Burden of vascular risk factors by age, sex, ethnicity and deprivation in young adults with and without newly diagnosed type 2 diabetes
Elservier
Jonathan Goldney, Mary M. Barker, Jack A. Sargeant, Enya Daynes, Dimitris Papamargaritis, Sharmin Shabnam, Louise M. Goff, Kamlesh Khunti, Joseph Henson, Melanie J. Davies, Francesco Zaccardi
Aims:
Do associations between age at diagnosis of type 2 diabetes and vascular risk factors vary by ethnicity and deprivation?
Methods:
Utilising the Clinical Practice Research Datalink, we matched 16–50-year-old individuals with newly diagnosed type 2 diabetes to ∼10 individuals without using sex, age and primary care practice. Differences in BMI, obesity, LDL-cholesterol, HbA1c, and hypertension between individuals with vs without type 2 diabetes across sex, age, ethnicity and deprivation quintiles were explored using generalised linear models.
Results:
We included 108,061 individuals (45.6% women) with newly diagnosed type 2 diabetes and 829,946 controls. BMI, obesity, LDL-cholesterol, and hypertension were higher in individuals with vs without type 2 diabetes. Across both sexes, all ethnic groups and deprivation quintiles, these differences were larger with an earlier age, particularly for BMI and obesity. Association between age and HbA1c were variable across subgroups. Differences in BMI, obesity, and hypertension (individuals with vs without diabetes) were largest in White individuals and with less deprivation.
Results:
A total of 38,356 studies were identified and 111 included. In most (74%) of the studies, MLTCs referred to having two or more long-term conditions. Others described MLTCs by high weighted indices: the Charlson Comorbidity Index in 11% and the Clinical Frailty Score in 7%. Using the National Institutes of Health quality
Conclusions and Relevance:
The increased vascular risk phenotype associated with an earlier age of diagnosis of type 2 diabetes was consistent across ethnic and deprivation groups. Population-based strategies are needed to address the risk associated with early-onset type 2 diabetes, especially weight-management-based strategies.
DOI:https://doi.org/10.1016/j.diabres.2025.112002