Low birthweight in patients with type 2 diabetes is associated with elevated risk of cardiovascular events and mortality
(2024) In Diabetologia- Abstract
Aims/hypothesis: Low birthweight is a risk factor for type 2 diabetes and CVD. This prospective cohort study investigated whether lower birthweight increases CVD risk after diagnosis of type 2 diabetes. Methods: Original midwife records were evaluated for 8417 participants recently diagnosed with type 2 diabetes in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. Patients were followed for the first occurrence of a composite CVD endpoint (myocardial infarction, coronary revascularisation, peripheral arterial disease, stroke, unstable angina, heart failure or CVD death), a three-component endpoint comprising major adverse cardiovascular events (MACE), and all-cause mortality. Ten-year risks were estimated using... (More)
Aims/hypothesis: Low birthweight is a risk factor for type 2 diabetes and CVD. This prospective cohort study investigated whether lower birthweight increases CVD risk after diagnosis of type 2 diabetes. Methods: Original midwife records were evaluated for 8417 participants recently diagnosed with type 2 diabetes in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. Patients were followed for the first occurrence of a composite CVD endpoint (myocardial infarction, coronary revascularisation, peripheral arterial disease, stroke, unstable angina, heart failure or CVD death), a three-component endpoint comprising major adverse cardiovascular events (MACE), and all-cause mortality. Ten-year risks were estimated using the Aalen–Johansen estimator considering non-CVD death as a competing risk. HRs were determined by Cox regression. Models were controlled for sex, age, calendar year at birth, family history of diabetes and born-at-term status. Results: A total of 1187 composite CVD endpoints, 931 MACE, and 1094 deaths occurred during a median follow-up period of 8.5 years. The 10-year standardised composite CVD risk was 19.8% in participants with a birthweight <3000 g compared with 16.9% in participants with a birthweight of 3000–3700 g, yielding a risk difference (RD) of 2.9% (95% CI 0.4, 5.4) and an adjusted HR of 1.20 (95% CI 1.03, 1.40). The 10-year MACE risk for birthweight <3000 g was similarly elevated (RD 2.4%; 95% CI 0.1, 4.7; HR 1.22; 95% CI 1.01, 1.46). The elevated CVD risk was primarily driven by stroke, peripheral arterial disease and CVD death. All-cause mortality showed no substantial difference. Conclusions/interpretation: Having a birthweight <3000 g is associated with higher CVD risk among patients with type 2 diabetes, driven primarily by risk of stroke and CVD death. Graphical Abstract: (Figure presented.)
(Less)
- author
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- epub
- subject
- keywords
- Birthweight, Cardiovascular disease, Cohort study, Epidemiology, Fetal programming, Mortality, Stroke, Type 2 diabetes
- in
- Diabetologia
- publisher
- Springer
- external identifiers
-
- pmid:38777869
- scopus:85193811716
- ISSN
- 0012-186X
- DOI
- 10.1007/s00125-024-06170-z
- language
- English
- LU publication?
- yes
- id
- 8d2c1ac1-4aeb-4ef1-867c-df23f7f1c3cb
- date added to LUP
- 2024-06-14 15:17:51
- date last changed
- 2024-06-15 03:00:05
@article{8d2c1ac1-4aeb-4ef1-867c-df23f7f1c3cb,
abstract = {{<p>Aims/hypothesis: Low birthweight is a risk factor for type 2 diabetes and CVD. This prospective cohort study investigated whether lower birthweight increases CVD risk after diagnosis of type 2 diabetes. Methods: Original midwife records were evaluated for 8417 participants recently diagnosed with type 2 diabetes in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. Patients were followed for the first occurrence of a composite CVD endpoint (myocardial infarction, coronary revascularisation, peripheral arterial disease, stroke, unstable angina, heart failure or CVD death), a three-component endpoint comprising major adverse cardiovascular events (MACE), and all-cause mortality. Ten-year risks were estimated using the Aalen–Johansen estimator considering non-CVD death as a competing risk. HRs were determined by Cox regression. Models were controlled for sex, age, calendar year at birth, family history of diabetes and born-at-term status. Results: A total of 1187 composite CVD endpoints, 931 MACE, and 1094 deaths occurred during a median follow-up period of 8.5 years. The 10-year standardised composite CVD risk was 19.8% in participants with a birthweight <3000 g compared with 16.9% in participants with a birthweight of 3000–3700 g, yielding a risk difference (RD) of 2.9% (95% CI 0.4, 5.4) and an adjusted HR of 1.20 (95% CI 1.03, 1.40). The 10-year MACE risk for birthweight <3000 g was similarly elevated (RD 2.4%; 95% CI 0.1, 4.7; HR 1.22; 95% CI 1.01, 1.46). The elevated CVD risk was primarily driven by stroke, peripheral arterial disease and CVD death. All-cause mortality showed no substantial difference. Conclusions/interpretation: Having a birthweight <3000 g is associated with higher CVD risk among patients with type 2 diabetes, driven primarily by risk of stroke and CVD death. Graphical Abstract: (Figure presented.)</p>}},
author = {{Hansen, Aleksander L. and Brøns, Charlotte and Engelhard, Leonie M. and Andersen, Mette K. and Hansen, Torben and Nielsen, Jens S. and Vestergaard, Peter and Højlund, Kurt and Jessen, Niels and Olsen, Michael H. and Sørensen, Henrik T. and Thomsen, Reimar W. and Vaag, Allan}},
issn = {{0012-186X}},
keywords = {{Birthweight; Cardiovascular disease; Cohort study; Epidemiology; Fetal programming; Mortality; Stroke; Type 2 diabetes}},
language = {{eng}},
publisher = {{Springer}},
series = {{Diabetologia}},
title = {{Low birthweight in patients with type 2 diabetes is associated with elevated risk of cardiovascular events and mortality}},
url = {{http://dx.doi.org/10.1007/s00125-024-06170-z}},
doi = {{10.1007/s00125-024-06170-z}},
year = {{2024}},
}