Age-, sex- and ethnicity-related differences in body weight, blood pressure, HbA1c and lipid levels at the diagnosis of type 2 diabetes relative to people without diabetes
Age-, sex- and ethnicity-related differences in body weight, blood pressure, HbA1c and lipid levels at the diagnosis of type 2 diabetes relative to people without diabetes
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DOI：
10.1007/s00125-020-05169-6
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发表时间：
2020-05-21
期刊：
影响因子：
8.2
通讯作者：
Sattar, Naveed
中科院分区：
文献类型：
--
作者：
Wright, Alison K.;Welsh, Paul;Sattar, Naveed
目的/假设这项工作的目的是确定体重模式以及血糖、血压和血脂在诊断糖尿病时如何随年龄、性别和种族而变化。方法采用英国临床实践研究数据链，对1998-2015年间确诊为2型糖尿病患者(n=187,601)和年龄匹配的非糖尿病患者(n=906,182)的体重、糖化血红蛋白(1c)、血压和血脂水平进行性别和种族比较。结果确诊时年龄较小的2型糖尿病患者与非2型糖尿病患者的体重调整平均差异(95%CI)较大：20~39岁时为18.7(18.3，19.1)kg，年龄=80岁时为5.3(5.0，5.5)kg。白人女性的体重差异最大，与南亚人和黑人相比，白人的体重差异约为两倍。尽管绝对值较低，但在发病年龄较小的糖尿病患者中，血压差异也更大：20-39岁时为7(6，7)毫米汞柱，而年龄=80岁时为-0.5(-0.9，-0.2)。白人的血压差异最大，尤其是女性。三酰甘油水平的差异在年轻男性中最大。最后，糖尿病发病年龄越小，HbA(1c)水平也越高，尤其是在黑人中。结论/解释在诊断2型糖尿病时，与没有糖尿病的人相比，年轻人与老年人、女性与男性以及白人与南亚人和黑人之间的体重和血压差异更大。尽管南亚人和黑人往往在十年前患上糖尿病，并伴有相似或更严重的血糖异常，但仍观察到了这些差异。这些显著的模式可能会对管理和预防产生影响。
Aims/hypothesis The aim of this work was to determine how weight patterns together with blood glucose, BP and lipids vary at diagnosis of diabetes by age, sex and ethnicity. Methods Using the UK Clinical Practice Research Datalink, we identified people with type 2 diabetes (n = 187,601) diagnosed in 1998-2015 and compared their weights, HbA(1c), BP and lipid levels at diagnosis with age-matched people without diabetes (n = 906,182), by sex and ethnic group. Results Younger age at diagnosis was associated with greater adjusted mean difference (95% CI) in weight between those with vs without type 2 diabetes: 18.7 (18.3, 19.1) kg at age 20-39 years and 5.3 (5.0, 5.5) kg at age >= 80 years. Weight differentials were maximal in white women, and were around double in white people compared with South Asian and black people. Despite lower absolute values, BP differences were also greater at younger age of diabetes onset: 7 (6, 7) mmHg at age 20-39 years vs -0.5 (-0.9, -0.2) at age >= 80 years. BP differences were greatest in white people, and especially in women. Triacylglycerol level differences were greatest in younger men. Finally, HbA(1c) levels were also higher with younger onset diabetes, particularly in black people. Conclusions/interpretation At diagnosis of type 2 diabetes, when compared with people without diabetes, weight and BP differentials were greater in younger vs older people, in women vs men and in white vs South Asian and black people. These differences were observed even though South Asian and black people tend to develop diabetes a decade earlier with either similar or greater dysglycaemia. These striking patterns may have implications for management and prevention.Graphical abstract