CV risk factors high among young adults with youth-onset type 2 diabetes
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Young adults with youth-onset type 2 diabetes developed multiple cardiovascular risk factors during a decade of follow-up, according to an analysis of follow-up data from the TODAY study.
“Adverse cardiovascular outcomes, including atherosclerotic cardiovascular disease and heart failure, are major causes of morbidity and mortality in type 2 diabetes,” Rachana D. Shah, MD, MS, assistant professor of pediatrics in the division of endocrinology and diabetes at the Children’s Hospital of Philadelphia and medical director of the Adolescent PCOS Center, Philadelphia, and colleagues wrote. “In addition to suboptimal glucose control, hypertension, dyslipidemia and tobacco use are risk factors for future cardiovascular disease and are prevalent in adults with type 2 diabetes.”
Researchers analyzed longitudinal data from 677 participants (mean age, 14 years at baseline; 65% female) from the TODAY study to assess relationships between hypertension, LDL cholesterol dyslipidemia, hypertriglyceridemia and smoking with risk factors.
After a mean follow-up period of 10.2 years, the cumulative 14-year incidences of CV risk factors were greater than those at baseline: hypertension (59.2% vs. 19.2%), LDL cholesterol dyslipidemia (32.9% vs. 3.4%) and hypertriglyceridemia (37.4% vs. 18.2%).
In addition, there was a significant association between male sex, non-Hispanic white race/ethnicity, obesity, poor glycemic control, lower insulin sensitivity and reduced beta-cell function and unfavorable CV risk profile. Smoking prevalence was reported by 23.6% of participants, with the lowest prevalence found among Hispanic participants compared with non-Hispanic Black and non-Hispanic white participants (16.1% vs. 25.5% and 26.9%, respectively).
At baseline, 33% of participants with type 2 diabetes had one or more CV risk factors, 26% had one risk factor, 7% had two, and fewer than 1% had three. By the end of the follow-up period, 83% of participants with type 2 diabetes had one or more CV risk factors, 29% had one risk factor, 34% had two, 16% had three and 4% had all four.
According to the researchers, these findings may signal significant CV morbidity in the third and fourth decades of life for those with type 2 diabetes during adolescence.
“Future studies, including clinical trials, should examine how early detection and control of cardiovascular risk factors may impact long-term outcomes in youth-onset type 2 diabetes,” the researchers wrote.
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