Observational Study
Copyright ©The Author(s) 2025.
World J Diabetes. Mar 15, 2025; 16(3): 99108
Published online Mar 15, 2025. doi: 10.4239/wjd.v16.i3.99108
Table 1 Baseline characteristics of the study participants, n (%)
VariablesTotal (n = 2505)High-sensitivity troponin T (ng/L)
P value
< 5.93
5.94-9.79
9.80-21.88
Tertile 1 (n = 839)
Tertile 2 (n = 831)
Tertile 3 (n = 835)
Age, years55.02 (0.72)47.64 (1.00)56.69 (1.09)62.99 (0.93)< 0.001
Sex< 0.001
Female1132 (44.87)569 (63.57)359 (38.07)204 (27.68)-
Male1373 (55.13)270 (36.43)472 (61.93)631 (72.32)-
Race-ethnicity0.010
Mexican American798 (8.10)313 (11.07)277 (6.98)208 (5.43)-
Non-Hispanic black537 (14.49)178 (16.02)159 (12.53)200 (14.71)-
Non-Hispanic white897 (60.58)234 (52.97)286 (60.22)377 (71.23)-
Other Hispanic158 (8.53)67 (9.92)64 (9.97)27 (4.95)-
Other race115 (8.31)47 (10.02)45 (10.30)23 (3.68)-
Poverty income ratio 2.62 (0.08)2.63 (0.15)2.72 (0.12)2.48 (0.11)0.220
BMI, kg/m232.62 (0.50)33.05 (0.61)32.69 (0.90)31.96 (0.52)0.306
Education level0.108
Low (< 9 years)683 (11.73)216 (11.02)232 (10.82)235 (13.74)-
Medium (9-13 years)1074 (47.90)362 (46.04)334 (44.80)378 (54.02)-
High (≥ 13 years)748 (40.37)261 (42.94)265 (44.38)222 (32.25)-
Smoking status0.030
Never smoker1144 (45.76)446 (51.51)360 (41.46)338 (43.06)-
Former smoker877 (32.26)214 (25.21)306 (34.64)357 (38.95)-
Current smoker484 (21.98)179 (23.28)165 (23.90)140 (17.99)-
Comorbidity
Hyperlipidemia0.948
No307 (10.33)92 (10.00)97 (10.78)118 (10.24)-
Yes2198 (89.67)747 (90.00)734 (89.22)717 (89.76)-
Hypertension0.001
No864 (39.05)375 (48.26)286 (40.55)203 (24.92)-
Yes1641 (60.95)464 (51.74)545 (59.45)632 (75.08)-
CVD< 0.001
No2064 (83.38)767 (90.46)702 (87.41)595 (69.16)-
Yes441 (16.62)72 (9.54)129 (12.59)240 (30.84)-
Alcohol intake0.510
None2094 (79.83)703 (79.11)683 (77.18)708 (83.89)-
Moderate188 (10.27)56 (9.83)75 (12.65)57 (8.10)-
Heavy223 (9.90)80 (11.07)73 (10.17)70 (8.00)-
Physical activity0.060
Inactive869 (28.65)285 (26.14)285 (25.77)299 (35.41)-
Active1636 (71.35)554 (73.86)546 (74.23)536 (64.59)-
Diabetes duration< 0.001
< 10 years1657 (69.37)653 (80.08)548 (70.91)456 (53.18)-
≥ 10 years848 (30.63)186 (19.92)283 (29.09)379 (46.82)-
Use of diabetes medications0.001
No442 (18.47)200 (24.69)154 (18.38)88 (10.23)-
Other1627 (26.07)196 (26.25)224 (27.90)207 (23.69)-
Insulin227 (9.70)62 (7.64)71 (7.50)94 (15.03)-
Oral medications1209 (45.76)381 (41.42)382 (46.21)446 (51.05)-
ACR category0.004
A1 (< 30 mg/g)1758 (73.89)617 (77.88)616 (75.15)525 (67.04)-
A2 (30-300 mg/g)600 (21.64)209 (20.30)174 (21.96)217 (23.07)-
A3 (≥ 300 mg/g)147 (4.47)13 (1.82)41 (2.89)93 (9.89)-
Diabetic kidney disease< 0.001
No1596 (67.66)612 (77.51)556 (68.63)428 (53.28)-
Yes909 (32.34)227 (22.49)275 (31.37)407 (46.72)-
HbA1c (%)7.56 (0.09)7.55 (0.18)7.55 (0.11)7.59 (0.14)0.977
Healthy eating index51.34 (0.71)50.36 (1.20)52.11 (1.07)51.77 (0.93)0.409
eGFR (mL/minute/1.73 m2)89.94 (0.79)100.45 (1.33)88.53 (1.48)77.47 (1.38)< 0.001
1Indicated drugs except diabetes medications.
Data are represented as the weighted proportion (%) or mean ± SE. BMI: Body mass index; CVD: Cardiovascular disease; ACR: Albumin-to-creatinine ratio; HbA1c: Glycated hemoglobin A1c; eGFR: Estimated glomerular filtration rate.
Table 2 Association between high-sensitivity troponin T and diabetic kidney disease in patients with type 2 diabetes mellitus
VariableDKD/total
Non-adjusted model
P valueModel I
P valueModel II
P valueModel III
P value
n
HR (95%CI)
HR (95%CI)
HR (95%CI)
HR (95%CI)
Continuous variable
hs-troponin T (ng/L)909/25051.11 (1.06-1.16)< 0.0011.11 (1.05-1.16)< 0.0011.08 (1.02-1.15)0.0171.07 (1.01-1.13)0.030
Binary variable
Tertile 1 (< 5.93)227/839Reference-Reference-Reference-Refrence-
Tertile 2 (5.94-9.79)275/8311.58 (1.00-2.48)0.0481.51 (0.91-2.50)0.1101.32 (0.82-2.13)0.2391.25 (0.77-2.02)0.350
Tertile 3 (9.80-21.88)407/8353.02 (1.87-4.88)< 0.0012.80 (1.62-4.83)< 0.0012.30 (1.20-4.41)0.0152.07 (1.13-3.80)0.022
P for trend--< 0.001-< 0.001-0.015-0.022
Model I: Adjusted for age (continuous) and sex (male or female); Model II: Adjusted for Model I plus race (Mexican American, non-Hispanic white, non-Hispanic black, Other Hispanic, other races including multi-racial), education level (< 9, 9-13, ≥ 13); body mass index (continuous), poverty income ratio (continuous), smoking status (never smoker, former smoker, current smoker), hypertension (no, yes), cardiovascular disease (no, yes), hyperlipidemia (no, yes), physical activity (inactive, active), alcohol intake (none, moderate, heavy), and estimated glomerular filtration rate(continuous); Model III: Adjusted for Model II plus diabetes duration (< 10 years, ≥ 10 years), use of diabetes medications (no, other, insulin, oral medications), healthy eating index (continuous), and glycated hemoglobin A1c (continuous); DKD: Diabetic kidney disease; HR: Hazard ratio; CI: Confidence interval; hs-troponin T: High-sensitivity troponin T.