoprotein; LDL, low-density lipoprotein; IHD, ischaemic heart disease; CeVD, cerebrovascular disease; DFU, diabetic foot ulcer. Discussion This study provides important local evidence on the timing and predictors of DR among adults with T2DM in Johor. The overall median time-to-DR was approximately 75 months, suggesting that a substantial proportion of patients developed retinopathy within about six years T2DM diagnosis. This finding supports the concept that DR is not merely a late complication, but a progressive neurovascular disease that may emerge relatively early when metabolic and vascular risks are not adequately controlled [ 17 ]. Similar cohort-based evidence has shown that diabetic complications can occur within the first few years after diagnosis, highlight that DR prevalence is strongly related to diabetes duration and glycaemic exposure [ 18 ]. Duration of diabetes was one of the strongest prognostic factors in this study, with patients who had diabetes for more than 10 years showing nearly twice the hazard of developing DR compared with those with shorter disease duration. This is biologically plausible because prolonged hyperglycaemia causes cumulative retinal microvascular injury through oxidative stress, advanced glycation end-product formation, inflammation, endothelial dysfunction, capillary basement membrane thickening, and pericyte loss [ 19 ]. Over time, these processes impair retinal perfusion, promote vascular leakage, and eventually contribute to non-proliferative and proliferative DR [ 20 ]. This finding is consistent with the American Diabetes Association Standards of Care, which state that DR prevalence is strongly related to diabetes duration, and with recent prediction studies identifying diabetes duration as a key predictor of retinopathy development [ 21 ]. Poor glycaemic control was independently associated with DR in this study, reinforcing the central role of chronic hyperglycaemia in retinal damage. Hyperglycaemia activates multiple biochemical pathways, including the polyol pathway, protein kinase C activation, oxidative stress, inflammation, and vascular endothelial growth factor expression, all of which contribute to retinal capillary leakage, ischaemia, and neovascularisation [ 22 ]. The finding is aligned with recent prognostic studies showing that HbA1c remains one of the most consistent predictors of DR and retinal disease progression [ 23 ]. However, the modest adjusted effect size in this study may reflect the categorisation of HbA1c, single-point HbA1c measurement, or residual confounding from diabetes duration, treatment intensity, and comorbid vascular disease. Hypertension and dyslipidaemia remained significant predictors after adjustment, indicating that DR in this population is shaped not only by glycaemic exposure but also by broader cardiometabolic risk. Hypertension accelerate retinal endothelial injury by increasing shear stress, disrupting autoregulation, and worsening capillary permeability [ 24 ]. Dyslipidaemia contribute to hard exudate formation, retinal inflammation, and diabetic macular oedema through lipid leakage and endothelial dysfunction [ 25 ]. These findings are consistent with established evidence that blood pressure and lipid abnormalities are important modifiable risk factors for diabetic eye disease [ 26 ]. The high prevalence of hypertension and dyslipidaemia among patients with DR in this study also suggests that integrated cardiovascular risk management should be considered part of DR prevention rather than a separate clinical agenda. Renal indicators, particularly urine protein and nephropathy, were strongly associated with DR. This finding reflects the shared microvascular pathogenesis between diabetic kidney disease and retinal disease. Both conditions arise from chronic hyperglycaemia-induced endothelial dysfunction, basement membrane thickening, oxidative stress, and inflammatory injury affecting small vessels [ 27 ]. The strong association between nephropathy and DR is therefore clinically meaningful because kidney involvement may act as a marker of systemic microvascular damage. Recent study also identified diabetic nephropathy as an important predictor of retinopathy progression, supporting the interpretation that renal disease and retinal disease frequently cluster in patients with advanced vascular injury [ 28 ]. Chinese and Indian ethnicity remained independently associated with higher DR risk compared with Malay ethnicity after adjustment. This finding suggests that ethnic differences may not be fully explained by measured clinical variables alone. Possible explanations include differences in genetic susceptibility, diabetes phenotype, health-seeking behaviour, screening uptake, socioeconomic factors, access to care, diet, and long-term metabolic control [ 29 ]. Previous study also reported ethnic variation in DR burden, supporting the need to interpret ethnicity as a complex marker of biological, behavioural, and health-system influences rather than a purely genetic determinant [ 30 ]. Patients not receiving metformin and those not receiving insulin had higher hazards of DR in this study. These findings should be interpreted cautiously because medication variables in observational surveillance data may reflect treatment pathways, disease severity, contraindications, adherence, prescribing practice, or timing of therapy initiation rather than direct causal effects. For example, patients not receiving insulin may include individuals with suboptimal treatment intensification, delayed escalation, or poorer continuity of care, which may increase cumulative glycaemic burden [ 31 ]. Similarly, the apparent protective pattern among metformin users may partly reflect its role as first-line therapy and its broader metabolic effects, although causal inference cannot be established without more detailed longitudinal treatment data [ 32 ]. The associations between DR and IHD, CeVD, nephropathy, and DFU suggest that retinopathy occurs within a wider context of systemic vascular disease. DFU showed the largest adjusted association, followed by nephropathy, indicating that patients with established complications may represent a high-risk subgroup with more severe endothelial dysfunction, inflammation, vascular insufficiency, and prolonged metabolic exposure [ 33 ]. This pattern is consistent with the understanding of T2DM as a systemic metabolic disorder affecting both microvascular and macrovascular beds through chronic hyperglycaemia, insulin resistance, and inflammation, leading to high morbidity [ 34 ]. Clinically, these findings support the need for more intensive retinal surveillance among patients with existing diabetes-related complications, especially nephropathy and diabetic foot disease. Strengths and limitations This study offers several key strengths. Firstly, it drew upon a large, population-based dataset from the Johor NDR, resulting in a sample size of nearly 48,000 patients. This considerably improves statistical power, enhances the precision of estimates, and supports the generalisability of the findings to routine clinical practice in Malaysia. Secondly, the retrospective cohort design, coupled with survival analysis, enabled the evaluation of time-to-DR, thereby providing deeper insight into disease progression beyond what cross-sectional studies can offer. The use of Kaplan–Meier methods and Cox proportional hazards models also ensured appropriate handling of censored observations and facilitated the identification of independent prognostic factors. Lastly, the inclusion of a broad range of sociodemographic, clinical, treatment-related, and complication variables allowed for a more comprehensive assessment of potential determinants, while enabling adjustment for multiple confounders in the multivariable analysis. Despite the strengths of this study, several important limitations remain. First, although this study identified key prognostic factors for time-to-DR, the analysis was limited to routinely available surveillance variables and did not capture more granular or dynamic risk indicators such as longitudinal HbA1c trends, glycaemic variability, time-in-range, or inflammatory biomarkers, all of which are increasingly recognised as important in the pathogenesis of microvascular complications. Second, the categorisation of continuous variables may have obscured potential dose–response relationships and threshold effects, limiting deeper understanding of how incremental changes in risk factors influence DR onset. Third, the registry-based nature of the data did not allow differentiation of DR severity (e.g., non-proliferative vs proliferative stages), thereby restricting insights into disease progression beyond initial onset. In addition, potential influences of health system factors such as screening frequency, access to ophthalmological services, and adherence to follow-up were not captured, which may contribute to variability in the timing of DR detection. Finally, while ethnic differences were observed, the underlying mechanisms whether biological, behavioural, or socioeconomic remain unclear and warrant further investigation. Future research recommendations Future research should aim to build on these findings by incorporating longitudinal and more detailed clinical data to better characterise the trajectory of DR development. Prospective cohort studies or enhanced registry linkages integrating laboratory trends, medication adherence, lifestyle factors, and retinal imaging data would allow more precise modelling of risk and disease progression. The application of advanced analytical approaches, including machine learning and dynamic prediction models, may further improve risk stratification and support the development of personalised screening intervals. Additionally, future studies should explore the progression of DR severity, not just onset, to better inform clinical decision-making and resource allocation. Investigating ethnic disparities in DR through mixed-methods or multidisciplinary approaches could help disentangle the contributions of genetic susceptibility, cultural practices, and healthcare access. Finally, interventional studies evaluating the effectiveness of targeted screening, early treatment optimisation, and integrated cardiometabolic management strategies would be valuable in translating epidemiological findings into improved patient outcomes within the Malaysian context. Conclusion In conclusion, this study demonstrates that DR develops relatively early among adults with T2DM in Johor, with a median time of approximately six years from diagnosis, highlighting the need for timely and sustained screening. The findings highlight that longer diabetes duration, poor glycaemic control, hypertension, dyslipidaemia, renal involvement, and the presence of other diabetes-related complications are key determinants of earlier DR onset, reflecting the cumulative impact of metabolic and vascular dysfunction. These results emphasise the importance of integrated risk factor management and early identification of high-risk individuals to delay disease progression, and support public health planning aimed at reducing the burden of DR in Malaysia. Declarations Contributors MMST contributed to the conceptualisation, project administration, data curation, methodology, formal analysis, draft writing and editing. MRI contributed to the methodology, formal analysis, project administration, draft review and responsible for the overall content as guarantor. SMY contributed to the methodology and draft review. TRR and AARA both contributed to the draft review. All authors have read and approved the final manuscript. Competing interests None declared. Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research. Patient consent for publication Not applicable Ethics approval This study was registered in the National Medical Research Register (registration number NMRR ID-25-03490-2XL [IIR]). Ethical approval was obtained from the Medical Research Ethics Committee (MREC) of the Ministry of Health Malaysia. The study was conducted in accordance with the principles of the Declaration of Helsinki and relevant local regulatory guidelines. Since the research was based on secondary data and patient identifying information had been stripped from the dataset for anonymity, thus, the requirement to obtain informed consent to participate was waived by the Research Ethics Committee ((REC/12/2025 (PG/EX/101)), Universiti Teknologi MARA (UiTM). Provenance and peer review Not commissioned; externally peer reviewed. ORCID iD Muhammad Muaz Shahriman Teruna https://orcid.org/0009-0005-9298-2367 Tajul Rosli Razak http://orcid.org/0000-0002-6389-8108 Siti Munira Yasin http://orcid.org/0000-0001-9072-5053 Abdullah Ashraf Rafique Ali http://orcid.org/0000-0003-3969-9413 Muhammad Muzzammil Mohamad Salleh https://orcid.org/0009-0007-1558-1943 Mohamad Zuhair Mohamed Yusoff https://orcid.org/0009-0003-9266-9237 Muhammad Hariz ‘Ammar Khebir https://orcid.org/0009-0003-1994-4044 Nur Adilla Che Rameli https://orcid.org/0009-0004-2893-0004 Muhammad Irfan Mohd Sallehhuddin https://orcid.org/0009-0002-7523-2175 Muhammad Syazni Mohamad Asraff https://orcid.org/0009-0006-7915-6842 Mohamad Rodi Isa https://orcid.org/0000-0002-8979-7794 Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not- for- profit sectors. Author Contribution MMST contributed to the conceptualization, project administration, data curation, methodology, formal analysis, draft writing and editing. MRI contributed to the methodology, formal analysis, project administration, draft review and responsible for the overall content as guarantor. SMY contributed to the methodology and draft review. TRR and AARA both contributed to the draft review. All authors have read and approved the final manuscript. Acknowledgement We thank the Director- General of Health Malaysia for the permission to publish this paper. We also thank Johor State Health Department for the data provision. Data Availability Data availability statement :Data can be obtained from a third party and are not publicly available. The data that produced the findings of this study are available in the Johor’s NDR, but restrictions may apply in requesting the data. 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Impact of diabetic foot ulcers and nephropathy on risk of treatment-warranted diabetic eye disease: A retrospective cohort study. AJO Int. 2026;3(1). Chawla A, Chawla R, Jaggi S. Microvasular and macrovascular complications in diabetes mellitus: Distinct or continuum? Indian J Endocrinol Metab. 2016;20(4):546–51. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 24 May, 2026 Reviewers agreed at journal 14 May, 2026 Reviewers invited by journal 08 May, 2026 Editor assigned by journal 08 May, 2026 Editor invited by journal 07 May, 2026 Submission checks completed at journal 05 May, 2026 First submitted to journal 05 May, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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16:08:27","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9556443/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9556443/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":109444654,"identity":"be04925f-3eeb-488c-b907-13ee90530add","added_by":"auto","created_at":"2026-05-18 08:02:08","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":56721,"visible":true,"origin":"","legend":"\u003cp\u003eFlow diagram of participants selection and exclusion for the study.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9556443/v1/2a2ea8010cd01f45ca702850.png"},{"id":109444655,"identity":"bada02d9-c857-4399-bfe2-ef9f595fd408","added_by":"auto","created_at":"2026-05-18 08:02:08","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":38077,"visible":true,"origin":"","legend":"\u003cp\u003eKaplan–Meier curve for overall DR-free survival among adults with T2DM in Johor\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-9556443/v1/ea0090dd074d15f4d21857fa.png"},{"id":109444737,"identity":"6c098b49-ab5e-48c7-adeb-3bd90c9fb9aa","added_by":"auto","created_at":"2026-05-18 08:02:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":679677,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9556443/v1/32e7efce-b9bd-4c37-97ae-1475c6786375.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Time to diabetic retinopathy and its prognostic factors among adults with type 2 diabetes mellitus in Johor, Malaysia from 2015 to 2019: a retrospective cohort study using surveillance data","fulltext":[{"header":"Background","content":"\u003cp\u003eTime to diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) plays a crucial role in understanding the disease's progression and its impact on public health. DR, a microvascular complication of diabetes, remains one of the leading causes of blindness worldwide among the diabetic population, particularly in individuals with T2DM [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. DR is defined as damage to the retinal blood vessels due to hyperglycaemia and typically manifests in stages, including non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. NPDR is characterized by the presence of microaneurysms, haemorrhages, and hard exudates, reflecting pathological changes such as retinal leakage and vessel blockage. In contrast, PDR involves the growth of new, fragile blood vessels known as neovascularization on the retina, posing an increased risk of significant vision loss due to potential bleeding.\u003c/p\u003e \u003cp\u003eThe global prevalence of T2DM has become a pressing public health issue, which increased across various demographics and regions. Current estimates indicate that approximately 463\u0026nbsp;million adults suffer from T2DM globally, which constitutes about one in eleven adults and represents a significant rise over the past decades [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Projections by the International Diabetes Federation (IDF) suggest that these figures could escalate to nearly 700\u0026nbsp;million by the year 2045 [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. This upward trend is particularly alarming in developing countries, where dietary transitions, urbanization, and sedentary lifestyles intensify the risk of developing diabetes.\u003c/p\u003e \u003cp\u003eApart from that, the prevalence rates of DR among individuals with T2DM have been reported to range from approximately 15% to nearly 50% globally. For example, a study conducted in Pakistan identified a prevalence of 15% among newly diagnosed T2DM patients [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In another study, a prevalence of 40.1% was reported among T2DM patients [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Additionally, findings from a South African cohort indicated a prevalence of 35.3%, particularly among older patients [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Furthermore, it is noted that the prevalence can be as high as 60% in individuals with a longer duration of diabetes, emphasizing that duration is a critical risk factor, as indicated by studies from the Wisconsin Epidemiologic Study of Diabetic Retinopathy, where the incidence of DR escalates significantly with prolonged diabetes duration [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTime-to-event analysis can be employed to evaluate the time until the onset of DR in relation to modifiable risk factors, providing insights into patient management practices that can enhance outcomes. Such analyses may involve the use of Cox proportional hazards models to determine the relationship between survival time and predictors such as fasting blood sugar, glycated haemoglobin (HbA1c) levels, and the presence of concomitant diabetic complications [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Moreover, using the Kaplan-Meier method allows researchers to visualize the incidence of DR over time, associating extended durations of diabetes with increased risks of DR. Findings suggest that longer durations of diabetes significantly correlate with adverse outcomes in various diabetic complications, including DR [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDespite the growing burden of DR, there remains a critical gap in locally contextualised evidence on the temporal progression to DR and its prognostic determinants within Malaysian populations, particularly using surveillance data. Understanding the timing and predictors of DR onset is essential to optimise early detection, allocate healthcare resources efficiently, and reduce preventable visual impairment [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Furthermore, time-to-event analysis approaches provide firmer framework for identifying high-risk individuals compared to conventional methods [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Therefore, this study is justified to bridge the existing evidence gap by utilising longitudinal registry data to generate population-specific insights. The aim of this study is to determine the time to DR and to identify its prognostic factors among adults with T2DM in Johor, Malaysia, from 2015 to 2019 using surveillance data.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and setting\u003c/h2\u003e \u003cp\u003eA retrospective cohort study was conducted encompassing all adult T2DM patients registered in Johor National Diabetes Registry (NDR) from 1st January 2015 to 31st December 2019. Johor is a state of Malaysia situated on the southern coast of Peninsular Malaysia, covering a land area of 19,166 km\u0026sup2; which recorded an approximate population of 4.0\u0026nbsp;million individuals in the year 2019 [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The state is divided into ten administrative districts, namely Johor Bahru (the capital district), Kulai, Batu Pahat, Kluang, Muar, Tangkak, Segamat, Kota Tinggi, Pontian, and Mersing (listed in descending order based on their respective population and urbanisation level) [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData source\u003c/h3\u003e\n\u003cp\u003eThe NDR records provided by the Non-Communicable Disease (NCD) Unit of Johor State Health Department was used. The personal information, sociodemographic and clinical characteristics, complications, as well as treatment details of patients with T2DM in Johor, were documented and stored in NDR, which is the online diabetes surveillance registry established by the Ministry of Health (MOH). The NCD units in each district carried out the data collection and recording process at district level, with oversight provided by the NCD unit at the state level. The State Health Department has access to the data of all patients with T2DM registered within their respective state. In order to maintain patients\u0026rsquo; anonymity, all identifying information, including the patient\u0026rsquo;s name, identification card number, contact number, and residential address were requested to be removed.\u003c/p\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eThis retrospective cohort study included adult patients aged 18 years and above with a confirmed diagnosis of T2DM who were registered in the National Diabetes Registry in Johor between 1st January 2015 and 31st December 2019, and who had no evidence of DR at baseline assessment. Patients were required to have complete baseline information on key sociodemographic and clinical variables, such as age, gender, duration of diabetes, glycaemic control, and comorbidities. Individuals were excluded if they had pre-existing DR at baseline, had missing or incomplete data on outcome status or follow-up duration that precluded time-to-event analysis. Additionally, patients with duplicate entries, or those who were lost to follow-up immediately after baseline without any subsequent assessment were excluded to ensure the validity and reliability of the time-to-event analysis.\u003c/p\u003e\n\u003ch3\u003eVariables\u003c/h3\u003e\n\u003cp\u003eThe independent variables in this study were divided according to four domains namely sociodemographic, clinical, medication, and complication. Sociodemographic comprised a range of sociodemographic characteristics such as age, gender, and ethnicity. Clinical variables encompassed comorbidities, complications, diabetes-related factors such as duration of diabetes, glycaemic control measured by HbA1c, body mass index (BMI), mean arterial pressure (MAP) status, waist circumference, urine microalbumin, urine protein, and lipid profile parameters. In addition, treatment-related variables, including the use of antidiabetic medications such as insulin and oral hypoglycaemic agents, were included to reflect real-world management. These variables were selected based on established literature as potential prognostic factors influencing the development of DR and were analysed to determine their association with time to event.\u003c/p\u003e \u003cp\u003eThe primary outcome of this study was the development of DR, defined as the first documented diagnosis of DR during the follow-up period based on retinal screening records within the registry. Time-to-event was calculated as the duration (in months) from the baseline date which is the date of T2DM diagnosis to the date of diagnosis of DR. Participants who did not develop DR during the study period were treated as censored observations at their last recorded follow-up. This outcome measure aligns with survival analysis methodology, allowing for estimation of DR-free survival and identification of prognostic factors associated with earlier onset of the condition.