Clinical Characteristics And Risk Factors Of Macro Vascular Complications In Early Onset Type2Diabetes

Objective: To investigate Clinical characteristics and risk factors of macrovascularcomplications in early onset type2diabetes.Methords: We selected hospitalized patients from Jan2009to Aug2011,in theDepartment of Endocrinology of the Second Affiliated Hospital of Dalian MedicalUniversity, with diagnosis of type2diabetes, excluding Type1diabetes,gestationaldiabetes and mitochondrial gene mutation diabetes,883cases(481men and402women).And325cases diagnosis age less than40years old and558cases diagnosis agemore than40years old.General informations of patients,family history ofdiabetes,biochemical and clinical datas were compared.To analysis clinicalcharacteristics and risk factors of macrovascular complications with early-onset type2diabetes.Results:1.Compared to late-onset type2diabetes,subjects with early-onset type2diabetes had higher proportion of male patients (64%vs49%),higher proportion ofsmoking patients (54%vs21%),higher proportion of patients with positive familyhistory (66%vs51%),higher non-alcoholic fatty liver disease prevalence rate (68%vs45%),longer duration,higher fasting blood glucose,higher2-hour postprandial plasmainsulin,higher triglycerides,higher HDL-C and higher blood uric acid (P＜0.05).Compared to late-onset type2diabetes,subjects with early-onset type2diabeteshad lower age,the age of diagnosis and hypertension prevalence rate (P＜0.05).2.Compared to late-onset type2diabetes,subjects with early-onset type2diabeteshad lower risk of the cardiovascular disease (9.85%vs21.33%),lower risk ofthe cerebrovascular disease (10.77%vs23.12%), and lower risk of the Carotid ArteryAtherosclerosis disease (54.46%vs61.65%).In the groups of≥10years duration,compared to late-onset type2diabetes,subjects with early-onset type2diabeteshad lower risk of the cardiovascular disease,lower risk of the cerebrovascular disease,lower risk of the Carotid Artery Atherosclerosis disease,and lower risk ofvascular disease in lower limbs（3.21%vs8.95%，1.28%vs12.96%，44.87%vs62.35%，4.00%vs9.00%，P＜0.05）.In the groups of10~≤20years duration,compared tolate-onset type2diabetes,subjects with early-onset type2diabetes had lower risk ofthe cardiovascular disease, lower risk of the cerebrovascular disease,and lower risk ofvascular disease in lower limbs（5.62%vs26.35%，13.48%vs23.65%，4.00%vs11.00%，P＜0.05）.In the groups of≥20years duration, compared to late-onset type2diabetes,subjects with early-onset type2diabetes had higher risk of the Carotid ArteryAtherosclerosis disease (70.00%vs53.49%),but had lower risk of the cardiovasculardisease and lower risk of the cerebrovascular disease（5.62%vs26.35%，13.48%vs23.65%,P＜0.05).The longitudinal comparation of different duration hints that the type2diabetes in the groups of≥20years duration had higher prevalence rate ofmacrovascular complications than that in the groups of10~≤20years duration and thetype2diabetes in the groups of10~≤20years duration had higher prevalence rate ofmacrovascular complications than that in the groups of≤10years duration.3.Compared to early-onset type2diabetes without macrovascularcomplications,subjects with early-onset type2diabetes with macrovascularcomplications had higher risk of proportion of male patients (68%vs55%),higherproportion of smoking patients (60%vs42%),higher hypertension prevalence rate (65%vs53%), higher age, longer duration,higher HbA1c,higher cholestenone,highertriglycerides and higher LDL-C (P＜0.05).4.Age, BMI, triglycerides,2h-PBG, HbA1c and smoking were identified asindependent predictors of Diabetic macrovascular disease in early-onset type2diabetes.Conclusion:1.Early-onset type2diabetes had higher proportion of patients withpositive family history and had more significant metabolism disorders of glucose andlipid.2.In the groups of﹤20years duration,compared to late-onset type2diabetes,subjects with early-onset type2diabetes had lower riskof the cardiovasculardisease,lower risk of the cerebrovascular disease,and lower risk of vascular disease inlower limbs.In the groups of≥20years duration,compared to late-onset type2diabetes,subjects with early-onset type2diabetes had higher risk of the Carotid ArteryAtherosclerosis disease.Following the process of the diabetes,the prevalence rate of macrovascular complications in type2diabetes tend to be more widespread.3.Age,BMI, triglycerides,2h-PBG, HbA1c and smoking were identified asindependent predictors of Diabetec macrovascular disease in early-onset type2diabetes.