2.1 Participants
The study population was from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a IONgigudinal (REACTION) study, which was a multicenter prospective observational study with the aim of evaluating chronic diseases in the Chinese population. Detailed information about the study design and protocols has been published previously17. A total of 9916 subjects from a community in Guangzhou, China signed the informed consent and were included in the baseline survey, from June to November 2011. All baseline examinations were performed in 2011, and follow-up examinations were carried out from 2014 to 2016. Of the 9,166 individuals included in baseline survey, 2,917 were lost to follow-up. Thus, a total of 6,999 participants were included in the final dataset (follow-up success rate = 71%). With a mean of 3.6 years’ follow-up, 125 subjects died and 995 subjects completed questionnaire by telephone interview. The subjects who failed to provided baseline information of albumin-to-creatinine ratio (ACR) (n=78), creatinine (n=8), FPG (n=7), PPG (n=35), OGTT 2h glucose (n=35) and HbA1c (n=19) were excluded from the analyses. The individuals who failed to provided follow-up information of ACR (n=50), creatinine (n=3), OGTT 2h glucose (n=23) and HbA1c (n=5) were excluded from the analyses. For the current study, subjects with baseline CKD were excluded (n=378). Thus, a total of 5,273 individuals were included in the current analyses. Detailed patient selection for this study is shown in Figure 1.
The study protocol was approved by the Institutional Review Board of Sun Yat-sen Memorial Hospital, Sun Yat-sen University (2014[3]). The study was performed in accordance with the principles of the Helsinki Declaration, and all participants provided written informed consent.