\u003c/p\u003e \u003cp\u003eIn term of the independent variables in this study, the BMI was classified into four categories, namely underweight (\u0026lt;\u0026thinsp;18.5 kg/m\u0026sup2;), normal (18.5\u0026ndash;22.9 kg/m\u0026sup2;), overweight (23.0\u0026ndash;27.4 kg/m\u0026sup2;), and obese (\u0026ge;\u0026thinsp;27.5 kg/m\u0026sup2;), reflecting the degree of body fatness and obesity status among participants [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Waist circumference was categorised into normal and high-risk groups using sex-specific cut-off points, whereby values\u0026thinsp;\u0026gt;\u0026thinsp;90 cm for men and \u0026gt;\u0026thinsp;80 cm for women were considered high, indicating central obesity and increased cardiometabolic risk [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Glycaemic control was assessed using glycated haemoglobin (HbA1c), which was divided into good control (\u0026lt;\u0026thinsp;7%), intermediate control (7% to \u0026lt;\u0026thinsp;8%), and poor control (\u0026ge;\u0026thinsp;8%), representing the long-term level of blood glucose control [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Lipid profile parameters included high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol, and triglycerides (TG). HDL levels were categorised into low and normal according to sex-specific thresholds, where lower HDL levels indicated poorer protective lipid status [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. LDL was classified into normal (\u0026le;\u0026thinsp;2.6 mmol/L) and high (\u0026gt;\u0026thinsp;2.6 mmol/L), reflecting the level of atherogenic cholesterol [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Total cholesterol was grouped into normal (\u0026lt;\u0026thinsp;4.5 mmol/L) and high (\u0026ge;\u0026thinsp;4.5 mmol/L), while triglycerides were categorised into normal (\u0026le;\u0026thinsp;1.7 mmol/L) and high (\u0026gt;\u0026thinsp;1.7 mmol/L), both representing abnormalities in lipid metabolism that may contribute to vascular complications among patients with diabetes mellitus [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eSample size and sampling method\u003c/h3\u003e\n\u003cp\u003eThe minimum sample size for this study was estimated using the single population proportion formula, \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:n=\\frac{{Z}^{2}P(1-P)}{{d}^{2}}\\)\u003c/span\u003e\u003c/span\u003e, where \u003cem\u003eZ\u003c/em\u003e represents the standard normal deviate at a 95% confidence level (1.96), \u003cem\u003eP\u003c/em\u003e is the estimated prevalence of DR, and \u003cem\u003ed\u003c/em\u003e is the margin of error set at 0.05. The prevalence of DR was taken as 36.8% based on a recent study done at Sabah, Malaysia which reported that approximately 36.8% of patients with T2DM had DR [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Substituting these values yielded a minimum required sample size of approximately 358 participants. After adjusting for an additional 20% to account for incomplete or missing data, the final minimum sample size was estimated to be 430 participants. The sampling method used in this study was universal sampling of secondary data in the Johor NDR database.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analyses\u003c/h2\u003e \u003cp\u003eAll statistical analyses were conducted using IBM SPSS version 30. All variables, including those originally continuous, were categorised and summarised using frequencies and percentages. The Kaplan\u0026ndash;Meier method was employed to estimate DR-free survival probabilities over time, and to illustrate the distribution of time to DR across different categories of independent variables. The log-rank test was used to determine whether there were statistically significant differences in the time to development of DR across categories of each independent variable by comparing the survival distributions between groups, and a p-value of less than 0.05 was considered statistically significant.\u003c/p\u003e \u003cp\u003eTo identify prognostic factors associated with the development of DR, Cox proportional hazards regression analyses were performed. Initially, simple (univariable) Cox regression was conducted to estimate crude hazard ratios (HRs), 95% confidence intervals (CIs), and corresponding p-values for each independent variable. Variables with a p-value of less than 0.05 in the univariable analysis were subsequently included in the multiple Cox proportional hazards model to obtain adjusted HRs while controlling for potential confounders. The Cox proportional hazards assumption was evaluated, and no significant violations were observed. The final model was assessed for multicollinearity and interaction effects where appropriate, ensuring the validity of the findings.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eStudy population and participant selection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 50,457 adults with T2DM were initially identified from the Johor NDR database between 2015 and 2019. After removing 1,056 duplicate records, 49,401 patients remained. Further exclusions were applied to ensure data completeness for time-to-event analysis, including cases with missing outcome data, missing date of DR diagnosis, and incomplete key clinical variables such as BMI, blood pressure (BP), and HbA1c. Following these exclusions, a final sample of 47,953 patients was included in the study. This selection process ensured that only individuals with complete and reliable data were analysed to accurately estimate the time-to-DR development and its associated prognostic factors (figure 1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCharacteristics of the study population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 1 presents the characteristics of adults with T2DM, of whom 6,402 (13.3%) developed DR while 41,551 (86.7%) were censored during the follow-up period. In term of sociodemographic, the cohort was predominantly older, with the majority aged \u0026ge;60 years (57.4%), followed by those aged 50\u0026ndash;59 years (28.2%). A higher proportion of DR cases was observed among older age groups, particularly those aged \u0026ge;60 years (68.7%). Males constituted a larger proportion of the study population (61.7%) and also had a slightly higher proportion of DR cases (62.2%) compared to females. In terms of ethnicity, Malays represented the majority (71.4%), followed by Chinese (20.4%) and Indians (7.8%), with DR cases distributed proportionately across these groups.\u003c/p\u003e\n\u003cp\u003eWith regard to clinical characteristics, most participants had comorbid hypertension (83.7%) and dyslipidaemia (78.8%), both of which were more prevalent among those who developed DR (90.1% and 85.8%, respectively). The majority of patients had a diabetes duration of \u0026le;10 years (77.3%), although a notable proportion of DR cases still occurred within this group (88.7%). In terms of metabolic indicators, more than half of the participants had high waist circumference (55.6%), and glycaemic control was largely suboptimal, with the largest proportion classified under intermediate control (46.4%), followed by poor control (33.7%). Patients with DR tended to have a higher proportion of intermediate glycaemic control (53.1%). Additionally, a greater proportion of DR cases was observed among those with positive urine protein (37.8%), suggesting a link with microvascular complications.\u003c/p\u003e\n\u003cp\u003eRegarding medication and complications, most patients were on metformin therapy (81.1%), although a relatively higher proportion of DR cases was observed among those not receiving metformin (26.5%). Insulin use was common (69.0%), but a higher proportion of DR cases was noted among those not on insulin (47.9%). In terms of diabetes-related complications, nephropathy was notably more prevalent among patients with DR, alongside higher proportions of ischaemic heart disease (IHD) and diabetic foot ulcer (DFU). Overall, the findings highlight that DR occurrence was more frequent among older individuals, those with longer disease duration, poorer metabolic profiles, and the presence of comorbidities and complications.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOverall median time-to-DR\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Kaplan\u0026ndash;Meier analysis demonstrated that the overall median time-to-DR among adults with T2DM was approximately 75 months (figure 2), indicating that half of the study population remained free of DR for about six years following diagnosis. The survival curve showed a gradual decline over time, reflecting a progressive increase in the cumulative incidence of DR as the duration of diabetes increased. This pattern suggests that the risk of developing DR accumulates steadily with longer disease duration, highlighting the importance of early and continuous screening, particularly within the first decade after diagnosis of T2DM.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e Characteristic of adults with T2DM and DR in Johor from 2015 to 2019\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"621\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" rowspan=\"3\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndependent Variables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" style=\"width: 275px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComplication Outcome\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal Patients\u003cbr\u003e\u0026nbsp;(N = 47,953)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCensored\u003cbr\u003e\u0026nbsp;(n = 41,551)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 169px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiabetic retinopathy\u003cbr\u003e\u0026nbsp;(n = 6,402)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eA) Sociodemographic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u0026lt; 30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e197 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e10 (0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e207 (0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e30 - 39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e1271 (3.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e100 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1371 (2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e40 - 49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e4855 (11.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e451 (7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e5306 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e50 - 59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e12099 (29.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e1442 (22.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e13541 (28.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u0026ge; 60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e23129 (55.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e4399 (68.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e27528 (57.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e15941 (38.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e2421 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e18362 (38.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e25610 (61.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e3981 (62.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e29591 (61.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eEthnic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eMalay\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e29842 (71.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e4398 (68.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e34240 (71.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eChinese\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e8377 (20.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e1429 (22.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e9806 (20.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eIndian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e3181 (7.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e560 (8.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e3741 (7.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e151 (0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e15 (0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e166 (0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eB) Clinical\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e7185 (17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e633 (9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e7818 (16.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e34366 (82.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e5769 (0.901)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e40135 (83.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eDyslipidaemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e9261 (22.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e908 (14.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e10169 (21.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e32290 (77.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e5494 (85.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e37784 (78.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eMAP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e25299 (60.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e4002 (62.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e29301 (61.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e25 (0.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e6 (0.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e31 (0.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e16227 (39.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e2394 (37.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e18621 (38.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eDuration of diabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u0026le; 10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e31405 (75.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e5676 (88.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e37081 (77.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u0026gt; 10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e10146 (24.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e726 (11.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e10872 (22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e20154 (48.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e2857 (44.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e23011 (48.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eUnderweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e14714 (35.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e2414 (37.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e17128 (35.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eOverweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e6011 (14.