Singhal Ayushi, Saxena Deepti, G Ashwini, Ahada Raviraj Singh, Kurian Navya Mary, Singh Alok Pratap, Garg Naveen, Bhatia Eesh, Chandra Yadav Subhash
Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Department of Ophthalmology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Endocr Connect. 2025 Aug 16;14(8). doi: 10.1530/EC-25-0226.
and Aims: The prevalence of T2DM is rising among young people, placing them at greater risk for complications. We studied the prevalence and predictors of micro- and macrovascular complications in early-onset diabetes subjects (EOD, <40 years) and compared with late-onset T2DM (LOD, ≥40 years).
A total of 800 subjects (400 EOD, 400 LOD), matched for gender and diabetes duration, were prospectively recruited and assessed for the prevalence of peripheral neuropathy, retinopathy, nephropathy, and ASCVD. Multivariate logistic regression analyzed predictors of diabetes complications.
The median age at diagnosis of diabetes was 35 years in EOD and 48 years in LOD. Hypertension was more common in LOD (73.8% vs. 58.8%, p<0.001). EOD patients had higher HbA1c (7.9% vs. 7.7%, p<0.05) and worse lipid profiles (non-HDL-C 129 vs.118 mg/dL, p<0.05; triglycerides 146 vs.130 mg/dL, p<0.001; HDL-C 36 vs. 38 mg/dL, p<0.01). The prevalence of retinopathy and nephropathy were similar between groups, while peripheral neuropathy and ASCVD were more prevalent in LOD. Increasing diabetes duration was associated with higher risk of all microvascular complications (p<0.01-0.001), while the age at onset of T2DM predicted peripheral neuropathy, nephropathy and ASCVD (p<0.05-0.001). Retinopathy (p<0.001) and female (p<0.05) gender increased peripheral neuropathy risk. Nephropathy (p<0.05) and smoking (p<0.01) were major ASCVD predictors.
EOD patients had worse glycemic and lipid profiles, but similar frequency of retinopathy and nephropathy as LOD. The high prevalence of microvascular complications in EOD may reduce productivity, highlighting the importance of early screening, better glycemic control, and timely complication management.
2型糖尿病（T2DM）在年轻人中的患病率正在上升，这使他们面临更高的并发症风险。我们研究了早发型糖尿病患者（EOD，年龄<40岁）微血管和大血管并发症的患病率及预测因素，并与晚发型T2DM（LOD，年龄≥40岁）进行比较。
前瞻性招募了800名受试者（400名EOD，400名LOD），根据性别和糖尿病病程进行匹配，评估外周神经病变、视网膜病变、肾病和动脉粥样硬化性心血管疾病（ASCVD）的患病率。多因素逻辑回归分析糖尿病并发症的预测因素。
EOD组糖尿病诊断时的中位年龄为35岁，LOD组为48岁。高血压在LOD组更常见（73.8%对58.8%，p<0.001）。EOD患者的糖化血红蛋白（HbA1c）水平更高（7.9%对7.7%，p<0.05），血脂谱更差（非高密度脂蛋白胆固醇[non-HDL-C]：129对118mg/dL，p<0.05；甘油三酯：146对130mg/dL，p<0.001；高密度脂蛋白胆固醇[HDL-C]：36对38mg/dL，p<0.01）。两组间视网膜病变和肾病的患病率相似，而外周神经病变和ASCVD在LOD组更普遍。糖尿病病程延长与所有微血管并发症风险增加相关（p<0.01 - 0.001），而T2DM发病年龄可预测外周神经病变、肾病和ASCVD（p<0.05 - 0.001）。视网膜病变（p<0.001）和女性（p<0.05）会增加外周神经病变风险。肾病（p<0.05）和吸烟（p<环0.01）是ASCVD的主要预测因素。
EOD患者的血糖和血脂谱更差，但视网膜病变和肾病的发生率与LOD相似。EOD中微血管并发症的高患病率可能会降低生产力，凸显了早期筛查、更好的血糖控制和及时的并发症管理的重要性。
