Age at type 2 diabetes onset and glycaemic control: results from the National Health and Nutrition Examination Survey (NHANES) 2005-2010
Age at type 2 diabetes onset and glycaemic control: results from the National Health and Nutrition Examination Survey (NHANES) 2005-2010
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DOI：
10.1007/s00125-013-3036-4
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发表时间：
2013-12-01
期刊：
影响因子：
8.2
通讯作者：
Wexler, Deborah J.
中科院分区：
文献类型：
--
作者：
Berkowitz, Seth A.;Meigs, James B.;Wexler, Deborah J.
我们检验了以下假设：2 型糖尿病诊断年龄小于 65 岁与随后的血糖控制较差有关。对 2005-2010 年国家健康和营养检查调查参与者的数据进行了横断面分析。对于自我报告患有糖尿病的成年人，我们将糖尿病诊断时的年龄分为年轻（< 65 岁）和老年（千分之一65 岁）。主要关注结果是 HbA(1c) > 9.0% (75 mmol/mol)。次要结局为 HbA(1c) > 8.0% (64 mmol/mol) 和 > 7.0% (53 mmol/mol)。我们使用多变量逻辑回归进行分析。在 1,438 名成人糖尿病患者中，与诊断时千分之几的患者相比，诊断时年龄 < 65 岁的患者中 HbA(1c) > 9.0% 的比例较高（14.4% vs 2.5%，p < 0.001）。调整性别、种族/民族、教育、收入、保险、常规护理来源、高血糖药物、糖尿病病程、家族史、BMI 和腰围后，诊断时年龄 < 65 岁仍与 HbA(1c) > 9.0% 的较大几率显着相关（OR 3.22，95% CI 1.54, 6.72），HbA(1c) > 8.0%（OR 2.72, 95% CI 1.43, 5.16) 且 HbA(1c) > 7.0%（OR 1.92, 95% CI 1.18, 3.11）。年轻组报告的合并症较少，但报告健康状况良好的可能性较小（OR 0.54，95% CI 0.36，0.83）。诊断 2 型糖尿病时的年龄较小与随后的血糖控制较差显着相关。由于诊断时年龄较小的患者具有较少的竞争性合并症和并发症，因此安全、积极、个体化的治疗可能会使这一高危人群受益。
We tested the hypothesis that age younger than 65 years at type 2 diabetes diagnosis is associated with worse subsequent glycaemic control.A cross-sectional analysis of data from participants in the 2005-2010 National Health and Nutrition Examination Survey was performed. For adults with self-reported diabetes, we dichotomised age at diabetes diagnosis as younger (< 65 years) vs older (a parts per thousand yen65 years). The primary outcome of interest was HbA(1c) > 9.0% (75 mmol/mol). Secondary outcomes were HbA(1c) > 8.0% (64 mmol/mol) and > 7.0% (53 mmol/mol). We used multivariable logistic regression for analysis.Among 1,438 adults with diabetes, a higher proportion of those < 65 years at diagnosis compared with those a parts per thousand yen65 at diagnosis had an HbA(1c) > 9.0% (14.4% vs 2.5%, p < 0.001). After adjustment for sex, race/ethnicity, education, income, insurance, usual source of care, hyperglycaemia medication, duration of diabetes, family history, BMI and waist circumference, age < 65 years at diagnosis remained significantly associated with greater odds of HbA(1c) > 9.0% (OR 3.22, 95% CI 1.54, 6.72), HbA(1c) > 8.0% (OR 2.72, 95% CI 1.43, 5.16) and HbA(1c) > 7.0% (OR 1.92, 95% CI 1.18, 3.11). The younger group reported fewer comorbidities, but were less likely to report good health (OR 0.54, 95% CI 0.36, 0.83).Younger age at type 2 diabetes diagnosis is significantly associated with worse subsequent glycaemic control. Because patients who are younger at diagnosis have fewer competing comorbidities and complications, safe, aggressive, individualised treatment could benefit this higher-risk group.