Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China.
Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Diabetes Care. 2021 Jun 1;44(6):1426-1432. doi: 10.2337/dc20-2375.
We aimed to explore the associations between type 2 diabetes onset age and cardiovascular disease (CVD) and all-cause mortality in the Chinese population.
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.
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.
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.
本研究旨在探讨中国人群 2 型糖尿病发病年龄与心血管疾病（CVD）及全因死亡率之间的关系。
本研究纳入了基线时无糖尿病和 CVD 的 101080 名参与者。所有参与者每两年监测一次，直至 2017 年 12 月 31 日。随访期间，有 11384 名参与者被诊断为 2 型糖尿病。每例病例患者均随机选择 1 例对照患者，年龄（±1 岁）和性别匹配。最终分析包括 10777 例病例-对照对。使用加权 Cox 回归模型评估新诊断的 2 型糖尿病患者与对照患者在不同年龄组中 CVD 和全因死亡率的平均危险比（AHR）和 95%可信区间。
在中位随访 5.57 年期间，发生了 1794 例新发事件（907 例 CVD 事件，其中 725 例为卒中，887 例为死亡）。在校正潜在混杂因素后，与匹配的对照相比，<45 岁发病的 2 型糖尿病患者发生 CVD 和全因死亡的相对风险最高，AHR 分别为 CVD 3.21（95%CI 1.18-8.72）、卒中 2.99（95%CI 1.01-9.17）和全因死亡率 4.79（95%CI 1.95-11.76）。随着 2 型糖尿病发病年龄每增加 10 年，风险逐渐减弱。
不同 2 型糖尿病发病年龄组的 CVD 和全因死亡率的风险不同，且在发病年龄较轻的患者中更为明显。
