Sherwood Forest Hospitals Foundation Trust, Nottinghamshire, UK.
QJM. 2010 Nov;103(11):881-4. doi: 10.1093/qjmed/hcq135. Epub 2010 Jul 30.
Young patients (aged < 40 years) with type 2 diabetes (T2D) have a high lifetime risk of developing cardiovascular disease (CVD). However, little is known about the CVD risk profile of this cohort in the UK primary care setting.
To determine CVD risk profile of young patients with T2D without CVD compared to older (aged >40 years) subjects.
A cross-sectional study using The Health Improvement Network (THIN) database, which contains anonymized patient information from more than 300 general practices throughout England and Wales.
T2D subjects above the age of 18 years without previous CVD and not on lipid or blood pressure lowering therapy were randomly selected. Data on glycaemic control and CVD risk factors [weight, body mass index (BMI), lipid profile] were collected.
A total of 49,919 patients with T2D were identified, of whom 2756 (0.5%) and 47,163 (99.5%) were aged below and above 40 years, respectively. Despite being at least 30 years younger (mean age: early vs. later onset; 33.8 vs. 66.9 years, P < 0.001), the proportions of adverse CVD risk profiles for young patients were similar to the older cohort with T2D. For young vs. old patients: the prevalence of BMI >25: 84.4% vs. 85.3%, P = 0.77; total cholesterol >4 mmol/l: 53.4% vs. 53.8%, P = 0.76; systolic hypertension: 58.2 vs. 58.4%, P = 0.36 and diastolic hypertension: 28.1 vs. 28.5%, P = 0.73). Glycaemic controls were similarly suboptimal between the two groups (mean HbA1c: young vs. old; 7.6% vs. 7.5%, P = 0.49). The prevalence of risk factor clustering were also similar between young vs. old patients with T2D.
Young T2D subjects possess risk factors that confer high lifetime risk for macrovascular complications, and therefore merits aggressive cardioprotective treatment.
患有 2 型糖尿病（T2D）的年轻患者（年龄<40 岁）终生罹患心血管疾病（CVD）的风险很高。然而，在英国初级保健环境中，人们对该队列的 CVD 风险状况知之甚少。
确定与年龄较大（>40 岁）的患者相比，无 CVD 的年轻 T2D 患者的 CVD 风险状况。
这是一项使用 The Health Improvement Network（THIN）数据库的横断面研究，该数据库包含来自英格兰和威尔士 300 多个全科诊所的匿名患者信息。
选择年龄在 18 岁以上、无既往 CVD 且未接受降脂或降压治疗的 T2D 患者。收集血糖控制和 CVD 危险因素[体重、体重指数（BMI）、血脂谱]的数据。
共确定了 49919 例 T2D 患者，其中 2756 例（0.5%）和 47163 例（99.5%）分别为年龄<40 岁和>40 岁的患者。尽管年轻患者至少年轻 30 岁（平均年龄：早发 vs. 晚发；33.8 岁 vs. 66.9 岁，P<0.001），但他们不良 CVD 风险特征的比例与 T2D 的老年患者相似。对于年轻患者与老年患者：BMI>25 的患病率：84.4% vs. 85.3%，P=0.77；总胆固醇>4mmol/l：53.4% vs. 53.8%，P=0.76；收缩压升高：58.2% vs. 58.4%，P=0.36；舒张压升高：28.1% vs. 28.5%，P=0.73。两组之间血糖控制也同样不理想（平均 HbA1c：年轻 vs. 老年；7.6% vs. 7.5%，P=0.49）。T2D 的年轻患者与老年患者之间的危险因素聚集患病率也相似。
年轻的 T2D 患者存在多种危险因素，这些危险因素会增加其发生大血管并发症的终生风险，因此需要积极的心脏保护治疗。
