Trends in prevalence of cardiovascular risk factors from 2002 to 2012 among youth early in the course of type 1 and type 2 diabetes. The SEARCH for Diabetes in Youth Study

Abstract

Background: Given diabetes is an important risk factor for cardiovascular disease (CVD), we examined temporal trends in CVD risk factors by comparing youth recently diagnosed with type 1 diabetes (T1D) and type 2 diabetes (T2D) from 2002 through 2012.

Methods: The SEARCH for Diabetes in Youth Study identified youth with diagnosed T1D (n = 3954) and T2D (n = 706) from 2002 to 2012. CVD risk factors were defined using the modified Adult Treatment Panel III criteria for metabolic syndrome: (a) hypertension; (b) high-density lipoprotein cholesterol ≤40 mg/dL; (c) triglycerides ≥110 mg/dL; and (d) waist circumference (WC) >90th percentile. Prevalence of CVD risk factors, stratified by diagnosis year and diabetes type, was reported. Univariate and multivariate logistic models and Poisson regression were fit to estimate the prevalence trends for CVD risk factors individually and in clusters (≥2 risk factors).

Results: The prevalence of ≥2 CVD risk factors was higher in youth with T2D than with T1D at each incident year, but the prevalence of ≥2 risk factors did not change across diagnosis years among T1D or T2D participants. The number of CVD risk factors did not change significantly in T1D participants, but increased at an annual rate of 1.38% in T2D participants. The prevalence of hypertension decreased in T1D participants, and high WC increased in T2D participants.

Conclusion: The increase in number of CVD risk factors including large WC among youth with T2D suggests a need for early intervention to address these CVD risk factors. Further study is needed to examine longitudinal associations between diabetes and CVD.

Keywords: abdominal obesity; diabetes mellitus; dyslipidemia; hypertension; metabolic syndrome.

FIGURE 1

Prevalence of individual and ≥2 CVD risk factors per year of incident diabetes from 2002 to 2012 by diabetes type. Y axis = % Prevalence; X axis = Year. *Significant at P < 0.05 (*P = 0.003 for T1D in A, P = 0.17 for T2D in A, P = 0.16 for T1D in B, P = 0.37 for T2D in B, P = 0.33 for T1D in C, P = 0.21 for T2D in C, P = 0.80 for T1D in D, *P = <0.0001 for T2D in D, P = 0.25 for T1D in E, P = 0.11 for T2D in E). A = Hypertension; B = ↓HDL-C;C = ↑WC; D = ↑TG; E = ≥2RF. Abbreviations: CVD, cardiovascular disease; HDL-C, high-density lipoprotein cholesterol; RF, risk factor; TG, triglycerides; WC, waist circumference