Abstract Number: PB0045
Meeting: ISTH 2021 Congress
Background: Diabetes is the seventh leading cause of death in the U.S, yet much remains unknown about its pathogenesis. D-dimer, a fibrin degradation product, is higher in Black individuals and women. Higher concentrations are also associated with risk of several chronic diseases. We hypothesized that higher D-dimer is associated with increased diabetes risk.
Aims: We aimed to determine the association of baseline D-dimer with incident diabetes in a biracial cohort study, and to identify differences in the association by race or gender.
Methods: The study included 3235 participants of the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort. All were diabetes-free at baseline, and they were followed for a median of 9.5 years for diabetes. Risk ratios of diabetes by baseline D-dimer were estimated, and interactions between D-dimer and race, and between D-dimer and gender were tested.
Results: About half of participants were women and 44% were Black; 434 developed diabetes over follow up (205 women, 229 men, 266 Black participants and 168 White participants). The Table shows for modeling results adjusting for age, gender, race, education and income, higher D-dimer was not associated with diabetes incidence; however, in the fully adjusted model, the risk was lower in the highest compared to the lowest quartile. The association differed by gender (p-interaction ≤0.05) but not race (p-interaction >0.10). In women, higher D-dimer was modestly associated with increased incidence of diabetes, but this was attenuated after full adjustment for risk factors (model 2). In men, D-dimer in the highest compared to the lowest quartile was associated with a 43% lower risk of diabetes in the fully adjusted model.
|p-value for trend*|
434 cases/3235 at risk
|Model 1||1.0||1.06 ( 0.82, 1.38)||0.84 ( 0.64, 1.11)||1.01 ( 0.77, 1.32)||0.6|
|Model 2||1.0||0.96 ( 0.74, 1.24)||0.74 ( 0.56, 0.97)||0.79 ( 0.61, 1.04)||0.03|
205 cases/1632 at risk
|Model 1||1.0||1.11 ( 0.74, 1.66)||0.86 ( 0.57, 1.29)||1.25 ( 0.85, 1.82)||0.5|
|Model 2||1.0||0.98 ( 0.65, 1.47)||0.76 ( 0.51, 1.13)||0.95 ( 0.66, 1.38)||0.5|
229 cases/1603 at risk
|Model 1||1.0||1.04 ( 0.74, 1.47)||0.85 ( 0.57, 1.25)||0.70 ( 0.47, 1.06)||0.06|
|Model 2||1.0||0.94 ( 0.67, 1.32)||0.69 ( 0.47, 1.01)||0.57 ( 0.38, 0.85)||0.002|
|Model 1: age, gender, race, education and income; model 2: model 1+ smoking, alcohol use, physical activity, BMI, systolic blood pressure, total cholesterol and C-reactive protein
The p-values of the interaction D-dimer*race were >0.1
The p-values of the interaction D-dimer*race were ≤ 0.05
*: p-value for trend across quartiles of D-dimer
Conclusions: Among men but not women, higher D-dimer was associated with lower risk of incident diabetes. Future studies are needed to understand biological mechanisms of this unexpected finding.
To cite this abstract in AMA style:Kamin Mukaz D, Long DL, Plante TB, Judd SE, McClure LA, Wolberg AS, Carson AP, Guo B, Cushman M. D-dimer and the Risk of Diabetes: The REasons for Geographic and Racial Differences in Stroke (REGARDS) [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/d-dimer-and-the-risk-of-diabetes-the-reasons-for-geographic-and-racial-differences-in-stroke-regards/. Accessed September 23, 2021.
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