Early-Onset Type 2 Diabetes as a Risk Factor for End-Stage Renal Disease in Patients With Diabetic Kidney Disease

• Published in: Preventing chronic disease 2020-07, Vol.17, p.E50-E50, Article 200076
• Main Authors: Zheng, Li, Chen, Xiangjun, Luo, Ting, Ran, Xi, Hu, Jinbo, Cheng, Qingfeng, Yang, Shumin, Wu, Jinshan, Li, Qifu, Wang, Zhihong
• Format: Article
• Language: English
• Subjects: Adult; Age; Age of Onset; Antihypertensives; Blood pressure; Body mass index; China - epidemiology; Cholesterol; Chronic illnesses; Creatinine; Cross-Sectional Studies; Diabetes; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - physiopathology; Diabetic Nephropathies - epidemiology; Diabetic nephropathy; Disease Progression; Drugs; Female; Glucose; Hospitals; Humans; Hypertension; Incidence; Kidney diseases; Kidney Failure, Chronic - epidemiology; Lipids; Male; Medical records; Middle Aged; Mortality; Original Research; Plasma; Retrospective Studies; Risk Factors; Statistical analysis; Urogenital system; Variables; Womens health
• ISSN: 1545-1151; 1545-1151
• DOI: 10.5888/pcd17.200076

Compared with the typical onset of type 2 diabetes in middle age or older, type 2 diabetes with early age of onset has a higher risk of diabetes-related complications. It is unclear whether the early age of diabetes diagnosis would affect the development of end-stage renal disease (ESRD) in patients with diabetic kidney disease (DKD) who are at higher risk of ESRD. We enrolled 1,111 type 2 diabetes patients with DKD in this study. We used the age at diabetes diagnosis of younger than 40 years to define early-onset diabetes and 40 years or older to define late-onset diabetes. Medical history, anthropometry, and laboratory indicators were documented. ESRD was defined by estimated glomerular filtration rate (eGFR) of less than 15 mL/min/1.73 m or dialysis. Logistic regression analysis was used to explore the association between early-onset diabetes and ESRD. Early-onset diabetes patients had a longer diabetes duration, higher body mass index, and worse blood lipid metabolism profile. Compared with late-onset diabetes patients, patients with early-onset diabetes had a prevalence of ESRD that was twofold higher (9.2% vs 4.3%; P = .009). Univariate analysis showed that early-onset diabetes was a risk factor for ESRD in patients with DKD (P < .05). In multivariate logistic regression analysis, even after adjusting for sex, traditional metabolic factors, drug factors, and diabetes duration, the risk of ESRD in patients with early-onset diabetes was still 3.58-fold higher than in subjects with late-onset (95% CI, 1.47-8.74; P = .005). In patients with DKD, early-onset type 2 diabetes is an independent risk factor of ESRD.