Work

Multivariate Trajectories of Cardiometabolic Risk Factors and Complications in Elderly Chinese Patients With Type 2 Diabetes: A Retrospective Cohort Study

Year: 2026

Type: article

Abstract: BACKGROUND: The current study aimed to identify the multivariate trajectories of cardiometabolic risk factors in elderly patients with type 2 diabetes and investigate their associations with cardiovascular disease and diabetic kidney disease (DKD). METHODS: A retrospective cohort of 27 288 patients with type 2 diabetes aged ≥60 years from China's National Basic Public Health Service Program was analyzed. All participants had ≥3 medical examinations from 2018 to 2023. A multivariate latent class mixed model was used to identify the sex-specific multitrajectories of fasting plasma glucose, low-density lipoprotein cholesterol, and diastolic blood pressure. Binary logistic regression estimated odds ratios (ORs) and 95% CIs for associations with cardiovascular disease, coronary heart disease, stroke, and DKD. RESULTS: Among elderly male patients, 3 quadratic trajectory groups were identified: stable (87.16%; n=7997), U shape (3.78%; n=347), and inverse U shape (9.06%; n=831). In elderly women, 2 quadratic trajectory groups were identified: stable (87.29%; n=15 810) and inverse U shape (12.71%; n=2303). In men, the U-shape group had elevated risks of cardiovascular disease (OR, 1.66 [95% CI, 1.26-2.20]), coronary heart disease (OR, 1.60 [95% CI, 1.09-2.33]), stroke (OR, 1.58 [95% CI, 1.12-2.23]), and DKD (OR, 1.39 [95% CI, 1.11-1.74]); the inverse U-shape group had increased DKD risk (OR, 1.35 [95% CI, 1.16-1.57]). In women, the inverse U-shape group was associated with coronary heart disease (OR, 1.31 [95% CI, 1.12-1.53]) and DKD (OR, 1.65 [95% CI, 1.51-1.81]). CONCLUSIONS: Distinct sex-specific trajectories of cardiometabolic risk factors were associated with different risks of cardiovascular and diabetic kidney complications in elderly patients with type 2 diabetes. These findings support early identification and personalized management of adverse trajectories to potentially reduce long-term complications in this population.

Source: Journal of the American Heart Association

DOI: 10.1161/jaha.125.047911