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新诊断2型糖尿病患者糖尿病发病年龄与临床结局的关系:一项真实世界的两中心研究

The Relationship Between Age at Diabetes Onset and Clinical Outcomes in Newly Diagnosed Type 2 Diabetes: A Real-World Two-Center Study.

作者信息

Chen Mengdie, Feng Ping, Liang Yao, Ye Xun, Wang Yiyun, Liu Qiao, Lu Chaoyin, Zheng Qidong, Wu Lijing

机构信息

Department of Endocrinology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, People's Republic of China.

Department of Internal Medicine, Yuhuan Second People's Hospital, Yuhuan, Zhejiang, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2024 Oct 29;17:4069-4078. doi: 10.2147/DMSO.S485967. eCollection 2024.

Abstract

PURPOSE

This study was developed with the goal of clarifying whether there is any relationship between type 2 diabetes mellitus (T2DM) age of onset and clinical outcomes for patients in National Metabolic Management Centers (MMC).

PATIENTS AND METHODS

From September 2017 - June 2022, 864 total T2DM patients were recruited in MMC and assigned to those with early-onset and late-onset diabetes (EOD and LOD) based on whether their age at disease onset was ≤ 40 or > 40 years. All patients received standardized management. Baseline and 1-year follow-up data from these two groups of patients were assessed. Associations between onset age and other factors were evaluated with a multivariate linear regression approach, adjusting for appropriate covariates. Outcomes in particular subgroups were also assessed in stratified analyses.

RESULTS

Markers of dysregulated glucose metabolism and BMI values were significantly higher among EOD patients as compared to LOD patients. Subjects in both groups exhibited significant improvements in several disease-related parameters on 1-year follow-up after undergoing metabolic management. EOD patients exhibited significantly greater percentage reductions in HbA1c levels (-28.49 (-44.26, -6.45)% vs -13.70 (-30.15,-1.60)%, P =0.017) relative to LOD patients following adjustment for confounders. Significant differences were also detected between these groups when focused on subgroups of patients who were male, exhibited a BMI ≥ 25, an HbA1c ≥ 9, or had a follow-up frequency < 2.

CONCLUSION

Data from a 1-year follow-up time point suggest that a standardized metabolic disease management model can promote effective metabolic control in newly diagnosed T2DM patients, particularly among individuals with EOD.

摘要

目的

本研究旨在明确国家代谢管理中心(MMC)中2型糖尿病(T2DM)患者的发病年龄与临床结局之间是否存在关联。

患者与方法

2017年9月至2022年6月,MMC共招募了864例T2DM患者,并根据疾病发病年龄≤40岁或>40岁将其分为早发型和晚发型糖尿病患者(EOD和LOD)。所有患者均接受标准化管理。评估了这两组患者的基线和1年随访数据。采用多元线性回归方法评估发病年龄与其他因素之间的关联,并对适当的协变量进行调整。还通过分层分析评估了特定亚组的结局。

结果

与LOD患者相比,EOD患者的糖代谢失调标志物和BMI值显著更高。两组患者在接受代谢管理后的1年随访中,多项疾病相关参数均有显著改善。在调整混杂因素后,EOD患者的糖化血红蛋白(HbA1c)水平降低百分比显著高于LOD患者(-28.49(-44.26,-6.45)%对-13.70(-30.15,-1.60)%,P = 0.017)。在关注男性、BMI≥25、HbA1c≥9或随访频率<2的患者亚组时,两组之间也检测到显著差异。

结论

1年随访时间点的数据表明,标准化的代谢疾病管理模式可促进新诊断T2DM患者的有效代谢控制,尤其是在EOD患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1dd/11531288/667bd95c3708/DMSO-17-4069-g0001.jpg

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