The association between age at diagnosis of type 2 diabetes and albuminuria in Chinese adults: A nationwide population study

Shujing Wu; Zhiyun Zhao; Shanshan Liu; Mian Li; Tiange Wang; Shuangyuan Wang; Min Xu; Yuhong Chen; Meng Dai; Di Zhang; Xuefeng Yu; Xulei Tang; Ruying Hu; Zhen Ye; Lixin Shi; Qing Su; Li Yan; Guijun Qin; Qin Wan; Gang Chen; Zhengnan Gao; Guixia Wang; Feixia Shen; Zuojie Luo; Yingfen Qin; Li Chen; Yanan Huo; Qiang Li; Yinfei Zhang; Chao Liu; Youmin Wang; Shengli Wu; Tao Yang; Huacong Deng; Lulu Chen; Jiajun Zhao; Yiming Mu; Yiping Xu; Yufang Bi; Jieli Lu; Yu Xu; Weiqing Wang; Guang Ning

doi:10.1111/1753-0407.13213

The association between age at diagnosis of type 2 diabetes and albuminuria in Chinese adults: A nationwide population study

J Diabetes. 2021 Dec;13(12):987-997. doi: 10.1111/1753-0407.13213. Epub 2021 Jul 27.

Authors

Shujing Wu^{1

2}, Zhiyun Zhao^{1

2}, Shanshan Liu^{1

2}, Mian Li^{1

2}, Tiange Wang^{1

2}, Shuangyuan Wang^{1

2}, Min Xu^{1

2}, Yuhong Chen^{1

2}, Meng Dai^{1

2}, Di Zhang^{1

2}, Xuefeng Yu³, Xulei Tang⁴, Ruying Hu⁵, Zhen Ye⁵, Lixin Shi⁶, Qing Su⁷, Li Yan⁸, Guijun Qin⁹, Qin Wan¹⁰, Gang Chen¹¹, Zhengnan Gao¹², Guixia Wang¹³, Feixia Shen¹⁴, Zuojie Luo¹⁵, Yingfen Qin¹⁵, Li Chen¹⁶, Yanan Huo¹⁷, Qiang Li¹⁸, Yinfei Zhang¹⁹, Chao Liu²⁰, Youmin Wang²¹, Shengli Wu²², Tao Yang²³, Huacong Deng²⁴, Lulu Chen²⁵, Jiajun Zhao²⁶, Yiming Mu²⁷, Yiping Xu²⁸, Yufang Bi^{1

2}, Jieli Lu^{1

2}, Yu Xu^{1

2}, Weiqing Wang^{1

2}, Guang Ning^{1

2}

Affiliations

¹ Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
² Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
³ Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁴ The First Hospital of Lanzhou University, Lanzhou, China.
⁵ Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, China.
⁶ Affiliated Hospital of Guiyang Medical College, Guiyang, China.
⁷ Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
⁸ Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
⁹ The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
¹⁰ The Affiliated Hospital of Luzhou Medical College, Luzhou, China.
¹¹ Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.
¹² Dalian Municipal Central Hospital, Dalian Medical University, Dalian, China.
¹³ The First Hospital of Jilin University, Changchun, China.
¹⁴ The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
¹⁵ The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
¹⁶ Qilu Hospital of Shandong University, Jinan, China.
¹⁷ Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China.
¹⁸ The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
¹⁹ Central Hospital of Shanghai Jiading District, Shanghai, China.
²⁰ Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China.
²¹ The First Affiliated Hospital of Anhui Medical University, Hefei, China.
²² Karamay Municipal People's Hospital, Xinjiang, China.
²³ The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
²⁴ The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
²⁵ Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
²⁶ Shandong Provincial Hospital affiliated to Shandong University, Jinan, China.
²⁷ Chinese People's Liberation Army General Hospital, Beijing, China.
²⁸ Clinical Trials Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

PMID: 34259386
DOI: 10.1111/1753-0407.13213

Abstract
in English, Chinese

Background: Type 2 diabetes is increasingly diagnosed at a younger age worldwide and in China. Limited data are available regarding the association between age at diabetes diagnosis and risks of albuminuria. This study sought to examine the independent effect of age at diagnosis of type 2 diabetes on the risk of albuminuria.

Methods: We used data from a nationwide multicenter study with 207 961 participants in mainland China. Age, sex, and study site were matched for 31 366 screen-detected type 2 diabetes cases and 31 366 normal controls. Age, sex, study site, and diabetes duration were matched for 7490 self-reported type 2 diabetes cases and 7490 normal controls. Risks of having albuminuria in matched type 2 diabetes vs controls were examined using multivariable logistic regression analysis in strata of age at diabetes diagnosis.

Results: Although the absolute rate of albuminuria is higher in older adults, the odds ratio of albuminuria in type 2 diabetes vs matched controls decreased with increasing age at diagnosis. For participants with diabetes diagnosed at an age of <50, 50 to 59, 60 to 69, or ≥70 years, the multivariable adjusted risk of albuminuria increased by 81%, 60%, 45%, and 33% for screen-detected diabetes, and 135%, 121%, 90%, and 58% for self-reported diabetes compared with their normal controls, respectively.

Conclusions: A younger age at diagnosis of type 2 diabetes is associated with a more significantly elevated risk of albuminuria than an older age at diagnosis in Chinese adults.

背景: 2型糖尿病的诊断年龄在全球及中国呈年轻化的趋势。目前较少研究糖尿病诊断年龄与白蛋白尿患病风险的相关性。本研究拟探讨糖尿病诊断年龄是否为白蛋白尿风险相关的独立危险因素。方法: 我们使用了来自中国大陆207961名研究对象的全国多中心研究数据。从年龄、性别和研究中心匹配的非糖尿病人群中随机选择正常对照, 另外对已诊断糖尿病患者的病程进行匹配, 最终共有31366 名新诊断2型糖尿病患者和 31366名正常对照, 及7490名已诊断2型糖尿病和7490名正常对照纳入分析。使用多元Logistic回归分析在不同糖尿病诊断年龄层中2型糖尿病患者与正常对照患白蛋白尿的风险。结果: 虽然年龄越大, 白蛋白尿患病风险越高, 但是2型糖尿病患者与正常对照组白蛋白尿的比值比随着诊断年龄的增加而降低。与正常对照组相比, 年龄 <50、50-59、60-69 或≥70 岁诊断为糖尿病的患者经过多变量校正后白蛋白尿风险仍然增加, 新诊断糖尿病分别增加了 81%、60%、45% 和 33%, 已诊断糖尿病分别增加了 135%、121%、90% 和 58%。结论: 在中国成人中, 2型糖尿病诊断年龄越低, 其白蛋白尿风险升高越明显。.

Keywords: 2型糖尿病; age at diagnosis; albuminuria; type 2 diabetes; 白蛋白尿; 诊断年龄.

Publication types

Multicenter Study

MeSH terms

Adult
Age of Onset
Aged
Albuminuria / epidemiology*
Albuminuria / etiology
Case-Control Studies
China / epidemiology
Diabetes Mellitus, Type 2 / complications*
Female
Humans
Male
Middle Aged

Abstract in English, Chinese

Publication types

MeSH terms

Grants and funding

Abstract
in English, Chinese