China: The positive association between diabetes duration and risk of chronic kidney disease (CKD) gets amplified in people with diabetes diagnosis at a young age, a recent study has found. The study is published in the journal Diabetologia.
Type 2 diabetes is a chronic condition in which the body is not able to efficiently utilize insulin hormone. According to data from WHO, the worldwide prevalence of diabetes has increased from 108 million in 1980 to 422 million in 2014. Diabetes is the leading cause of kidney failure, accounting for 44% percent of new cases.
Andrea O. Y. Luk, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China, and colleagues postulated that increased lifetime risk of CKD in young-onset diabetes is attributable to both more aggressive disease and long disease duration. They examined if age at diabetes diagnosis changes the effect of diabetes duration on CKD risk.
For this purpose, the researchers included 436,744 people with incident type 2 diabetes in the Hong Kong Diabetes Surveillance Database (HKDSD) and 16,979 people with prevalent type 2 diabetes in the Hong Kong Diabetes Register (HKDR). Using Poisson models, they described joint effects of age at diabetes diagnosis, diabetes duration, and attained age on incidence of CKD in HKDSD. Interaction effect of age at diabetes diagnosis and diabetes duration on risk of CKD were also examined with adjustment for confounders in HKDR.
Based on the study, the researchers found the following:
During a median follow-up of 5.3 years, 134,043 cases of CKD were recorded in the HKDSD.
The incidence rate ratio for CKD comparing people of the same attained age but diagnosed with diabetes at ages 5 years apart was higher for people with a younger age at diabetes diagnosis, but decreased with increasing age at diabetes diagnosis.
During a median follow-up of 6.3 years, 6500 people developed CKD in the HKDR.
The increased risk of CKD with longer diabetes duration decreased with older age at diabetes diagnosis.
The adjusted HR for CKD associated with 5-year increase in diabetes duration was 1.37 in people with diabetes diagnosed at 20–29 years and 1.01 in those diagnosed at ≥70 years.
The researchers concluded, "young age at diabetes diagnosis amplified the effect of increasing diabetes duration on increased risk of CKD."
Reference:
The study titled, "Young age at diabetes diagnosis amplifies the effect of diabetes duration on risk of chronic kidney disease: a prospective cohort study," is published in the journal Diabetologia.
DOI: https://link.springer.com/article/10.1007/s00125-021-05494-4