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. 2021 Jun 1;44(6):1426-1432.
doi: 10.2337/dc20-2375.

Associations of Type 2 Diabetes Onset Age With Cardiovascular Disease and Mortality: The Kailuan Study

Maoxiang Zhao  1 , Lulu Song  2   3 , Lan Sun  4 , Miao Wang  1 , Chi Wang  1 , Siyu Yao  1 , Yao Li  1 , Cuijuan Yun  1 , Sijin Zhang  1 , Yizhen Sun  1 , Ziwei Hou  1 , Shouling Wu  5 , Hao Xue  1
Affiliations

Associations of Type 2 Diabetes Onset Age With Cardiovascular Disease and Mortality: The Kailuan Study

Maoxiang Zhao et al. Diabetes Care. .

Abstract

Objective: We aimed to explore the associations between type 2 diabetes onset age and cardiovascular disease (CVD) and all-cause mortality in the Chinese population.

Research design and methods: This study included 101,080 participants free of prevalent diabetes and CVD at baseline from the Kailuan Study. All participants were monitored biennially until 31 December 2017. During follow-up, 11,384 participants were diagnosed as having type 2 diabetes. For each case subject, one control subject was randomly selected, matched for age (± 1 years) and sex. The final analysis comprised 10,777 case-control pairs. Weighted Cox regression models were used to evaluate the average hazard ratios (AHRs) and 95% CIs of incident CVD and all-cause mortality among patients with new-onset type 2 diabetes versus control subjects across age-groups.

Results: During a median follow-up of 5.57 years, 1,794 incident events (907 CVD events, of which there were 725 strokes and 887 deaths) occurred. After adjustment for potential confounders, participants with type 2 diabetes diagnosed at age <45 years had the highest relative risks of CVD and all-cause mortality relative to the matched control subjects, with AHRs of 3.21 (95% CI 1.18-8.72) for CVD, 2.99 (95% CI 1.01-9.17) for stroke, and 4.79 (95% CI 1.95-11.76) for all-cause mortality. The risks gradually attenuated with each decade increase in type 2 diabetes onset age.

Conclusions: The relative risks of CVD and all-cause mortality differed across type 2 diabetes onset age-groups, and the associations were more evident in younger-onset type 2 diabetes.

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Figures

Figure 1
Figure 1
Flowchart of the current study.
Figure 2
Figure 2
AHRs (95% CIs) for incident CVD and all-cause mortality among patients with new-onset type 2 diabetes versus control subjects, across age-groups. The rate is per 1,000 person-years. All models were adjusted for smoking status, drinking status, hypertension, LDL-C, HDL-C, obesity, eGFR, and physical exercise. Y, years of age.
See this image and copyright information in PMC

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