Clinical Characteristics And Risk Factors Of Early-onset Type 2 Diabetes Mellitus

Background:The number of patients with type 2 diabetes is increa-sing and the age of onset is decreasing. Children and adolescents with type 2 diabetes are common now. Clinical characteristics and pathogenesis of early-onset type 2 diabetes are not fully elucidated yet. Many factors are involved in early-onset type 2 diabetes. Some of patients have already with chronic complications of diabetes at the beginning of diagnosis particularly Diabetic macrovascular disease. The main reason of disabled and death was Diabetic macrovascular complications. In this study, we compare clinical datas of patients between early-onset and late-onset type 2 diabetes, looking for independent risk factors of early-onset type 2 diabetes, and for delaying early-onset type 2 diabetes.Objective:To investigate clinical characteristics and risk factors of patients with early-onset type 2 diabetes.Methods:We selected hospitalized patients from Jan 2009 to Jan 2010, in the Department of Endocrinology of the Second Affiliated Hospital of Dalian Medical University, with diagnosis of type 2 diabetes, excluding type 1 diabetes, gestational diabetes and mitochondrial gene mutation diabetes,538 cases (271 men and 267 women). And 103 cases diagnosis age less than 40 years old and 435 cases diagnosis age more than 40 years old. General informations of patients, family history of diabetes, biochemical and clinical datas were compared. To analysis clinical characteristics and risk factors of patients with early-onset type 2 diabetes.Results:1. Compared to late-onset type 2 diabetes, subjects with early-onset type 2 diabetes had higher proportion of male patients (72.8% vs45.1%), higher proportion of smoking patients (59.22%vs34.48%), higher proportion of patients with positive family history (66.02%vs 53.33%), higher non-alcoholic fatty liver disease prevalence rate (68.9% vs50.8%), higher fasting blood glucose, triglycerides, HDL-C and blood uric acid (P<0.05). Compared to late-onset type 2 diabetes, subjects with early-onset type 2 diabetes had lower hypertension prevalence rate (36.9% vs56.3%),2-hour postprandial plasma insulin and HOMA-β(P<0.05).2. Compared to late-onset type 2 diabetes, subjects with early-onset type 2 diabetes had higer proportion of patients, who were treated both oral hypoglycemic agents and insulin (70.9%vs56.6%) (P<0.05).3. The proportion that only mother history in daibetes were higher in the group of early-onset type 2 diabetes (47.1%vs27.6%) (P<0.05).4. Compared to female patients with early-onset type 2 diabetes, male had higer waist circumference, hip circumference, BMI, smoking rate, serum uric acid and lower HDL-C (P<0.05).5. By multivariate logistic regression analysis, gender, non-alcoholic fatty liver disease,2hC-P, AST were identified as independent predictors of early-onset type 2 diabetes. Hypertension, smoking, FC-P and HbAlc were identified as independent predictors of Diabetic macrovascular disease in early-onset type 2 diabetes.Conclusion:Early-onset type 2 diabetes had more significant metabo-lism disorders of glucose and lipid, more severe dysfunction of pancreaticβcell, higher proportion of patients with positive family history. And the proportion that only mother history in daibetes were higher in the group of early-onset type 2 diabetes. Male patients with early-onset type 2 diabetes had abnormal abdominal obesity, higher blood uric acid. Patients with early-onset type 2 diabetes had multiple risk factors for macrovascular disease.