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e988 (15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e6999 (14.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eObese\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e672 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e143 (2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e815 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eWaist circumference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e18561 (44.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e2737 (42.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e21298 (44.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e22990 (55.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e3665 (57.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e26655 (55.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eUrine microalbumin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e31050 (74.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e4739 (74.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e35789 (74.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e10501 (25.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e1663 (26.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e12164 (25.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eUrine protein\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e29119 (70.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e3982 (62.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e33101 (69.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e12432 (29.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e2420 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e14852 (31.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHbA1c\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eGood control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e8393 (20.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e1147 (17.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e9540 (19.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eIntermediate control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e18874 (45.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e3399 (53.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e22273 (46.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePoor control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e14284 (34.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e1856 (29.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e16140 (33.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 1: \u003cem\u003eContinued\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"621\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" rowspan=\"3\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndependent Variables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" style=\"width: 275px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComplication Outcome\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal Patients\u003cbr\u003e\u0026nbsp;(N = 47,953)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCensored\u003cbr\u003e\u0026nbsp;(n = 41,551)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 169px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiabetic retinopathy\u003cbr\u003e\u0026nbsp;(n = 6,402)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eTotal cholesterol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e27450 (66.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e4051 (63.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e31501 (65.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e14101 (33.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e2351 (36.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e16452 (34.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eTriglycerides\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e15847 (38.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e2459 (38.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e18306 (38.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e25704 (61.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e3943 (61.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e29647 (61.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e20796 (50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e3150 (49.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e23946 (49.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e20755 (50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e3252 (50.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e24007 (50.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eLDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e17422 (41.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e2799 (43.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e20221 (42.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e24129 (58.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e3603 (56.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e27732 (57.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC) Medication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eMetformin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e34195 (82.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e4705 (73.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e38900 (81.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e7356 (17.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e1697 (26.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e9053 (18.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eSulphonylureas\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e17795 (42.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e2349 (36.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e20144 (42.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e23756 (57.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e4053 (63.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e27809 (58.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eInsulin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e29742 (71.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e3333 (52.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e33075 (69.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e11809 (28.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e3069 (47.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e14878 (31.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eD) Complication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eIHD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e38190 (91.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e5497 (85.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e43687 (91.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e3361 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e905 (14.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e4266 (8.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eCeVD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e40949 (98.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e6233 (97.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e47182 (98.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e602 (1.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e169 (2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e771 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNephropathy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e32710 (78.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e3679 (57.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e36389 (75.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e8841 (21.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e2723 (42.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e11564 (24.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eDFU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e41094 (98.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e6148 (96.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e47242 (98.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e457 (1.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e254 (4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e711 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eAmputation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e41326 (99.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e6302 (98.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e47628 (99.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e225 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 169px;\"\u003e\n \u003cp\u003e100 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e325 (0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eT2DM, type 2 diabetes mellitus; DR, diabetic retinopathy; HbA1c, glycated haemoglobin; BMI, body mass index; MAP, mean arterial pressure; HDL, high-density lipoprotein; LDL, low-density lipoprotein; IHD, ischaemic heart disease; CeVD, cerebrovascular disease; DFU, diabetic foot ulcer.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMedian time-to-DR by independent variables\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 2 summarises the median time-to-DR across categories of the independent variables, along with the corresponding log-rank test results. Median time-to-DR tended to increase with age, rising from 61 months among those aged \u0026lt;30 years to 75 months among individuals aged \u0026ge;60 years (p\u0026lt;0.001). Males demonstrated a slightly longer median time-to-DR compared to females (77 vs 73 months, p\u0026lt;0.001). Differences were also evident across ethnic groups, with Malays exhibiting a longer median survival (76 months), while comparatively shorter durations were observed among Indians (72 months) and those classified as others (60 months), suggesting potential underlying disparities.\u003c/p\u003e\n\u003cp\u003eWith respect to clinical characteristics, patients with hypertension and dyslipidaemia had shorter DR-free survival compared to those without these conditions (p\u0026lt;0.001). Duration of diabetes emerged as one of the most influential factors, where individuals with more than 10 years of disease had a markedly shorter median time-to-DR (46 months) compared to those with \u0026le;10 years (77 months), with strong statistical significance (p\u0026lt;0.001). Glycaemic control also played an important role, as patients with good HbA1c control had a longer median survival time (85 months), whereas those with intermediate and poor control had shorter durations (75 and 73 months, respectively; p\u0026lt;0.001). Additionally, high waist circumference and positive urine protein were associated with reduced time-to-DR, suggesting the impact of metabolic and renal factors on disease progression.\u003c/p\u003e\n\u003cp\u003eIn contrast, some variables did not demonstrate significant differences in time-to-DR. These included BMI, urine microalbumin, total cholesterol, triglycerides, and LDL, all of which had p-values greater than 0.05, indicating no statistically significant variation in median survival across their categories. Regarding treatment factors, insulin use showed a significant difference, with those not receiving insulin experiencing a shorter median time-to-DR (72 months vs 76 months, p\u0026lt;0.001), while metformin use showed a modest but statistically significant difference (p=0.008).\u003c/p\u003e\n\u003cp\u003eThe presence of diabetes-related complications was consistently associated with shorter DR-free survival. Patients with IHD, CeVD, nephropathy, and DFU exhibited significantly reduced median time-to-DR compared to those without these conditions (all p\u0026lt;0.001). Among these, nephropathy and DFU showed particularly marked reductions, reflecting the interconnected nature of microvascular and macrovascular complications in accelerating disease progression. Collectively, these findings emphasise that the time-to-DR is shaped by a complex interplay of demographic characteristics, disease burden, metabolic control, and existing complications.