Changes in cardiovascular risk factors for diabetes among young versus older English adult populations

Abstract

Background To examine the prevalence of cardiovascular disease (CVD) risk factors among young, middle-aged and older adults with and without diabetes. Method Among 23,501 participants of pooled nationally representative Health Survey for England years 2003, 2006, 2011 and 2017 (new sample was interviewed each year), CVD risk-factors associated with diabetes versus non-diabetes among young (18-54y), middle (55-74y) and older (≥ 75y) adults were assessed. Models were adjusted for age, sex, locality, ethnicity, qualification, survey year, cardiovascular disease, raised blood pressure, dyslipidaemia, combined obesity, current smoking, and excessive drinking. Results 11.9% of adults had diabetes: prevalence was 5.3% in aged 18-54y, 18.1% in aged 55-74y, and 29.1% in older adults. Diabetes prevalence was higher in 2017 than 2003 in each age-group. After adjustments for confounding variables, significant predictors of diabetes among young were CVD history, raised BP, dyslipidaemia, combined obesity, and survey year 2006. Effect of dyslipidaemia in young adults on the risk of diabetes was stronger in more recent years 2006 (Odds Ratio =3.87), 2011 (3.04) and 2017 (3.42) as compared with 2003. Among middle age, CVD history, raised BP, dyslipidaemia, combined obesity and survey years 2006 and 2011 were significant predictors of diabetes whereas in older populations only dyslipidaemia, combined obesity and survey year 2011 showed strong association with risk of diabetes. Irrespective of age, smoking and excessive drinking were not significantly associated with diabetes. Conclusion Young adults with diabetes have higher odds of having cardiovascular risk factors, with dyslipidaemia being the strongest risk factor. Early and specific intervention among young adults would delay CVD outcomes.