Positive Psychosocial Factors in Childhood Predicting Lower Risk for Adult Type 2 Diabetes: The Cardiovascular Risk in Young Finns Study, 1980–2012

Objective: To evaluate the temporal patterns of cardiometabolic multimorbidity (CM) and depression in White Caucasian (WC) and African American (AA) with early-onset type 2 diabetes, and their impact on long-term Atherosclerotic Cardiovascular Disease (ASCVD). Research Design and Methods: From US electronic medical record, 101,104 AA and 505,336 WC subjects with type 2 diabetes diagnosis between 2000-2017 were identified (mean follow-up: 5.3 years). Among those without ASCVD at diagnosis, risk of ASCVD and MACE-3 (HF, myocardial infarction, or stroke) was evaluated between ethnicities by age groups. Results: Proportion of patients diagnosed at <50 years increased during 2012-2017 (AA: 34-38%; WC: 26-29%). Depression prevalence increased during 2000-2017 (AA: 15-23%; WC: 20-34%) with an increasing trend for CM at diagnosis in both groups. Compared to WC, the adjusted MACE-3 risk was significantly higher in AA across all age groups, more pronounced in 18-39 years group (HR CI: 1.42-1.88) and in people with and without depression. AA had 17% (HR CI: 1.05-1.31) significantly higher adjusted ASCVD risk in the 18-39 years group only. Depression was independently associated with ASCVD and MACE-3 risk in both ethnic groups across all age groups. Other comorbidities were independently associated with ASCVD and MACE-3 risk only among WC. Conclusions: AA have higher cardiovascular risk compared to WC, particularly in early-onset T2DM. CM and depression at diabetes diagnosis has been increasing over last two decades in both ethnic groups. Strategies for screening and optimal management of CM and depression particularly in early-onset T2DM may result in a lower cardiovascular risk.

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Role of Conventional Childhood Risk Factors Versus Genetic Risk in the Development of Type 2 Diabetes and Impaired Fasting Glucose in Adulthood: The Cardiovascular Risk in Young Finns Study

Diabetes Care ◽

10.2337/dc16-0167 ◽

2016 ◽

Vol 39 (8) ◽

pp. 1393-1399 ◽

Cited By ~ 12

Author(s):

Niina Pitkänen ◽

Markus Juonala ◽

Tapani Rönnemaa ◽

Matthew A. Sabin ◽

Nina Hutri-Kähönen ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Cardiovascular Risk ◽

Impaired Fasting Glucose ◽

Genetic Risk ◽

Fasting Glucose ◽

Childhood Risk Factors ◽

Young Finns Study

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Association of cardiometabolic multimorbidity and depression with cardiovascular events in early-onset adult type 2 diabetes: a multi-ethnic study in the USA

10.2337/figshare.13100141 ◽

2020 ◽

Author(s):

John Epoh Dibato ◽

Olga Montvida ◽

Francesco Zaccardi ◽

Jack Alistair Sargeant ◽

Melanie J Davies ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Risk ◽

Ethnic Groups ◽

Early Onset ◽

Age Groups ◽

Atherosclerotic Cardiovascular Disease ◽

Diabetes Diagnosis ◽

Adult Type ◽

The Usa

Objective: To evaluate the temporal patterns of cardiometabolic multimorbidity (CM) and depression in White Caucasian (WC) and African American (AA) with early-onset type 2 diabetes, and their impact on long-term Atherosclerotic Cardiovascular Disease (ASCVD). Research Design and Methods: From US electronic medical record, 101,104 AA and 505,336 WC subjects with type 2 diabetes diagnosis between 2000-2017 were identified (mean follow-up: 5.3 years). Among those without ASCVD at diagnosis, risk of ASCVD and MACE-3 (HF, myocardial infarction, or stroke) was evaluated between ethnicities by age groups. Results: Proportion of patients diagnosed at <50 years increased during 2012-2017 (AA: 34-38%; WC: 26-29%). Depression prevalence increased during 2000-2017 (AA: 15-23%; WC: 20-34%) with an increasing trend for CM at diagnosis in both groups. Compared to WC, the adjusted MACE-3 risk was significantly higher in AA across all age groups, more pronounced in 18-39 years group (HR CI: 1.42-1.88) and in people with and without depression. AA had 17% (HR CI: 1.05-1.31) significantly higher adjusted ASCVD risk in the 18-39 years group only. Depression was independently associated with ASCVD and MACE-3 risk in both ethnic groups across all age groups. Other comorbidities were independently associated with ASCVD and MACE-3 risk only among WC. Conclusions: AA have higher cardiovascular risk compared to WC, particularly in early-onset T2DM. CM and depression at diabetes diagnosis has been increasing over last two decades in both ethnic groups. Strategies for screening and optimal management of CM and depression particularly in early-onset T2DM may result in a lower cardiovascular risk.

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Abstract P498: Association of Steps Per Day With Diabetes, Hypertension, and Obesity Over 10 Years: Results From the Coronary Artery Risk Development in Young Adults Study

Circulation ◽

10.1161/circ.141.suppl_1.p498 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Amanda E Paluch ◽

Kelley Pettee Gabriel ◽

Janet E Fulton ◽

Juned Siddique ◽

Kara M Whitaker ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Lower Risk ◽

Cox Models ◽

Step Counts ◽

Steps Per Day

Introduction: Step counts are an easy way for individuals to quantify their physical activity; there is limited data relating accelerometer-derived step counts with the onset of cardiovascular risk factors. We hypothesized that steps/day are inversely associated with type 2 diabetes, stage 2 hypertension, and obesity 10 years later. Methods: Data are from 1,923 CARDIA study participants with valid (≥4 days with ≥10 hours/day) accelerometer wear (ActiGraph 7164) in 2005-2006 with at least one follow-up visit 5- or 10- years later. Multivariable Cox models calculated hazard ratios (HR) and 95% confidence intervals (CI) for incidence of type 2 diabetes, stage 2 hypertension, and obesity. Results: The analytic sample (45.3±3.6 years; 58% women, 41% black) had a mean follow-up of 9.7±1.3 years. After adjusting for demographics and lifestyle characteristics, every 1000 higher steps/day was associated with a 10% lower risk of diabetes and 5% lower risk of hypertension. When adding comorbidities to the model, the HRs were slightly attenuated, and remained significant for diabetes [0.93 (95% CI, 0.87-0.99)]. Compared to the lowest step quartile, the highest quartile was at a 43% lower risk of diabetes and a 31% lower risk of hypertension. When testing for interactions by race or sex, the only significant interaction was for sex with obesity as the outcome. Steps were only associated with obesity in women, where every 1000 higher steps/day were associated with a 13% lower risk, and the highest quartile was 61% less likely to develop obesity compared to the lowest quartile. Conclusions: Among middle age adults, accumulating a higher volume of steps/day was associated with a lower risk of type 2 diabetes and stage 2 hypertension. In women, higher steps/day was associated with lower risk of obesity. Encouraging the accumulation of steps/day may be an effective public health strategy to lower the burden of cardiovascular risk factors.

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