Cardiovascular disease risk prediction and profiling among Asian Indians with young-onset type 1 and type 2 diabetes.

AIMS

This study aims to describe the profile of Asian Indians with young-onset type 1 diabetes (T1D) and type 2 diabetes (T2D) who have 'low cardiovascular disease (CVD) risk' and 'high CVD risk' based on QRESEARCH risk estimator version 3(QRISK3) and Framingham Risk Score (FRS). It also aims to assess the predictive ability of these risk calculators to estimate CVD risk in this population.

METHODS

Retrospective data of 18,837 individuals with T1D or T2D with an age of onset of between 10 to 30 years were retrieved from Diabetes Electronic Medical Records. QRISK3 algorithm and FRS were used to estimate the 10-year risk of CVD. After excluding individuals with preexisting CVD (n = 175), the QRISK3 score was calculated for 5371, and FRS for 7444 individuals with young-onset T1D and T2D. CVD risk was categorized as high if the QRISK3 and FRS scores ≥10.0% and low, if <10.0%.

RESULTS

Among individuals with T1D,17.3% had high QRISK3 scores and 19.0% had high FRS scores. Among individuals with T2D, 31.9% had high QRISK3 scores and 37.2% had high FRS scores. Individuals with T2D had a higher risk than those with T1D by both risk scores (p < 0.001). The frequency of high-risk scores increased with age and was higher among men. The receiver operating characteristic-area under the curve (ROC-AUC) showed that both scores (QRISK3-0.788; FRS-0.746; p = 0.241) predicted 10-year cardiovascular disease risk well.

CONCLUSION

Both QRISK and FRS were good predictors of CVD in this population. Individuals with young-onset diabetes have a high propensity to develop cardiovascular disease within 10 years, with T2D having a higher risk than T1D. Regular risk monitoring, lifestyle modifications and medical interventions are essential among individuals with young-onset T2D and T1D.