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u003c/strong\u003e Median time-to-DR for all independent variables\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"616\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" rowspan=\"2\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndependent Variables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" style=\"width: 212px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian time-to-DR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLog-rank test\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMonths\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eX\u0026sup2; (df)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eA) Sociodemographic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e27.5 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u0026lt; 30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e44 - 77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e30 - 39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e59 - 66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e40 - 49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e66 - 77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e50 - 59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e70 - 77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u0026ge; 60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e73 - 76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e13.1 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e70 - 75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e74 - 79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eEthnic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e22.1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eMalay\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e74 - 77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eChinese\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e69 - 76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eIndian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e66 - 77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e52 - 67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eB) Clinical\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e43.9 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e65 - 76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e73 - 76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eDyslipidaemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e155.7 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e71 - 82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e72 - 75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eMAP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e6.4 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e74 - 79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e71 - 190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e70 - 75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eDuration of diabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e205.7 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u0026le; 10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e75 - 78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u0026gt; 10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e44 - 47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e4.9 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.178\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e70 - 75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eUnderweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e73 - 78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eOverweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e73 - 82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eObese\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e69 - 92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eWaist circumference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e9.3 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e75 - 80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e71 - 76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eUrine microalbumin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e0.2 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.643\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e68 - 75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e74 - 79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eUrine protein\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e125.8 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e74 - 79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e69 - 74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 2: \u003cem\u003eContinued\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"616\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" rowspan=\"2\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndependent Variables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" style=\"width: 212px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian time-to-DR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLog-rank test\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMonths\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eX\u0026sup2; (df)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHbA1c\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e27.9 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eGood control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e81 - 88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eIntermediate control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e72 - 77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePoor control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e70 - 75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eTotal cholesterol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e2.6 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e73 - 76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e74 - 79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eTriglycerides\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e0.009 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.925\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e72 - 77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e73 - 78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e32.1 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e76 - 81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e71 - 74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eLDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e0.029 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.865\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e74 - 79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e71 - 76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC) Medication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eMetformin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e7.1 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e73 - 76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e73 - 79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eSulphonylureas\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e2.5 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.111\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e73 - 78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e72 - 77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eInsulin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e157.6 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e73 - 78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e69 - 74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eD) Complication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eIHD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e25.7 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e73 - 76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e67 - 76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eCeVD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e37.6 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e74 - 77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e54 - 65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNephropathy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e279.6 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e74 - 79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e66 - 61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eDFU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e35.1 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e74 - 77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e57 - 70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eAmputation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003e0.6 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.413\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e73 - 76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 224px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e68 - 85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eDR, diabetic retinopathy; CI, confidence interval; df, degree of freedom; HbA1c, glycated haemoglobin; BMI, body mass index; MAP, mean arterial pressure; HDL, high-density lipoprotein; LDL, low-density lipoprotein; IHD, ischaemic heart disease; CeVD, cerebrovascular disease; DFU, diabetic foot ulcer.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePrognostic factors associated with time-to-DR\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 3 summarizes the results of both simple and multiple Cox proportional hazards regression analyses examining the association between various factors and the time-to-DR. In the univariable analysis, several sociodemographic variables appeared to be associated with DR risk. Older age groups and male sex showed increased hazards, and individuals of Indian ethnicity had a higher risk compared to Malays. However, after adjustment in the multivariable model, age and gender were no longer statistically significant, suggesting that their apparent effects were confounded by other clinical and disease-related factors. Ethnicity, on the other hand, remained independently associated with DR, with both Chinese and Indian patients were statistically significant increased risk compared to Malays.\u003c/p\u003e\n\u003cp\u003eClinical variables such as hypertension and dyslipidaemia remained significant predictors after adjustment, indicating that patients with these comorbidities had a higher hazard of developing DR. Duration of diabetes emerged as a key determinant, with individuals having more than 10 years of disease nearly twice as likely to develop DR compared to those with a shorter duration. Measures reflecting metabolic and renal status also contributed independently in which increased waist circumference and the presence of urine protein were both associated with higher risk. Poor glycaemic control remained a significant predictor in the adjusted model, reinforcing the central role of sustained hyperglycaemia in accelerating microvascular damage.\u003c/p\u003e\n\u003cp\u003eMedication factors further contributed to the overall risk profile. Patients not receiving metformin had a slightly higher hazard of DR, while those not on insulin therapy showed a more pronounced increase in risk. These findings likely reflect differences in disease severity, treatment intensity, and clinical management pathways rather than direct causal effects of the medications themselves. The use of sulphonylureas was not significantly associated with DR in the final model, suggesting a limited independent role after accounting for other variables. The presence of diabetes-related complications demonstrated strong and independent associations with DR. Patients with IHD, CeVD, nephropathy, and DFU had significantly higher hazards of developing DR. These findings highlight the clustering of microvascular and macrovascular complications in patients with more advanced disease. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u003c/strong\u003e Univariable and multivariable analysis of prognostic factors of DR among adults with T2DM in Johor\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"860\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndependent variables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" style=\"width: 335px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSimple Cox proportional hazard regression\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" style=\"width: 335px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMultiple Cox proportional hazard regression\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegression\u0026nbsp;\u003cbr\u003e\u0026nbsp;coefficient (b)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 137px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCrude HR\u0026nbsp;\u003cbr\u003e\u0026nbsp;(95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegression\u0026nbsp;\u003cbr\u003e\u0026nbsp;coefficient (b)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 137px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjusted HR\u0026nbsp;\u003cbr\u003e\u0026nbsp;(95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eA) Sociodemographic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u0026lt; 30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e30 - 39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.391\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.47 (0.77, 2.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.239\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.394\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.48 (0.77, 2.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.235\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e40 - 49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.508\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.66 (0.88, 3.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.42 (0.76, 2.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.271\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e50 - 59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.616\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.85 (0.99 - 3.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.387\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.47 (0.79, 2.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.224\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u0026ge; 60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.689\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.99 (1.10, 3.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.588\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.80 (0.97, 3.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.09 (1.04, 1.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.050\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.05 (1.00, 1.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eEthnic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eMalay\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eChinese\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.05 (0.99, 1.