The Association Between Age at Diagnosis of Type 2 Diabetes and Albuminuria in Chinese Adults

Abstract

Background: Type 2 diabetes is increasingly diagnosed at a younger age worldwide and in China. Limited data are available regarding the association between age at diabetes diagnosis and risks of albuminuria, which is a common microvascular complication in diabetes patients. In addition, few studies on age at diagnosis and outcomes have fully accounted for the complex interplay between age at diagnosis and the actual age or diabetes duration, all of which are independently associated with vascular risks.Methods: We used data from a nationwide multicenter study with 207,961 participants recruited from 25 communities across mainland China during 2010-2012. Age, sex, and study sites were matched for 31,366 screen-detected type 2 diabetes and 31,366 normal controls. Age, sex, study sites, and diabetes duration were matched for 7,490 self-reported type 2 diabetes and 7,490 normal controls. Risks of having albuminuria in matched type 2 diabetes vs. normal controls were examined using multivariable logistic regression analysis in strata of age at type 2 diabetes diagnosis (<50, 50-59, 60-69, or ≥70 years). Albuminuria was defined as urinary albumin-to-creatinine ratio ≥30 mg/g.Results: Percentages of albuminuria were significantly higher among type 2 diabetes patients compared with normal controls in each stratum of age at diagnosis. Although the absolute rate of albuminuria is higher in older adults, the odds ratio of albuminuria in type 2 diabetes vs. matched controls decreased with increasing age at diagnosis. For participants with diabetes diagnosed at an age of <50, 50-59, 60-69, or ≥70 years, the multivariable adjusted risk of albuminuria increased by 81%, 60%, 45%, and 33% for screen-detected diabetes, and 135%, 121%, 90%, and 58% for self-reported diabetes compared with their normal controls, respectively. Conclusions: A younger age at diagnosis of type 2 diabetes is associated with a more significantly elevated risk of albuminuria than an older age at diagnosis in Chinese adults.