Goldney Jonathan, Barker Mary M, Sargeant Jack A, Daynes Enya, Papamargaritis Dimitris, Shabnam Sharmin, Goff Louise M, Khunti Kamlesh, Henson Joseph, Davies Melanie J, Zaccardi Francesco
Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester General Hospital, Leicester LE5 4PW UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW UK.
Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW UK; Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Sweden.
Diabetes Res Clin Pract. 2025 Feb;220:112002. doi: 10.1016/j.diabres.2025.112002. Epub 2025 Jan 10.
Do associations between age at diagnosis of type 2 diabetes and vascular risk factors vary by ethnicity and deprivation?
Utilising the Clinical Practice Research Datalink, we matched 16-50-year-old individuals with newly diagnosed type 2 diabetes to ∼10 individuals without using sex, age and primary care practice. Differences in BMI, obesity, LDL-cholesterol, HbA1c, and hypertension between individuals with vs without type 2 diabetes across sex, age, ethnicity and deprivation quintiles were explored using generalised linear models.
We included 108,061 individuals (45.6% women) with newly diagnosed type 2 diabetes and 829,946 controls. BMI, obesity, LDL-cholesterol, and hypertension were higher in individuals with vs without type 2 diabetes. Across both sexes, all ethnic groups and deprivation quintiles, these differences were larger with an earlier age, particularly for BMI and obesity. Association between age and HbA1c were variable across subgroups. Differences in BMI, obesity, and hypertension (individuals with vs without diabetes) were largest in White individuals and with less deprivation.
The increased vascular risk phenotype associated with an earlier age of diagnosis of type 2 diabetes was consistent across ethnic and deprivation groups. Population-based strategies are needed to address the risk associated with early-onset type 2 diabetes, especially weight-management-based strategies.
2型糖尿病诊断时的年龄与血管危险因素之间的关联是否因种族和贫困程度而异？
利用临床实践研究数据链，我们将16至50岁新诊断为2型糖尿病的个体与约10名非糖尿病个体进行匹配，匹配因素包括性别、年龄和初级医疗实践。使用广义线性模型探讨了2型糖尿病患者与非糖尿病患者在性别、年龄、种族和贫困五分位数方面的体重指数（BMI）、肥胖、低密度脂蛋白胆固醇、糖化血红蛋白（HbA1c）和高血压差异。
我们纳入了108,061名新诊断为2型糖尿病的个体（45.6%为女性）和829,946名对照。2型糖尿病患者的BMI、肥胖、低密度脂蛋白胆固醇和高血压水平高于非糖尿病患者。在所有性别、种族群体和贫困五分位数中，这些差异在年龄较早时更大，尤其是BMI和肥胖。年龄与HbA1c之间的关联在各亚组中有所不同。BMI、肥胖和高血压（糖尿病患者与非糖尿病患者之间）的差异在白人个体中最大，且贫困程度较低。
2型糖尿病诊断年龄较早与血管风险表型增加之间的关联在种族和贫困群体中是一致的。需要基于人群的策略来应对早发型2型糖尿病相关的风险，尤其是基于体重管理的策略。
