We compared beta-cell function in Chinese with type 2 diabetes diagnosed at age <40 years (young-onset diabetes, YOD) and ≥40 years (late-onset diabetes, LOD).
In this cross-sectional study, we selected participants from two cohorts of people with type 2 diabetes recruited in 1996-2012 (n =4,376) and 2020-2021 (n =794). Multivariable linear regression models were applied to compare homeostasis model assessment of beta-cell function (HOMA2-%B) and fasting plasma C-peptide across diabetes duration at enrolment between YOD and LOD.
The YOD group (n=1,876, mean [SD] age: 39.9 [7.5] years, median [IQR] diabetes duration: 6 [2-12] years) was more likely to have family history of diabetes (61.6% vs 43.6%), obesity (41.9% vs 26.8%), dyslipidaemia (61.7% vs 54.4%), and worse glycaemic control (mean HbA1c 7.7% vs 7.4%) than those with LOD (n =3,294, age: 60.8 [10.6] years, diabetes duration: 5 [1-10] years). When compared to people with LOD, HOMA2-%B and fasting plasma C-peptide were lower in the YOD group, consistently among those with BMI <27.5 kg/m and HOMA2-IR ≤1.6 (median value), adjusted for year at enrolment, sex, diabetes duration, family history of diabetes, HbA1c, weight and lipid indices (p <0.01). Cross-sectionally, the slopes of decline in HOMA2-%B by diabetes duration were greater in YOD than LOD among individuals with BMI <27.5 kg/m (p-interaction =0.015).
Chinese with YOD had accelerated loss of beta-cell function than those with LOD especially in non-obese individuals.
Copyright © 2023. Published by Elsevier B.V.
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