期刊
DIABETES CARE
卷 39, 期 12, 页码 2296-2303出版社
AMER DIABETES ASSOC
DOI: 10.2337/dc16-1162
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资金
- National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health [R01-DK034818]
- Rossi Memorial Fund
- National Institutes of Health [P30-MH-090333]
OBJECTIVE The degree towhichmortality and cardiovascular disease (CVD) incidence remains elevated in young U.S. adultswith type 1 diabetes (T1DM) is unclear. We determined contemporary rates for adults < 45 years old with long-standing, childhood-onset T1DM from the Pittsburgh Epidemiology of Diabetes Complications (EDC) Study. RESEARCH DESIGN AND METHODS Members of the EDC Study cohort < 45 years old during the 1996-2012 follow-up period (n = 502) were studied. Mortality and CVD rateswere calculated for those aged 30-39 and 40-44 years. Data from the background Allegheny County, Pennsylvania, population were used to calculate age-and sex-matched standardized mortality (SMR) and incidence rate ratios (IRR). RESULTS In both age groups, the SMRfor total mortality was similar to 5 (95% CIs: 30-39-year-olds, 2.8, 7.2; 40-44-year-olds, 3.4, 7.8). CVD mortality SMRs ranged from 19 (95% CI 11, 32) to 33 (95% CI 17, 59). Hospitalized CVD IRR was similar to 8 (95% CIs: 30-39-year-olds, 2.5, 18.9; 40-44-year-olds, 4.5, 12.8); revascularization procedures account for much of the increased risk. For all outcomes, the relative risk was larger in women. Participants aged 30-39 years had 6.3% (95% CI 3.8, 9.8) absolute 10-year CVD risk, approaching the American College of Cardiology/American Heart Association-recommended cut point of 7.5% for initiation of statin therapy in older adults. CONCLUSIONS Total and CVD mortality and hospitalized CVD are all significantly increased in this contemporary U.S. cohort of young adults with long-standing T1DM. These findings support more aggressive risk factor management in T1DM, especially among women.
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