Table 3

Biological interactions of LDL cholesterol with albuminuria and copresence of these two risk factors with statin use for the risk of cancer in type 2 diabetes

Measures of biological interactionEstimate (95% CI)
Interaction models for albuminuria and low LDL cholesterol*
    Model 1
        RERI1.32 (0.28–2.37)
        AP0.43 (0.18–0.68)
        S2.75 (1.01–7.49)
    Model 2§
        RERI1.01 (0.08–1.94)
        AP0.39 (0.11–0.68)
        S2.76 (0.78–9.71)
    Model 3
        RERI1.05 (0.04–2.06)
        AP0.38 (0.09–0.66)
        S2.46 (0.85–7.09)
Interaction models for LDL cholesterol <2.80 mmol/l plus albuminuria and nonuse of statins
    Model 1
        RERI4.07 (1.56–6.76)
        AP0.65 (0.42–0.89)
        S4.48 (1.26–15.91)
    Model 2§
        RERI2.55 (0.57–4.52)
        AP0.58 (0.24–0.91)
        S3.90 (0.68–22.29)
    Model 3#
        RERI2.87 (0.64–5.09)
        AP0.60 (0.29–0.90)
        S4.03 (0.82–19.78)
  • *The analysis was performed in 3,793 patients without use of statins.

  • †Adjusted for LDL cholesterol ≥3.80 mmol/l.

  • ‡Statistically significant with RERI > 0, AP > 0, or S > 1 indicating biological interaction.

  • §Further adjusted for age, sex, BMI, smoking status (current smoker plus ex-smoker), drinking status (current drinker plus ex-drinker), duration of diabetes, A1C, systolic blood pressure, HDL cholesterol, triglycerides, eGFR, and medications from enrollment to cancer, death, or censoring date, whichever came first. Medications include ACEIs or ARBs, oral antidiabetes drugs, insulin, fibrates, and other antihypertensive drugs.

  • ‖Adjusted for covariates listed in ‡, but restricted cubic spline functions were used for all the continuous covariates.

  • ¶The analysis was performed in 3,793 patients without use of statins plus 1,483 patients who used statins during follow-up.

  • #Stratified Cox models on deciles of propensity scores were used to adjust for likelihood of using statins during follow-up. The propensity score was calculated using a logistic regression procedure with statin use as the dependent variable and the variables listed in Table 2, footnote ¶, as independent variables.