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.12 (1.05, 1.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eIndian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.23 (1.12, 1.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.10 (1.01, 1.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.041\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e0.99 (0.60, 1.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.993\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.13 (0.68, 1.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.636\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eB) Clinical\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.278\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.32 (1.21, 1.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.20 (1.10, 1.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eDyslipidaemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.445\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.56 (1.45, 1.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.25 (1.16, 1.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eMAP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-0.787\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e0.45 (0.20, 1.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.058\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.04 (0.99, 1.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eDuration of diabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u0026le; 10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u0026gt; 10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.607\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.83 (1.68, 1.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.673\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.96 (1.79, 2.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;Table 3: \u003cem\u003eContinued\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"860\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndependent variables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" style=\"width: 335px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSimple Cox proportional hazard regression\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" style=\"width: 335px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMultiple Cox proportional hazard regression\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegression\u0026nbsp;\u003cbr\u003e\u0026nbsp;coefficient (b)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 137px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCrude HR\u0026nbsp;\u003cbr\u003e\u0026nbsp;(95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegression\u0026nbsp;\u003cbr\u003e\u0026nbsp;coefficient (b)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 137px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjusted HR\u0026nbsp;\u003cbr\u003e\u0026nbsp;(95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eUnderweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.00 (0.95, 1.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.918\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eOverweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-0.073\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e0.93 (0.86, 1.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eObese\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e0.94 (0.80, 1.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.524\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eWaist circumference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.077\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.08 (1.03, 1.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.076\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.08 (1.02, 1.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eUrine microalbumin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.01 (0.95, 1.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.646\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eUrine protein\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.33 (1.26, 1.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.09 (1.04, 1.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eHbA1c\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eGood control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eIntermediate control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-0.073\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e0.93 (0.86, 1.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.032\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.03 (0.96, 1.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.363\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003ePoor control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.10 (1.03, 1.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.11 (1.03, 1.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eTotal cholesterol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.04 (0.99, 1.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eTriglicerides\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e0.99 (0.94, 1.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.926\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eHDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.15 (1.09, 1.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.02 (0.97, 1.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.455\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eLDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.01 (0.95, 1.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.866\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 3: \u003cem\u003eContinued\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"860\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndependent variables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" style=\"width: 335px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSimple Cox proportional hazard regression\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" style=\"width: 335px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMultiple Cox proportional hazard regression\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegression\u0026nbsp;\u003cbr\u003e\u0026nbsp;coefficient (b)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 137px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCrude HR\u0026nbsp;\u003cbr\u003e\u0026nbsp;(95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegression\u0026nbsp;\u003cbr\u003e\u0026nbsp;coefficient (b)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 137px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjusted HR\u0026nbsp;\u003cbr\u003e\u0026nbsp;(95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC) Medication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eMetformin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.075\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.07 (1.02, 1.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.068\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.07 (1.01, 1.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.026\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eSulphonylureas\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-0.041\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e0.96 (0.91, 1.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eInsulin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.37 (1.31, 1.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.313\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.37 (1.28, 1.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eD) Complication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eIHD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.20 (1.11, 1.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.30 (1.21, 1.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eCeVD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.471\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.60 (1.37, 1.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.21 (1.04, 1.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNephropathy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.435\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.54 (1.46, 1.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.578\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.78 (1.69, 1.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eDFU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.375\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.45 (1.28, 1.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.652\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.92 (1.67, 2.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eAmputation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003eref.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" style=\"width: 191px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.082\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1.08 (0.89, 1.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.418\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 137px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 75px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eT2DM, type 2 diabetes mellitus; DR, diabetic retinopathy; HR, hazard ratio; CI, confidence interval; ref., reference; HbA1c, glycated haemoglobin; BMI, body mass index; MAP, mean arterial pressure; HDL, high-density lipoprotein; LDL, low-density lipoprotein; IHD, ischaemic heart disease; CeVD, cerebrovascular disease; DFU, diabetic foot ulcer.\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study provides important local evidence on the timing and predictors of DR among adults with T2DM in Johor. The overall median time-to-DR was approximately 75 months, suggesting that a substantial proportion of patients developed retinopathy within about six years T2DM diagnosis. This finding supports the concept that DR is not merely a late complication, but a progressive neurovascular disease that may emerge relatively early when metabolic and vascular risks are not adequately controlled [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Similar cohort-based evidence has shown that diabetic complications can occur within the first few years after diagnosis, highlight that DR prevalence is strongly related to diabetes duration and glycaemic exposure [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDuration of diabetes was one of the strongest prognostic factors in this study, with patients who had diabetes for more than 10 years showing nearly twice the hazard of developing DR compared with those with shorter disease duration. This is biologically plausible because prolonged hyperglycaemia causes cumulative retinal microvascular injury through oxidative stress, advanced glycation end-product formation, inflammation, endothelial dysfunction, capillary basement membrane thickening, and pericyte loss [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Over time, these processes impair retinal perfusion, promote vascular leakage, and eventually contribute to non-proliferative and proliferative DR [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. This finding is consistent with the American Diabetes Association Standards of Care, which state that DR prevalence is strongly related to diabetes duration, and with recent prediction studies identifying diabetes duration as a key predictor of retinopathy development [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePoor glycaemic control was independently associated with DR in this study, reinforcing the central role of chronic hyperglycaemia in retinal damage. Hyperglycaemia activates multiple biochemical pathways, including the polyol pathway, protein kinase C activation, oxidative stress, inflammation, and vascular endothelial growth factor expression, all of which contribute to retinal capillary leakage, ischaemia, and neovascularisation [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The finding is aligned with recent prognostic studies showing that HbA1c remains one of the most consistent predictors of DR and retinal disease progression [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. However, the modest adjusted effect size in this study may reflect the categorisation of HbA1c, single-point HbA1c measurement, or residual confounding from diabetes duration, treatment intensity, and comorbid vascular disease.\u003c/p\u003e \u003cp\u003eHypertension and dyslipidaemia remained significant predictors after adjustment, indicating that DR in this population is shaped not only by glycaemic exposure but also by broader cardiometabolic risk. Hypertension accelerate retinal endothelial injury by increasing shear stress, disrupting autoregulation, and worsening capillary permeability [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Dyslipidaemia contribute to hard exudate formation, retinal inflammation, and diabetic macular oedema through lipid leakage and endothelial dysfunction [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. These findings are consistent with established evidence that blood pressure and lipid abnormalities are important modifiable risk factors for diabetic eye disease [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. The high prevalence of hypertension and dyslipidaemia among patients with DR in this study also suggests that integrated cardiovascular risk management should be considered part of DR prevention rather than a separate clinical agenda.