Dr. Yen's Clinic, Gueishan District, Taoyuan, Taiwan.
Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, Taiwan.
Diabetes Res Clin Pract. 2021 Dec;182:109129. doi: 10.1016/j.diabres.2021.109129. Epub 2021 Nov 9.
To compare long-term outcomes among three groups with different ages of diabetes onset.
66,520 paired age-, and sex-matched persons with and without type 2 diabetes were selected from the Taiwan National Health Insurance Research Database from 2000 to 2012. Cox proportional hazards models were used to compare the outcomes. Using late-onset diabetes as a reference, adjusted difference in differences analyses were performed to assess excessive odds comparing diabetes versus non-diabetes for young-onset diabetes (YOD) and early-onset diabetes in the risks of mortality and vascular complications.
Persons with type 2 diabetes, irrespective of the onset age, had higher associated risks of all-cause mortality and vascular complications than their matched counterparts without diabetes. Compared to the odds of complications between those with diabetes and non-diabetes in the late-onset diabetes group, the excess odds in YOD are generally greater than in the early-onset diabetes (for stroke: 1.90 vs. 1.32; heart failure: 2.03 vs. 1.58; myocardial infarction: 3.02 vs. 1.56; and microvascular complications: 3.52 vs. 3.01).
Diabetes with different ages of onset may imply distinct long-term health outcomes. The persons with young-onset and early-onset diabetes seem to bear excess risk for mortality and vascular complications.
比较三组不同发病年龄的 2 型糖尿病患者的长期结局。
从 2000 年至 2012 年，从台湾全民健康保险研究数据库中选择了 66520 对年龄和性别匹配的伴发或不伴发 2 型糖尿病的患者。使用 Cox 比例风险模型比较结局。使用迟发型糖尿病作为参考，进行调整后差异分析，以评估早发型和青年发病型糖尿病患者（YOD）与非糖尿病患者相比，在死亡风险和血管并发症风险方面的优势比是否过高。
无论发病年龄如何，患有 2 型糖尿病的患者发生全因死亡率和血管并发症的风险均高于无糖尿病的匹配患者。与迟发型糖尿病组中糖尿病与非糖尿病患者之间并发症的优势比相比，YOD 的超额优势比通常大于早发型糖尿病（中风：1.90 比 1.32；心力衰竭：2.03 比 1.58；心肌梗死：3.02 比 1.56；微血管并发症：3.52 比 3.01）。
不同发病年龄的糖尿病可能意味着不同的长期健康结局。早发型和青年发病型糖尿病患者的死亡和血管并发症风险似乎更高。
