Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Medical Informatics, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-Gu, Seoul, 06591, Republic of Korea.
Sci Rep. 2023 Jun 21;13(1):10100. doi: 10.1038/s41598-023-36711-2.
We investigated the risk of developing chronic kidney disease (CKD) in patients with young-onset Type 2 diabetes (YOD, diagnosed age < 40 years). We enrolled 84,384 patients aged 20-64 who started anti-diabetic medication between 2010 and 2011 from the Korea National Health Insurance Sharing Service; patients with Type 1 diabetes or a history of CKD were excluded. Multivariate logistic regression analyses were performed to adjust for YOD-distinct variables and compare the incidence of CKD between YOD and late-onset diabetes (LOD, diagnosed age ≥ 40 years). During the median observation period of 5.16 years (interquartile range: 4.58-5.77 years), 1480 out of 77,039 LOD patients and 34 out of 7345 YOD patients developed CKD. Patients with YOD had distinct baseline characteristics compared with the patients with LOD. The odds ratio of developing CKD in patients with YOD over LOD was 1.70 (95% CI 1.15-2.51) after adjusting clinically distinct variables. The increased CKD odds in YOD compared with LOD was greater in the non-smoking group (OR 2.03, 95% CI 1.26-3.26) than in the smoking group (OR 1.49, 95% CI 0.74-2.98, p = 0.0393 for interaction). Among YOD patients, hypertension (34.76% vs. 64.71%, p = 0.0003), dyslipidemia (46.87% vs. 73.53%, p = 0.0019), and sulfonylurea use (35.54% vs. 52.94%, p = 0.0345) were associated with CKD development. YOD patients have a greater risk of developing CKD than LOD patients after adjusting clinically distinct variables.
我们研究了年轻起病的 2 型糖尿病(YOD,发病年龄<40 岁)患者发生慢性肾脏病(CKD)的风险。我们纳入了 2010 年至 2011 年期间从韩国国家健康保险共享服务开始使用抗糖尿病药物的 84384 名年龄在 20-64 岁的患者;排除了 1 型糖尿病或 CKD 病史的患者。进行多变量逻辑回归分析以调整 YOD 特有变量,并比较 YOD 和晚发糖尿病(LOD,发病年龄≥40 岁)之间 CKD 的发生率。在中位观察期 5.16 年(四分位距:4.58-5.77 年)期间,77039 名 LOD 患者中有 1480 名和 7345 名 YOD 患者中有 34 名发展为 CKD。与 LOD 患者相比,YOD 患者具有明显的基线特征。在调整临床特有变量后,YOD 患者发生 CKD 的优势比为 1.70(95%CI 1.15-2.51)。在非吸烟组中,YOD 与 LOD 相比,CKD 发生的风险增加(OR 2.03,95%CI 1.26-3.26)大于吸烟组(OR 1.49,95%CI 0.74-2.98,p=0.0393 用于交互作用)。在 YOD 患者中,高血压(34.76%比 64.71%,p=0.0003)、血脂异常(46.87%比 73.53%,p=0.0019)和使用磺脲类药物(35.54%比 52.94%,p=0.0345)与 CKD 发展相关。在调整临床特有变量后,YOD 患者发生 CKD 的风险大于 LOD 患者。