\u003c/p\u003e \u003cp\u003eRenal indicators, particularly urine protein and nephropathy, were strongly associated with DR. This finding reflects the shared microvascular pathogenesis between diabetic kidney disease and retinal disease. Both conditions arise from chronic hyperglycaemia-induced endothelial dysfunction, basement membrane thickening, oxidative stress, and inflammatory injury affecting small vessels [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. The strong association between nephropathy and DR is therefore clinically meaningful because kidney involvement may act as a marker of systemic microvascular damage. Recent study also identified diabetic nephropathy as an important predictor of retinopathy progression, supporting the interpretation that renal disease and retinal disease frequently cluster in patients with advanced vascular injury [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eChinese and Indian ethnicity remained independently associated with higher DR risk compared with Malay ethnicity after adjustment. This finding suggests that ethnic differences may not be fully explained by measured clinical variables alone. Possible explanations include differences in genetic susceptibility, diabetes phenotype, health-seeking behaviour, screening uptake, socioeconomic factors, access to care, diet, and long-term metabolic control [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Previous study also reported ethnic variation in DR burden, supporting the need to interpret ethnicity as a complex marker of biological, behavioural, and health-system influences rather than a purely genetic determinant [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePatients not receiving metformin and those not receiving insulin had higher hazards of DR in this study. These findings should be interpreted cautiously because medication variables in observational surveillance data may reflect treatment pathways, disease severity, contraindications, adherence, prescribing practice, or timing of therapy initiation rather than direct causal effects. For example, patients not receiving insulin may include individuals with suboptimal treatment intensification, delayed escalation, or poorer continuity of care, which may increase cumulative glycaemic burden [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Similarly, the apparent protective pattern among metformin users may partly reflect its role as first-line therapy and its broader metabolic effects, although causal inference cannot be established without more detailed longitudinal treatment data [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe associations between DR and IHD, CeVD, nephropathy, and DFU suggest that retinopathy occurs within a wider context of systemic vascular disease. DFU showed the largest adjusted association, followed by nephropathy, indicating that patients with established complications may represent a high-risk subgroup with more severe endothelial dysfunction, inflammation, vascular insufficiency, and prolonged metabolic exposure [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. This pattern is consistent with the understanding of T2DM as a systemic metabolic disorder affecting both microvascular and macrovascular beds through chronic hyperglycaemia, insulin resistance, and inflammation, leading to high morbidity [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Clinically, these findings support the need for more intensive retinal surveillance among patients with existing diabetes-related complications, especially nephropathy and diabetic foot disease.\u003c/p\u003e \u003cp\u003e \u003cb\u003eStrengths and limitations\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThis study offers several key strengths. Firstly, it drew upon a large, population-based dataset from the Johor NDR, resulting in a sample size of nearly 48,000 patients. This considerably improves statistical power, enhances the precision of estimates, and supports the generalisability of the findings to routine clinical practice in Malaysia. Secondly, the retrospective cohort design, coupled with survival analysis, enabled the evaluation of time-to-DR, thereby providing deeper insight into disease progression beyond what cross-sectional studies can offer. The use of Kaplan\u0026ndash;Meier methods and Cox proportional hazards models also ensured appropriate handling of censored observations and facilitated the identification of independent prognostic factors. Lastly, the inclusion of a broad range of sociodemographic, clinical, treatment-related, and complication variables allowed for a more comprehensive assessment of potential determinants, while enabling adjustment for multiple confounders in the multivariable analysis.\u003c/p\u003e \u003cp\u003eDespite the strengths of this study, several important limitations remain. First, although this study identified key prognostic factors for time-to-DR, the analysis was limited to routinely available surveillance variables and did not capture more granular or dynamic risk indicators such as longitudinal HbA1c trends, glycaemic variability, time-in-range, or inflammatory biomarkers, all of which are increasingly recognised as important in the pathogenesis of microvascular complications. Second, the categorisation of continuous variables may have obscured potential dose\u0026ndash;response relationships and threshold effects, limiting deeper understanding of how incremental changes in risk factors influence DR onset. Third, the registry-based nature of the data did not allow differentiation of DR severity (e.g., non-proliferative vs proliferative stages), thereby restricting insights into disease progression beyond initial onset. In addition, potential influences of health system factors such as screening frequency, access to ophthalmological services, and adherence to follow-up were not captured, which may contribute to variability in the timing of DR detection. Finally, while ethnic differences were observed, the underlying mechanisms whether biological, behavioural, or socioeconomic remain unclear and warrant further investigation.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eFuture research recommendations\u003c/h2\u003e \u003cp\u003eFuture research should aim to build on these findings by incorporating longitudinal and more detailed clinical data to better characterise the trajectory of DR development. Prospective cohort studies or enhanced registry linkages integrating laboratory trends, medication adherence, lifestyle factors, and retinal imaging data would allow more precise modelling of risk and disease progression. The application of advanced analytical approaches, including machine learning and dynamic prediction models, may further improve risk stratification and support the development of personalised screening intervals.\u003c/p\u003e \u003cp\u003eAdditionally, future studies should explore the progression of DR severity, not just onset, to better inform clinical decision-making and resource allocation. Investigating ethnic disparities in DR through mixed-methods or multidisciplinary approaches could help disentangle the contributions of genetic susceptibility, cultural practices, and healthcare access. Finally, interventional studies evaluating the effectiveness of targeted screening, early treatment optimisation, and integrated cardiometabolic management strategies would be valuable in translating epidemiological findings into improved patient outcomes within the Malaysian context.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, this study demonstrates that DR develops relatively early among adults with T2DM in Johor, with a median time of approximately six years from diagnosis, highlighting the need for timely and sustained screening. The findings highlight that longer diabetes duration, poor glycaemic control, hypertension, dyslipidaemia, renal involvement, and the presence of other diabetes-related complications are key determinants of earlier DR onset, reflecting the cumulative impact of metabolic and vascular dysfunction. These results emphasise the importance of integrated risk factor management and early identification of high-risk individuals to delay disease progression, and support public health planning aimed at reducing the burden of DR in Malaysia.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eContributors\u003c/h2\u003e\n\u003cp\u003eMMST contributed to the conceptualisation, project administration, data curation, methodology, formal analysis, draft writing and editing. MRI contributed to the methodology, formal analysis, project administration, draft review and responsible for the overall content as guarantor. SMY contributed to the methodology and draft review. TRR and AARA both contributed to the draft review. All authors have read and approved the final manuscript.\u003c/p\u003e\n\u003ch2\u003eCompeting interests\u003c/h2\u003e\n\u003cp\u003eNone declared.\u003c/p\u003e\n\u003ch2\u003ePatient and public involvement\u003c/h2\u003e\n\u003cp\u003ePatients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePatient consent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003ch2\u003eEthics approval\u003c/h2\u003e\n\u003cp\u003eThis study was registered in the National Medical Research Register (registration number NMRR ID-25-03490-2XL [IIR]). Ethical approval was obtained from the Medical Research Ethics Committee (MREC) of the Ministry of Health Malaysia. The study was conducted in accordance with the principles of the Declaration of Helsinki and relevant local regulatory guidelines. Since the research was based on secondary data and patient identifying information had been stripped from the dataset for anonymity, thus, the requirement to obtain informed consent to participate was waived by the Research Ethics Committee ((REC/12/2025 (PG/EX/101)), Universiti Teknologi MARA (UiTM).\u003c/p\u003e\n\u003ch2\u003eProvenance and peer review\u003c/h2\u003e\n\u003cp\u003eNot commissioned; externally peer reviewed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eORCID iD\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMuhammad Muaz Shahriman Teruna \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://orcid.org/0009-0005-9298-2367\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eTajul Rosli Razak \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://orcid.org/0000-0002-6389-8108\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eSiti Munira Yasin \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://orcid.org/0000-0001-9072-5053\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eAbdullah Ashraf Rafique Ali \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://orcid.org/0000-0003-3969-9413\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eMuhammad Muzzammil Mohamad Salleh \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://orcid.org/0009-0007-1558-1943\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eMohamad Zuhair Mohamed Yusoff \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://orcid.org/0009-0003-9266-9237\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eMuhammad Hariz \u0026lsquo;Ammar Khebir \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://orcid.org/0009-0003-1994-4044\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eNur Adilla Che Rameli \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://orcid.org/0009-0004-2893-0004\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eMuhammad Irfan Mohd Sallehhuddin \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://orcid.org/0009-0002-7523-2175\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eMuhammad Syazni Mohamad Asraff \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://orcid.org/0009-0006-7915-6842\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eMohamad Rodi Isa \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://orcid.org/0000-0002-8979-7794\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThe authors have not declared a specific grant for this research from any funding agency in the public, commercial or not- for- profit sectors.\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eMMST contributed to the conceptualization, project administration, data curation, methodology, formal analysis, draft writing and editing. MRI contributed to the methodology, formal analysis, project administration, draft review and responsible for the overall content as guarantor. SMY contributed to the methodology and draft review. TRR and AARA both contributed to the draft review. All authors have read and approved the final manuscript.\u003c/p\u003e\n\u003ch2\u003eAcknowledgement\u003c/h2\u003e\n\u003cp\u003eWe thank the Director- General of Health Malaysia for the permission to publish this paper. We also thank Johor State Health Department for the data provision.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eData availability statement :Data can be obtained from a third party and are not publicly available. The data that produced the findings of this study are available in the Johor\u0026rsquo;s NDR, but restrictions may apply in requesting the data. Data are, however, available from the authors on reasonable request and with permission from the Johor\u0026rsquo;s State Health Department.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBulum T, Tomic M, Vrabec R, Brkljacic N, Ljubic S. Systolic and Diastolic Blood Pressure Are Independent Risk Factors for Diabetic Retinopathy in Patients with Type 2 Diabetes. Biomedicines. 