Increased predicted risk for fatal/non-fatal cardiac events in youth-onset type 2 diabetes

Authors

• JL Golino
• X Wang
• J Bian
• B Ruf
• M Kelly
• BO Karim
• MC Cam
• C Xie

Abstract

Youth-onset type 2 diabetes (YT2D) is associated with traditional markers of cardiovascular disease (CVD), but the relative risk for fatal/non-fatal cardiac events in YT2D compared to their peers is unknown. Our objectives were to quantify CVD risk in youth and young adults (YYA) to inform primary prevention efforts in YT2D. Risk for fatal/non-fatal cardiac events were calculated in a pooled cohort analysis of 146 YYA, including 112 YYA<20y (15.8 (15.4-16.3y), mean (95% CI)) and 34 25y‚â•YYA‚â•20y (22.2 (21.6-22.8y)). The i3C 35-year combined risk z-score was used for YYA<20y. The ASCVD Lifetime and Framingham Lipid and BMI 30-year risk scores were used for YYA‚â•20 years. High sensitivity C-reactive protein (hsCRP) was measured as a CVD risk biomarker. ANOVA models with Bonferroni corrections were used to compare groups. YT2D had higher HbA1c and BMI, with no differences by age category. All YYA with YT2D had 3-fold higher hsCRP, and higher i3C z-score (YT2D: 0.52 (0.38-0.66); OW/OB: 0.20 (0.0-0.41); Lean: -0.53 (-0.78--0.27), P<0.01), ASCVD Lifetime risk score (YT2D: 50 (44-57%); OW/OB: 28 (12-37%); Lean: 26 (10-40%), P<0.01), Framingham BMI risk score (YT2D: 15 (11-19%); OW/OB: 5 (4-6%); Lean: 4 (2-5%), P<0.01), Framingham lipid risk score (YT2D: 10 (7-13%); OW/OB: 4 (3-6%); Lean: 4 (2-5%), P<0.01) compared to OW/OB and Lean. Youth/young adults with YT2D are predicted to have at least twice the lifetime or 30-year risk for fatal/non-fatal cardiac events compared to age-matched peers with OW/OB or normal weight. Future studies are needed to verify predicted risk, especially in the YYA population.

Scientific Focus Area: Clinical Research

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