Abstract
ObjectivesNationwide studies focusing on the impact of early-onset type 2 diabetes and obesity on the development of cardiovascular diseases (CVD) are limited in China. We aimed to investigate the association between age at diagnosis of type 2 diabetes and the risk of CVD, and to further examine the modifying effect of obesity on this association among Chinese adults.MethodsThis study included 23,961 participants with previously diagnosed diabetes from a large nationwide population-based cohort study across mainland China. With an interviewer-assisted questionnaire, we collected detailed information on CVDs. Logistic regression analysis was used to evaluate the risk of CVDs associated with age at diagnosis of diabetes.ResultsCompared with patients with late-onset diabetes (≥60 years), those with earlier-onset diabetes had increased risks for CVD, with adjusted ORs (95% CIs) of 1.72 (1.36-2.17), 1.52 (1.31-1.75) and 1.33 (1.19-1.48) for patients diagnosed aged <40, 40-49 and 50-59 years, respectively. Each 5-year earlier age at diagnosis of type 2 diabetes was significantly associated with 14% increased risk of CVD (OR, 1.14; 95%CI, 1.11-1.18). This association was more prominent for patients with obesity than those with normal body mass index (BMI). Significant interaction was detected between age at diagnosis and BMI categories on CVD risk (P for interaction=0.0457).ConclusionEarly-onset type 2 diabetes was significantly associated with higher risk of CVD, and this association was more prominent among patients with obesity.
Highlights
Type 2 diabetes has become a major health burden worldwide
We further examined the combined effects of body mass index (BMI) and age at diagnosis of diabetes on the risk of cardiovascular disease (CVD)
Characteristics of the study population according to age at diagnosis of type 2 diabetes were presented in (Table 1)
Summary
Type 2 diabetes has become a major health burden worldwide. In the past few decades, the prevalence of diabetes in China has increased dramatically, with 12.8% of adults of diabetes and 35.2% of prediabetes in 2017 [1, 2]. Type 2 diabetes was conventionally recognized as a disease of the middle-aged and elderly, a rapid growth of type 2 diabetes has been observed among younger adults and even adolescents [3, 4], especially in developing countries. The impact of age at diagnosis of type 2 diabetes on the risk of cardiovascular disease (CVD) has been investigated in previous studies [8, 9, 13,14,15,16,17], the results remain inconclusive. Some studies proposed inverse association between age at diagnosis of diabetes and risk of CVD [8, 14, 15], whereas others suggested positive [16, 17] or null association [9, 18] in prospective analyses
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