2023;11(8).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAnsari P, Tabasumma N, Snigdha NN, Siam NH, Panduru RVNRS, Azam S, et al. Diabetic Retinopathy: An Overview on Mechanisms, Pathophysiology and Pharmacotherapy. Diabetology. 2022;3(1):159\u0026ndash;75.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSafiri S, Karamzad N, Kaufman JS, Bell AW, Nejadghaderi SA, Sullman MJM, et al. Prevalence, Deaths and Disability-Adjusted-Life-Years (DALYs) Due to Type 2 Diabetes and Its Attributable Risk Factors in 204 Countries and Territories, 1990\u0026ndash;2019: Results From the Global Burden of Disease Study 2019. Front Endocrinol (Lausanne). 2022;13:838027.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSanz-Canovas J, Ricci M, Cobos-Palacios L, Lopez-Sampalo A, Hernandez-Negrin H, Vazquez-Marquez M, et al. Effects of a New Group of Antidiabetic Drugs in Metabolic Diseases. Rev Cardiovasc Med. 2023;24(2):36.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUsman M, Khan G, Wassan AA, Zulfiqar A, Jahan Zaib HM. Frequency of Retinopathy in Newly Diagnosed Type 2 Diabetes Mellitus. Pakistan J Med Health Sci. 2022;16(11):558\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRehman M, Hussain J, Ahmad I, Ahmad A, Farhan M, Humayun J. Frequency of Diabetic Retinopathy Amongst Type 2 Diabetes Mellitus Patients. Pakistan J Med Health Sci. 2022;16(12):631\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMaluleke KD, Ntimana CB, Mashaba RG, Seakamela KP, Maimela E. Associated factors of diabetic retinopathy in type 1 and 2 diabetes in Limpopo province in South Africa. Front Clin Diabetes Healthc. 2024;5:1319840.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSurasmiati A, Suryathi A, Andayani A. Serum microRNA-126 expression as a biomarker of diabetic retinopathy. Universa Med. 2023;42(2):121\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFirouzabadi DF, Poopak A, Samimi S, Deravi N, Nakhaei P, Sheikhy A, et al. Glycemic profile variability as an independent predictor of diabetic retinopathy in patients with type 2 diabetes: a prospective cohort study. Front Endocrinol (Lausanne). 2024;15:1383345.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBhatti SA, Ahmad HM, Khan MA, Babar ZU, Rafe A, Ahmad W. 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Household income and basic amenities survey report by state and administrative district Selangor 2020 [Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.dosm.gov.my/portal-main/release-archive/household-income-survey-report--malaysia--states\u003c/span\u003e\u003cspan address=\"https://www.dosm.gov.my/portal-main/release-archive/household-income-survey-report--malaysia--states\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMinistry of Health Malaysia. Clinical Practice Guideline: Management of Obesity (Second Edition). Ministry of Health, Malaysia; 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbera RG, Demesse ES, Boko WD. Evaluation of glycemic control and related factors among outpatients with type 2 diabetes at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study. BMC Endocr Disord. 2022;22(1):54.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNaserrudin NA, Jeffree MS, Kaur N, Syed Abdul Rahim SS, Ibrahim MY. Diabetic retinopathy among type 2 diabetes mellitus patients in Sabah primary health clinics-Addressing the underlying factors. PLoS ONE. 2022;17(1):e0261249.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArtha Dewi N, Arfan M, Rahmasari H, Kristiani Putri M, Rosandi R, Nandar Kurniawan S. Neurodegeneration as an Early Sign of Diabetic Retinopathy. MNJ (Malang Neurol Journal). 2022;8(1):58\u0026ndash;63.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePerkins BA, Lovblom LE, Lanctot SO, Lamb K, Cherney DZI. Discoveries from the study of longstanding type 1 diabetes. Diabetologia. 2021;64(6):1189\u0026ndash;200.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuo X, Xing Y, Jin W. Role of ADMA in the pathogenesis of microvascular complications in type 2 diabetes mellitus. Front Endocrinol (Lausanne). 2023;14:1183586.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi Y, Liu Y, Liu S, Gao M, Wang W, Chen K, et al. Diabetic vascular diseases: molecular mechanisms and therapeutic strategies. Signal Transduct Target Ther. 2023;8(1):152.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmerican Diabetes Association Professional Practice C. 12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes-2025. Diabetes Care. 2025;48(1 Suppl 1):S252-S65.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMorya AK, Ramesh PV, Nishant P, Kaur K, Gurnani B, Heda A, et al. Diabetic retinopathy: A review on its pathophysiology and novel treatment modalities. World J Methodol. 2024;14(4):95881.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGao JJ, Liu H, Zhang TY, Wang YW. A simple and accessible diabetic retinopathy risk prediction model: Establishment and validation in a hospital-based cohort of type 2 diabetes patients. Diabetes Res Clin Pract. 2025;224:112211.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDel Pinto R, Mule G, Vadala M, Carollo C, Cottone S, Agabiti Rosei C et al. Arterial Hypertension and the Hidden Disease of the Eye: Diagnostic Tools and Therapeutic Strategies. Nutrients. 2022;14(11).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHiran HM, Kamath A, Mendonca TM, Rodrigues GR, Nayak RR, Kamath G, et al. Association of serum lipid profile and other systemic risk factors with retinal hard exudates in diabetic retinopathy. Int Ophthalmol. 2024;44(1):338.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRosu CD, Bratu ML, Stoicescu ER, Iacob R, Hategan OA, Ghenciu LA et al. Cardiovascular Risk Factors as Independent Predictors of Diabetic Retinopathy in Type II Diabetes Mellitus: The Development of a Predictive Model. Med (Kaunas). 2024;60(10).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLu X, Xie Q, Pan X, Zhang R, Zhang X, Peng G, et al. Type 2 diabetes mellitus in adults: pathogenesis, prevention and therapy. Signal Transduct Target Ther. 2024;9(1):262.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYip W, Ong PG, Teo BW, Cheung CY, Tai ES, Cheng CY, et al. Retinal Vascular Imaging Markers and Incident Chronic Kidney Disease: A Prospective Cohort Study. Sci Rep. 2017;7(1):9374.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang Y, Tan NC, Jafar TH. Ethnic variation, socioeconomic status, and factors associated with cardio-metabolic multi-morbidity among uncontrolled hypertension in multiethnic Singapore. J Hum Hypertens. 2022;36(2):218\u0026ndash;27.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSerener A, Serte S. Geographic variation and ethnicity in diabetic retinopathy detection via deeplearning. Turkish J Electr Eng Comput Sci. 2020;28(2):664\u0026ndash;78.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGavin JR, Abaniel RM, Virdi NS. Therapeutic Inertia and Delays in Insulin Intensification in Type 2 Diabetes: A Literature Review. Diabetes Spectr. 2023;36(4):379\u0026ndash;84.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSportelli C, Urso D, Jenner P, Chaudhuri KR. Metformin as a Potential Neuroprotective Agent in Prodromal Parkinson's Disease-Viewpoint. Front Neurol. 2020;11:556.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHong AT, Luu IY, Tan T-W, Toy BC. Impact of diabetic foot ulcers and nephropathy on risk of treatment-warranted diabetic eye disease: A retrospective cohort study. AJO Int. 2026;3(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChawla A, Chawla R, Jaggi S. Microvasular and macrovascular complications in diabetes mellitus: Distinct or continuum? Indian J Endocrinol Metab. 2016;20(4):546\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"boph","sideBox":"Learn more about [BMC Ophthalmology](http://bmcophthalmol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/boph","title":"BMC Ophthalmology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Diabetic retinopathy, Type 2 diabetes mellitus, Time-to-event, Prognostic factors","lastPublishedDoi":"10.21203/rs.3.rs-9556443/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9556443/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDiabetic retinopathy is a major microvascular complication of type 2 diabetes mellitus and remains a leading cause of preventable visual impairment worldwide. Understanding the time to onset of diabetic retinopathy and its prognostic factors is essential to optimise screening strategies and guide early intervention. This study aimed to determine the time to development of diabetic retinopathy and identify its associated prognostic factors among adults with type 2 diabetes mellitus in Johor, Malaysia.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA retrospective cohort study was conducted using secondary data from the National Diabetes Registry of Johor from 2015 to 2019. Adults aged 18 years and above with type 2 diabetes mellitus and no diabetic retinopathy at baseline were included. Time-to-event was defined as the duration from the date of type 2 diabetes mellitus diagnosis to the first diagnosis of diabetic retinopathy. All variables were categorised and analysed using survival analysis techniques. Kaplan\u0026ndash;Meier methods were used to estimate diabetic retinopathy-free survival, with differences assessed using the log-rank test. Cox proportional hazards regression analyses were performed to identify independent prognostic factors.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 47,953 patients were included, of whom 6,402 (13.3%) developed diabetic retinopathy during follow-up. The overall median time to diabetic retinopathy was approximately 75 months. Significant differences in diabetic retinopathy-free survival were observed across several variables (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). In the multivariable Cox regression model, duration of diabetes greater than 10 years (AHR\u0026thinsp;=\u0026thinsp;1.96, 95% CI: 1.79\u0026ndash;2.14), hypertension (AHR\u0026thinsp;=\u0026thinsp;1.20, 95% CI: 1.10\u0026ndash;1.31), dyslipidaemia (AHR\u0026thinsp;=\u0026thinsp;1.25, 95% CI: 1.16\u0026ndash;1.34), high waist circumference (AHR\u0026thinsp;=\u0026thinsp;1.08, 95% CI: 1.02\u0026ndash;1.14), positive urine protein (AHR\u0026thinsp;=\u0026thinsp;1.09, 95% CI: 1.04\u0026ndash;1.15), poor glycaemic control (AHR\u0026thinsp;=\u0026thinsp;1.11, 95% CI: 1.03\u0026ndash;1.20), and complications such as nephropathy (AHR\u0026thinsp;=\u0026thinsp;1.78, 95% CI: 1.69\u0026ndash;1.88) and diabetic foot ulcer (AHR\u0026thinsp;=\u0026thinsp;1.92, 95% CI: 1.67\u0026ndash;2.20) were independently associated with an increased risk of diabetic retinopathy. Ethnicity also remained significant, with Chinese and Indian patients demonstrating higher risk compared to Malays.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eDiabetic retinopathy develops within a relatively short duration following type 2 diabetes mellitus diagnosis and is influenced by a combination of metabolic, clinical, and complication-related factors. Early risk stratification and integrated management of modifiable risk factors are essential to delay the onset of diabetic retinopathy. These findings provide important real-world evidence to support targeted screening and public health strategies in Malaysia.\u003c/p\u003e","manuscriptTitle":"Time to diabetic retinopathy and its prognostic factors among adults with type 2 diabetes mellitus in Johor, Malaysia from 2015 to 2019: a retrospective cohort study using surveillance data","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-18 08:02:04","doi":"10.21203/rs.3.rs-9556443/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-24T11:03:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"299207867294970710164769501153438711673","date":"2026-05-14T09:12:12+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-05-08T08:07:15+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-05-08T07:29:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-05-07T13:55:10+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-05-06T03:42:40+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Ophthalmology","date":"2026-05-06T03:36:39+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"boph","sideBox":"Learn more about [BMC Ophthalmology](http://bmcophthalmol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/boph","title":"BMC Ophthalmology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"23e2cd85-df87-4d1c-809d-c1e8c8c11ecd","owner":[],"postedDate":"May 18th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-24T11:03:03+00:00","index":28,"fulltext":""},{"type":"reviewerAgreed","content":"299207867294970710164769501153438711673","date":"2026-05-14T09:12:12+00:00","index":25,"fulltext":""},{"type":"reviewersInvited","content":"9","date":"2026-05-08T08:07:15+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-05-08T07:29:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-05-07T13:55:10+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-05-06T03:42:40+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Ophthalmology","date":"2026-05-06T03:36:39+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-18T08:02:04+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-18 08:02:04","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9556443","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9556443","identity":"rs-9556443","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}