Zhang Qingqing, Cheng Liang, Li Boliang, Lu Yu, Yang Shufang, Wu Yucheng
Department of Endocrinology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, People's Republic of China.
Department of Pan-Vascular Management Center, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, People's Republic of China.
Diabetes Metab Syndr Obes. 2024 Apr 4;17:1543-1549. doi: 10.2147/DMSO.S454867. eCollection 2024.
Early-onset diabetes appears to be an aggressive phenotype of type 2 diabetes (T2D). The impact of the age of onset of T2D on albuminuria, especially high urinary albumin excretion, remains to be investigated.
To determine whether adults diagnosed with T2D between the ages of 18 and 45 more aggressively develop albuminuria.
Conducted at Taizhou People's Hospital from November 2018 to August 2020, this cross-sectional study enrolled T2D patients. Anthropometric measures, metabolic profiles, and urinary albumin creatinine ratio were examined. Patients were categorized into early-onset (≤45 years) and late-onset (> 45 years) groups. Univariate and multivariate analyses were performed to identify albuminuria risk factors. Subgroups were formed based on age at diabetes diagnosis and gender. Multivariate ordinal logistic regression analysis was then conducted to identify distinct risk factors within each subgroup.
Analyzing 1900 T2D patients, it was found significantly higher albuminuria prevalence in early-onset patients (35.08% vs 29.92%, P = 0.022). The risk of albuminuria in early-onset patients was 1.509 times higher than that in late-onset patients, especially among male patients, where the risk increased to 1.980. For late-onset patients, disease duration and glycated hemoglobin (HbA1c) were identified as risk factors, whereas for early-onset patients, body-mass index (BMI) and systolic blood pressure were associated with increased risk. Among male patients, age at diagnosis of diabetes, blood pressure, and BMI were identified as risk factors, while for female patients, disease duration and HbA1c played a significant role. Additionally, high-density lipoprotein cholesterol was found to be a protective factor against albuminuria.
Individuals diagnosed with T2D before 45 face heightened albuminuria risk, especially males. Risk factors vary by gender and onset age, highlighting the need for tailored management strategies.
早发型糖尿病似乎是2型糖尿病（T2D）的一种侵袭性表型。T2D发病年龄对蛋白尿，尤其是高尿白蛋白排泄的影响仍有待研究。
确定18至45岁被诊断为T2D的成年人是否更易发生蛋白尿。
本横断面研究于2018年11月至2020年8月在泰州市人民医院进行，纳入了T2D患者。检查了人体测量指标、代谢谱和尿白蛋白肌酐比值。患者被分为早发型（≤45岁）和晚发型（>45岁）组。进行单因素和多因素分析以确定蛋白尿的危险因素。根据糖尿病诊断时的年龄和性别形成亚组。然后进行多因素有序逻辑回归分析以确定每个亚组内不同的危险因素。
分析1900例T2D患者发现，早发型患者的蛋白尿患病率显著更高（35.08%对29.92%，P = 0.022）。早发型患者发生蛋白尿的风险比晚发型患者高1.509倍，尤其是男性患者，风险增加至1.980。对于晚发型患者，疾病病程和糖化血红蛋白（HbA1c）被确定为危险因素，而对于早发型患者，体重指数（BMI）和收缩压与风险增加相关。在男性患者中，糖尿病诊断年龄、血压和BMI被确定为危险因素，而对于女性患者，疾病病程和HbA1c起重要作用。此外，高密度脂蛋白胆固醇被发现是预防蛋白尿的保护因素。
45岁之前被诊断为T2D的个体面临更高的蛋白尿风险，尤其是男性。危险因素因性别和发病年龄而异，凸显了制定个性化管理策略的必要性。
