Low birthweight in patients with type 2 diabetes is associated with elevated risk of cardiovascular events and mortality
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Low birthweight in patients with type 2 diabetes is associated with elevated risk of cardiovascular events and mortality. / Hansen, Aleksander L.; Brøns, Charlotte; Engelhard, Leonie M.; Andersen, Mette K.; Hansen, Torben; Nielsen, Jens S.; Vestergaard, Peter; Højlund, Kurt; Jessen, Niels; Olsen, Michael H.; Sørensen, Henrik T.; Thomsen, Reimar W.; Vaag, Allan.
In: Diabetologia, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Low birthweight in patients with type 2 diabetes is associated with elevated risk of cardiovascular events and mortality
AU - Hansen, Aleksander L.
AU - Brøns, Charlotte
AU - Engelhard, Leonie M.
AU - Andersen, Mette K.
AU - Hansen, Torben
AU - Nielsen, Jens S.
AU - Vestergaard, Peter
AU - Højlund, Kurt
AU - Jessen, Niels
AU - Olsen, Michael H.
AU - Sørensen, Henrik T.
AU - Thomsen, Reimar W.
AU - Vaag, Allan
N1 - Publisher Copyright: © The Author(s) 2024.
PY - 2024
Y1 - 2024
N2 - 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.)
AB - 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.)
KW - Birthweight
KW - Cardiovascular disease
KW - Cohort study
KW - Epidemiology
KW - Fetal programming
KW - Mortality
KW - Stroke
KW - Type 2 diabetes
U2 - 10.1007/s00125-024-06170-z
DO - 10.1007/s00125-024-06170-z
M3 - Journal article
C2 - 38777869
AN - SCOPUS:85193811716
JO - Diabetologia
JF - Diabetologia
SN - 0012-186X
ER -
ID: 394709432