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首页> 外文期刊>Diabetes care >Temporal Trend in Young-Onset Type 2 Diabetes-Macrovascular and Mortality Risk: Study of UK Primary Care Electronic Medical Records
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Temporal Trend in Young-Onset Type 2 Diabetes-Macrovascular and Mortality Risk: Study of UK Primary Care Electronic Medical Records

机译：幼小发病2型糖尿病 - 大血管和死亡风险的时间趋势：研究英国初级保健电子病历

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OBJECTIVE To evaluate temporal prevalence trend, cardiometabolic risk factors, and the risk of atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality (ACM) in incident young- and usual-onset type 2 diabetes. RESEARCH DESIGN AND METHODS From the U.K. primary care database, 370,854 people with a new diagnosis of type 2 diabetes from 2000 to 2017 were identified. Analyses were conducted by age- group (18-39, 40-49, 50-59, 60-69, 70-79 years) and high-/low-risk status without history of ASCVD at diagnosis, with subjects with two or more of current smoking, high systolic blood pressure, high LDL cholesterol (LDL-C), or chronic kidney disease classified as high risk. RESULTS The proportion of people aged = 50 years but did not decrease in people = 50 years, those aged 18-39 years at diagnosis had a higher proportion of obesity (71% obese) and higher HbA(1c)(8.6%), and 71% had high LDL-C, while only 18% were on cardioprotective therapy. Although 2% in this age-group had ASCVD at diagnosis, 23% were identified as high risk. In the 18-39-year age-group, the adjusted average years to ASCVD/ACM in high-risk individuals (9.1 years [95% CI 8.2-10.0]/9.3 years [8.1-10.4]) were similar to the years in those with low risk (10.0 years [9.5-10.5]/10.5 years [9.7-11.2]). However, individuals aged >= 50 years with high risk were likely to experience an ASCVD event 1.5-2 years earlier and death 1.1-1.5 years earlier compared with low-risk groups (P< 0.01). CONCLUSIONS Unlike usual-onset, young-onset type 2 diabetes has similar cardiovascular and mortality risk irrespective of cardiometabolic risk factor status at diagnosis. The guidelines on the management of young-onset type 2 diabetes for intensive risk factor management and cardioprotective therapies need to be urgently reevaluated through prospective studies.
机译：目的探讨颞育趋势，心肌危险因素和动脉粥样硬化心血管疾病（ASCVD）的风险，以及发生幼苗2型糖尿病中的发生手术中的血管疾病（ACSVD）和全因死亡率（ACM）。从U.K.初级保健数据库，2000〜2017年初级保健数据库，370,854名患有2型糖尿病患者的初级保健数据库。分析由年龄（18-39,40-49,50-59,60-69,70-79岁）和高/低风险状态进行，没有ASCVD在诊断历史，具有两个或更多个受试者目前吸烟，高收缩压，高等LDL胆固醇（LDL-C），或慢性肾病被归类为高风险。结果= 50岁的人数= 50年的人数= 50年的比例= 50年，诊断年龄18-39岁的人具有较高比例的肥胖（71％肥胖）和更高的HBA（1C）（8.6％），和71％的LDL-C具有高LDL-C，而只有18％的人在心脏保护疗法上。虽然该年龄段中的2％患有ASCVD在诊断中，23％被确定为高风险。在18-39岁的年龄组中，调整的平均年龄为ASCVD / ACM，高危人员（9.1年[95％CI 8.2-10.0] / 9.3年[8.1-10.4]）类似于多年风险低的人（10.0年[9.5-10.5] /10.5年[9.7-11.2]）。然而，较高风险的人员> = 50年的人可能会遇到1.5-2年之前的ASCVD事件1.1-1.5年前与低风险群体相比（P <0.01）。结论与常见发病不同，幼眼2型糖尿病具有类似的心血管和死亡率风险，而不管诊断的心肌差异危险因素状况如何。通过前瞻性研究，需要迫切地重新评估患有强烈风险因素管理和心脏保护疗法的幼年患者2型糖尿病的指导方针。

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