Association Between Age at Diagnosis of Type 2 Diabetes and Cardiovascular Diseases: A Nationwide, Population-Based, Cohort Study

Abstract

ObjectivesNationwide studies focusing on the impact of early-onset type 2 diabetes and obesity on the development of cardiovascular diseases (CVD) are limited in China. We aimed to investigate the association between age at diagnosis of type 2 diabetes and the risk of CVD, and to further examine the modifying effect of obesity on this association among Chinese adults.MethodsThis study included 23,961 participants with previously diagnosed diabetes from a large nationwide population-based cohort study across mainland China. With an interviewer-assisted questionnaire, we collected detailed information on CVDs. Logistic regression analysis was used to evaluate the risk of CVDs associated with age at diagnosis of diabetes.ResultsCompared with patients with late-onset diabetes (≥60 years), those with earlier-onset diabetes had increased risks for CVD, with adjusted ORs (95% CIs) of 1.72 (1.36-2.17), 1.52 (1.31-1.75) and 1.33 (1.19-1.48) for patients diagnosed aged <40, 40-49 and 50-59 years, respectively. Each 5-year earlier age at diagnosis of type 2 diabetes was significantly associated with 14% increased risk of CVD (OR, 1.14; 95%CI, 1.11-1.18). This association was more prominent for patients with obesity than those with normal body mass index (BMI). Significant interaction was detected between age at diagnosis and BMI categories on CVD risk (P for interaction=0.0457).ConclusionEarly-onset type 2 diabetes was significantly associated with higher risk of CVD, and this association was more prominent among patients with obesity.

Cellular enlargement - A new hallmark of aging?

“…Mean adipocyte size increases between middle and old age and then decreases with advanced age ( Miller et al, 2017 ). Interestingly, this correlates with the risk for the onset of type 2 diabetes, which peaks at 45–65 years and lowers afterwards ( Plummer et al, 2016 ; Sattar et al, 2019 ; Jacobs et al, 2020 ; Hu et al, 2021 ). Nevertheless, while smaller adipocyte size during advanced age correlates with a lower onset risk of type 2 diabetes, it coincides also with another unfavorable outcome: A result of decreased adipocyte size is the decline in fat depot size, which leads to the accumulation of fat outside adipose tissue like in the bone marrow, muscle and liver.…”

Resilience, self‐efficacy and diabetes distress on self‐management behaviours in patients newly diagnosed with type 2 diabetes: A moderated mediation analysis

“…In this study, the mean age of diagnosis with diabetes was 50.37 ± 11.48, which is younger than 54.60 ± 9.48 and 61.79 ± 12.27 years of age in previous large sample studies (Hu et al, 2021;Sattar et al, 2019). This might be because early screening of diabetes is promoted in Taiwan, so patients first diagnosed with T2DM are at a relatively younger age.…”

Cardiovascular disease risk in early‐onset vs late‐onset type 2 diabetes in China: A population‐based cross‐sectional study

“…26 It has been suggested that EOD carried a greater risk of cardiovascular complications compared to LOD, with complications developing and progressing more quickly. [27][28][29][30] In Taiwan, a prospective study revealed that individuals diagnosed with EOD before the age of 45 faced a 3.8-fold increased risk of developing macrovascular complication compared to those diagnosed after the age of 45 years. 31 Similarly, data from a predominantly white population demonstrated that patients diagnosed before the age of 45 had a 14-fold higher risk of developing myocardial infarction than the control group.…”