Xu Lan, Ran Jinjun, Shao Hui, Chen Meng, Tang Hao, Li Yongxuan, Xu Yaqing, Huang Yue, Tao Feng, Liu Zhenxiu, Zhong Victor W
Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Emory Global Diabetes Research Center, Emory University, Atlanta, GA.
Diabetes Care. 2025 Mar 1;48(3):371-380. doi: 10.2337/dc24-1699.
To estimate the incidence and identify risk factors for diagnosed type 2 diabetes (T2D) among young U.S. adults.
We analyzed 142,884 adults aged 18-79 years with self-reported diabetes type from the cross-sectional National Health Interview Survey in 2016-2022, representing the noninstitutionalized U.S. civilian population. Incidence of diagnosed T2D was calculated for three age groups: young-adult onset (18-44 years), middle-age onset (45-64 years), and older-adult onset (65-79 years); the latter two groups were included to highlight the distinct risk factor profile of young-adult-onset T2D. Multivariable logistic regressions were used to identify risk factors for young-adult-onset T2D.
The estimated incidence of diagnosed young-adult-onset T2D was 3.0 per 1,000 adults (95% CI 2.6-3.5). Minority groups, socioeconomically disadvantaged individuals, and people with cardiometabolic diseases or psychological conditions had a higher incidence of diagnosed young-adult-onset T2D compared with their counterparts. Lipid-lowering medication use (adjusted odds ratio [aOR] 13.15, 95% CI 8.85-19.55), antihypertensive medication use (aOR 11.89, 95% CI 7.97-17.73), and obesity (BMI ≥30 vs. <25 kg/m2, aOR 10.89, 95% CI 6.69-17.7) were the strongest risk factors for young-adult-onset T2D; these risk factors, along with hypertension, hyperlipidemia, and coronary heart disease, were more strongly associated with young-adult-onset T2D compared with later-onset T2D, with up to 4.5 times higher aORs.
This study quantified the incidence of diagnosed young-adult-onset T2D in U.S. adults and identified its distinct risk factor profile. Targeted prevention strategies for young-adult-onset T2D are needed for minority and socioeconomically disadvantaged people and those with cardiometabolic diseases.
评估美国年轻成年人中确诊的2型糖尿病（T2D）的发病率，并确定其危险因素。
我们分析了2016 - 2022年横断面全国健康访谈调查中142,884名年龄在18 - 79岁、自我报告糖尿病类型的成年人，这些数据代表了非机构化的美国平民人口。计算了三个年龄组确诊T2D的发病率：青年发病组（18 - 44岁）、中年发病组（45 - 64岁）和老年发病组（65 - 79岁）；纳入后两组是为了突出青年发病型T2D独特的危险因素特征。采用多变量逻辑回归来确定青年发病型T2D的危险因素。
估计青年发病型T2D确诊的发病率为每1000名成年人中有3.0例（95%置信区间2.6 - 3.5）。与同龄人相比，少数群体、社会经济地位不利的个体以及患有心脏代谢疾病或心理疾病的人，青年发病型T2D确诊的发病率更高。使用降脂药物（调整后的优势比[aOR] 13.15，95%置信区间8.85 - 19.55）、使用抗高血压药物（aOR 11.89，95%置信区间7.97 - 17.73）和肥胖（BMI≥30 vs. <25 kg/m²，aOR 10.89，95%置信区间6.69 - 17.7）是青年发病型T2D最强的危险因素；与晚发型T2D相比，这些危险因素以及高血压、高脂血症和冠心病与青年发病型T2D的关联更强，aOR高达4.5倍。
本研究量化了美国成年人中确诊的青年发病型T2D的发病率，并确定了其独特的危险因素特征。对于少数群体、社会经济地位不利的人群以及患有心脏代谢疾病的人，需要针对性的青年发病型T2D预防策略。
