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| Association between age at onset of type 2 diabetes mellitus and cardiovascular and cerebrovascular diseases: a retrospective cohort study |
| WANG Xiaohong, XU Zelin, WANG Cheng, JIANG Feng
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| Jinhua Center for Disease Control and Prevention, Jinhua, Zhejiang 321002, China |
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Abstract Objective To explore the association between age at onset of type 2 diabetes mellitus (T2DM) and the risk of cardiovascular and cerebrovascular diseases, so as to provide evidence for the early diagnosis and treatment of cardiovascular and cerebrovascular diseases. Methods Patients aged ≥30 years newly diagnosed with T2DM and without a baseline history of cardiovascular and cerebrovascular diseases in Jinhua City, Zhejiang Province from 2015 to 2020 were collected. Basic information, disease information, and blood biochemical indicators were collected through the Zhejiang Provincial Chronic Disease Surveillance Information Management System. A retrospective cohort study was conducted with 2024 as the follow-up endpoint. The first onset of coronary heart disease or stroke was defined as the outcome event. A multivariable Cox proportional hazards regression model was used to analyze the association between age at onset of T2DM and the risk of cardiovascular and cerebrovascular diseases. Results A total of 110 766 T2DM patients were included, including 62 312 males (56.26%) and 48 454 females (43.74%). The median age at onset of T2DM was 57.00 (interquartile range, 17.00) years. By the end of 2024, the median follow-up duration was 6.34 (interquartile range, 2.92) years, and 8 122 cases of cardiovascular and cerebrovascular diseases occurred, with an incidence of 7.33%. After adjusting for basic information such as gender and occupation, as well as blood biochemical indicators such as fasting blood glucose, the group with T2DM onset age of 30-<40?years as the reference group, the risk of cardiovascular and cerebrovascular diseases among patients with T2DM onset age of 40-<50 years, 50-<60 years, 60-<70 years, 70-<80 years and ≥80 years was reduced by 53.1% (HR=0.469, 95%CI: 0.336-0.655), 80.2% (HR=0.198, 95%CI: 0.137-0.287), 90.9% (HR=0.091, 95%CI: 0.062-0.134), 95.1% (HR=0.049, 95%CI: 0.033-0.073) and 97.6% (HR=0.024, 95%CI: 0.016-0.037), showing a downward trend (P for trend < 0.05). Conclusions The age at onset of T2DM was negatively correlated with the risk of cardiovascular and cerebrovascular diseases. Earlier age at onset of T2DM was associated with a higher risk of cardiovascular and cerebrovascular diseases.
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Received: 30 April 2026
Revised: 24 July 2026
Published: 21 August 2026
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