美国糖尿病退伍军人全国初始队列中2型糖尿病检测年龄与糖化血红蛋白的关联。
Associations of age at T2D detection with hemoglobin A1c in a national inception cohort of U.S. Veterans with diabetes.
作者信息
Avramovic Sanja, Li Xumin, Enquobahrie Daniel A, Schwartz Mark D, Korpak Anna, Boyko Edward J, Wander Pandora L
机构信息
Veterans Affairs New York Harbor Healthcare System, New York, NY, USA; Health Administration and Policy, George Mason University, Fairfax, VA, USA.
Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA.
出版信息
Diabetes Res Clin Pract. 2025 Aug;226:112332. doi: 10.1016/j.diabres.2025.112332. Epub 2025 Jun 20.
OBJECTIVE
To investigate associations of age at type 2 diabetes (T2D) detection with HbA1c.
RESEARCH DESIGN AND METHODS
We examined associations of early-onset T2D (age of detection 20-39 years) and age at T2D detection with HbA1c in Veterans with incident T2D (1/1/2008-12/31/2016; n = 851,302).
RESULTS
About 3 % (n = 22,649) of men and 11 % (n = 5,117) of women had early-onset T2D. Compared to men with later-onset T2D, men with early-onset T2D had a 0.71 (95 %CI 0.69,0.73) greater HbA1c after detection, a 0.78 (95 %CI 0.77,0.80) greater mean HbA1c, and a 0.05 (95 %CI 0.04,0.05) greater coefficient of variation (CV). Each 10-year decrease in age was associated with greater HbA1c after detection, mean HbA1c, and HbA1c CV (β 0.21 (95 %CI 0.21,0.21), 0.25 (95 %CI 0.24,0.25), 0.02 (95 %CI 0.02,0.02), respectively). In women, early-onset T2D was associated with a 0.14 (95 %CI -0.18,-0.10) lower HbA1c after detection and a 0.01 greater CV (95 %CI 0.01,0.01). Each ten-year decrease in age was associated with greater mean HbA1c and CV (β 0.09 (95 %CI 0.08,0.10); 0.01 (95 %CI 0.01,0.01), respectively).
CONCLUSION
Among male Veterans, early-onset T2D was associated with greater HbA1c and greater HbA1c variability. Similar results were seen among women but of lesser magnitude. Longitudinal research examining sex-specific impacts of early-onset T2D on clinical course is needed.
目的
研究2型糖尿病（T2D）检测时的年龄与糖化血红蛋白（HbA1c）之间的关联。
研究设计与方法
我们在2008年1月1日至2016年12月31日期间确诊T2D的退伍军人（n = 851,302）中，研究早发型T2D（检测年龄20 - 39岁）及T2D检测时的年龄与HbA1c之间的关联。
结果
约3%（n = 22,649）的男性和11%（n = 5,117）的女性患有早发型T2D。与晚发型T2D的男性相比，早发型T2D的男性在检测后糖化血红蛋白水平高0.71（95%置信区间0.69,0.73），平均糖化血红蛋白水平高0.78（95%置信区间0.77,0.80），变异系数（CV）高0.05（95%置信区间0.04,0.05）。年龄每降低10岁，检测后的糖化血红蛋白水平、平均糖化血红蛋白水平及糖化血红蛋白CV均升高（β分别为0.21（95%置信区间0.21,0.21）、0.25（95%置信区间0.24,0.25）、0.02（95%置信区间0.02,0.02））。在女性中，早发型T2D与检测后的糖化血红蛋白水平低0.14（95%置信区间 - 0.18, - 0.10）及CV高0.01（95%置信区间0.01,0.01）相关。年龄每降低10岁，平均糖化血红蛋白水平及CV均升高（β分别为0.09（95%置信区间0.08,0.10）；0.01（95%置信区间0.01,0.01））。
结论
在男性退伍军人中，早发型T2D与更高的糖化血红蛋白水平及更大的糖化血红蛋白变异性相关。女性中也观察到类似结果，但程度较轻。需要进行纵向研究以探讨早发型T2D对临床病程的性别特异性影响。
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