Danish Diabetes Academy, Odense, Denmark.
Department of Public Health, Aarhus University, Aarhus, Denmark.
Diabetes Metab Res Rev. 2018 Mar;34(3). doi: 10.1002/dmrr.2968. Epub 2017 Dec 21.
To examine the association between early onset of type 2 diabetes mellitus (DM) and clinical and behavioural risk factors for later complications of diabetes.
We conducted a cross-sectional study of 5115 persons with incident type 2 DM enrolled during 2010-2015 in the Danish Centre for Strategic Research in Type 2 Diabetes-cohort. We compared risk factors at time of diagnosis among those diagnosed at ≤45 years (early onset) with diagnosis age 46 to 55, 56 to 65 (average onset = reference), 66 to 75, and >75 years (late onset). Prevalence ratios (PRs) were computed by using Poisson regression.
Poor glucose control, ie, HbA1c ≥ 75 mmol/mol (≥9.0%) in the early-, average-, and late-onset groups was observed in 12%, 7%, and 1%, respectively (PR 1.70 [95% confidence intervals (CI) 1.27, 2.28] and PR 0.17 [95% CI 0.06, 0.45]). A similar age gradient was observed for severe obesity (body mass index > 40 kg/m : 19% vs. 8% vs. 2%; PR 2.41 [95% CI 1.83, 3.18] and 0.21 (95% CI 0.08, 0.57]), dyslipidemia (90% vs. 79% vs. 68%; PR 1.14 [95% CI 1.10, 1.19] and 0.86 [95% CI 0.79, 0.93]), and low-grade inflammation (C-reactive protein > 3.0 mg/L: 53% vs. 38% vs. 26%; PR 1.41 [95% CI 1.12, 1.78] and 0.68 [95% CI 0.42, 1.11]). Daily smoking was more frequent and meeting physical activity recommendations less likely in persons with early-onset type 2 DM.
We found a clear age gradient, with increasing prevalence of clinical and behavioural risk factors the younger the onset age of type 2 DM. Younger persons with early-onset type 2 DM need clinical awareness and support.
研究 2 型糖尿病(DM)早发与糖尿病后期并发症的临床和行为危险因素之间的关联。
我们对 2010 年至 2015 年期间在丹麦 2 型糖尿病战略研究中心登记的 5115 例新发 2 型 DM 患者进行了一项横断面研究。我们比较了≤45 岁(早发)、46 至 55 岁、56 至 65 岁(平均发病年龄=参考)、66 至 75 岁和>75 岁(晚发)诊断时的危险因素。使用泊松回归计算患病率比(PR)。
在早发、平均发病年龄和晚发组中,血糖控制不佳(HbA1c≥75mmol/mol(≥9.0%))的比例分别为 12%、7%和 1%(PR 1.70[95%置信区间(CI)1.27,2.28]和 PR 0.17[95%CI 0.06,0.45])。严重肥胖(体重指数>40kg/m2:19% vs. 8% vs. 2%;PR 2.41[95%CI 1.83,3.18]和 0.21[95%CI 0.08,0.57])、血脂异常(90% vs. 79% vs. 68%;PR 1.14[95%CI 1.10,1.19]和 0.86[95%CI 0.79,0.93])和低度炎症(C 反应蛋白>3.0mg/L:53% vs. 38% vs. 26%;PR 1.41[95%CI 1.12,1.78]和 0.68[95%CI 0.42,1.11])也存在类似的年龄梯度。早发 2 型 DM 患者中,每日吸烟更为频繁,符合身体活动建议的可能性更低。
我们发现了一个明显的年龄梯度,2 型 DM 发病年龄越小,临床和行为危险因素的患病率越高。需要对年轻的早发 2 型 DM 患者给予临床关注和支持。