Diabetic retinopathy and mortality in adults with diabetes: causal mediation analysis of the role of HbA1c
Main finding · All-cause mortalityResult — go to the resultAdjusted hazard ratio 1.34 95 % CI 1.20–1.51Authors' conclusion
DR is associated with an increased risk of all-cause mortality, and this excess risk appears to be partly linked through higher HbA1c levels. These findings suggest that elevated glycemic burden may serve as one pathway connecting DR to increased mortality in adults with diabetes.
Study context
- Population
- Adults with self-reported diabetes, NHANES 2001–2018
- Participants
- 5,658 adults
- Exposure
- Diabetic retinopathy (DR) vs no DR
- Outcome
- All-cause mortality, via linkage to the National Death Index
Methodological detailsNHANES 2001-2018, Cox proportional hazards models
- NHANES 2001-2018
- Cox proportional hazards models
Main finding
All-cause mortality
Adjusted hazard ratio
1.34
95 % CI 1.20–1.51
P < 0.0001
DRvs Without DR
adjusted HR 1.34 (95 % CI 1.20–1.51); P < 0.0001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95 % CI) | P value | |
|---|---|---|---|
| All-cause mortality, highestvs lowest HbA1c tertile30 % greater risk of death | 1.30 (1.14–1.48) | P < 0.0001 | |
| 0.512Hazard ratio (log scale) |
All-cause mortality per 1 % increase in HbA1c
- HR per 1 % HbA1c increase
- 1.07 (95 % CI 1.04-1.10; P < 0.0001)
Mediation by HbA1c of DR-associated excess mortality
- Proportion of excess mortality risk associated with DR accounted for by HbA1c
- 9.1 %
Original publication
Diabetic retinopathy and mortality in adults with diabetes: causal mediation analysis of the role of HbA1c. Diabetes Res Clin Pract. Published 9 October 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →