Young-onset diabetes poses a greater risk of end-stage renal disease (ESRD) than cardiovascular disease and stroke: a retrospective cohort study of UK Biobank

Debasish Kar; Richard Byng; Stuart Spicer; Nicolas Farina; Jonathan Pinkney; Soon Song; Bedowra Zabeen; Shubharthi Kar; Jitendra Jonnagaddala; Siaw-Teng Liaw; Aya El-Wazir; Mintu Nath; Moein AB Khan; Aziz Sheikh; Simon de Lusignan

doi:10.21203/rs.3.rs-5951257/v1

Young-onset diabetes poses a greater risk of end-stage renal disease (ESRD) than cardiovascular disease and stroke: a retrospective cohort study of UK Biobank

Debasish Kar
, Richard Byng
, Stuart Spicer
, Nicolas Farina
, Jonathan Pinkney
, Soon Song
, Bedowra Zabeen
, Shubharthi Kar
, Jitendra Jonnagaddala
, Siaw-Teng Liaw
, Aya El-Wazir
, Mintu Nath
, Moein AB Khan
, Aziz Sheikh
, Simon de Lusignan

Sheffield Teaching Hospital NHS Trust, UK
Bangladesh Institute for Research and Rehabilitation in Diabetes, Endocrinology and Metabolism, Bangladesh.
Sylhet M.A.G Osmani Medical College, Bangladesh
UNSW, Sydney, Australia
Suez Canal University, Ismailia, Egypt
University of Aberdeen
University of Al-Ain, UAE
Nuffield Dep[artment of Primary Care Health Sciences, University of Oxford, UK

Research output: Working paper / Preprint › Preprint

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Abstract

Background
In the last three decades, in people with diabetes, while the mortality and morbidity due to cardiovascular disease (CVD) and stroke have declined, the incidence of end-stage renal disease (ESRD) has crept up. The precise cause for this shift is unknown. Intriguingly, during the same period, the incidence of diabetes in younger people has almost tripled worldwide. This study examines whether young-onset diabetes is a greater risk for ESRD compared to CVD and stroke.

Methods
We conducted this retrospective cohort study using data from volunteers (n = 502,408) aged 40–69 years recruited in UK Biobank between 2006 and 2010. The exposure variable was the age of diabetes diagnosis, while the outcomes of interest were ESRD, myocardial infarction, angina, and stroke. The cumulative follow-up period from the mean age of diabetes to the mean age of the outcomes of interest was 838,592 person-years. Univariate and multivariate logistic regression models were fitted to assess odds ratios (ORs) and 95% confidence intervals (CIs). Model performance was evaluated using receiver operating characteristics (ROC) analysis and calibration plots.

Findings:
Out of 26,206 people with diabetes, 1.16% (n = 303) had ESRD, 8.58% (n = 2250) had a myocardial infarction, 7.47% (n = 1958) had angina, and 2.94% (n = 771) had a stroke. Compared to later-onset, young-onset diabetes is linked with an earlier onset of ESRD. Based on the age of diabetes diagnosis, the univariate logistic regression showed that compared to those diagnosed after the age of 60, the odds of ESRD for those diagnosed at ages < 20, 20–40, and 41–60 years were OR [2.33 (95% CI 1.50–3.84), 7.78 (95% CI 4.81–13.16), and 5.26 (95% CI 3.00–9.40)], respectively. Myocardial infarction and stroke did not have a statistically significant relationship with diabetes diagnosis age. Multivariate models adjusted for sex and albuminuria confirmed the increased odds of ESRD in people with younger onset and longer duration of diabetes.

Interpretation:
People with younger onset and longer duration of diabetes are at a higher risk of ESRD than CVD and stroke.

Original language	English
Publisher	Research Square Platform LLC
DOIs	https://doi.org/10.21203/rs.3.rs-5951257/v1
Publication status	Published - 14 Feb 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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10.21203/rs.3.rs-5951257/v1Licence: CC BY

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https://www.researchsquare.com/article/rs-5951257/v1

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Kar, D., Byng, R., Spicer, S., Farina, N., Pinkney, J., Song, S., Zabeen, B., Kar, S., Jonnagaddala, J., Liaw, S.-T., El-Wazir, A., Nath, M., Khan, M. AB., Sheikh, A., & de Lusignan, S. (2025). Young-onset diabetes poses a greater risk of end-stage renal disease (ESRD) than cardiovascular disease and stroke: a retrospective cohort study of UK Biobank. Research Square Platform LLC. https://doi.org/10.21203/rs.3.rs-5951257/v1

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title = "Young-onset diabetes poses a greater risk of end-stage renal disease (ESRD) than cardiovascular disease and stroke: a retrospective cohort study of UK Biobank",

abstract = "Background In the last three decades, in people with diabetes, while the mortality and morbidity due to cardiovascular disease (CVD) and stroke have declined, the incidence of end-stage renal disease (ESRD) has crept up. The precise cause for this shift is unknown. Intriguingly, during the same period, the incidence of diabetes in younger people has almost tripled worldwide. This study examines whether young-onset diabetes is a greater risk for ESRD compared to CVD and stroke. Methods We conducted this retrospective cohort study using data from volunteers (n = 502,408) aged 40–69 years recruited in UK Biobank between 2006 and 2010. The exposure variable was the age of diabetes diagnosis, while the outcomes of interest were ESRD, myocardial infarction, angina, and stroke. The cumulative follow-up period from the mean age of diabetes to the mean age of the outcomes of interest was 838,592 person-years. Univariate and multivariate logistic regression models were fitted to assess odds ratios (ORs) and 95\% confidence intervals (CIs). Model performance was evaluated using receiver operating characteristics (ROC) analysis and calibration plots. Findings: Out of 26,206 people with diabetes, 1.16\% (n = 303) had ESRD, 8.58\% (n = 2250) had a myocardial infarction, 7.47\% (n = 1958) had angina, and 2.94\% (n = 771) had a stroke. Compared to later-onset, young-onset diabetes is linked with an earlier onset of ESRD. Based on the age of diabetes diagnosis, the univariate logistic regression showed that compared to those diagnosed after the age of 60, the odds of ESRD for those diagnosed at ages < 20, 20–40, and 41–60 years were OR [2.33 (95\% CI 1.50–3.84), 7.78 (95\% CI 4.81–13.16), and 5.26 (95\% CI 3.00–9.40)], respectively. Myocardial infarction and stroke did not have a statistically significant relationship with diabetes diagnosis age. Multivariate models adjusted for sex and albuminuria confirmed the increased odds of ESRD in people with younger onset and longer duration of diabetes. Interpretation: People with younger onset and longer duration of diabetes are at a higher risk of ESRD than CVD and stroke.",

author = "Debasish Kar and Richard Byng and Stuart Spicer and Nicolas Farina and Jonathan Pinkney and Soon Song and Bedowra Zabeen and Shubharthi Kar and Jitendra Jonnagaddala and Siaw-Teng Liaw and Aya El-Wazir and Mintu Nath and Khan, \{Moein AB\} and Aziz Sheikh and \{de Lusignan\}, Simon",

year = "2025",

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day = "14",

doi = "10.21203/rs.3.rs-5951257/v1",

language = "English",

publisher = " Research Square Platform LLC",

type = "WorkingPaper",

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}

Kar, D , Byng, R , Spicer, S , Farina, N , Pinkney, J, Song, S, Zabeen, B, Kar, S, Jonnagaddala, J, Liaw, S-T, El-Wazir, A, Nath, M, Khan, MAB, Sheikh, A & de Lusignan, S 2025 'Young-onset diabetes poses a greater risk of end-stage renal disease (ESRD) than cardiovascular disease and stroke: a retrospective cohort study of UK Biobank' Research Square Platform LLC. https://doi.org/10.21203/rs.3.rs-5951257/v1

TY - UNPB

T1 - Young-onset diabetes poses a greater risk of end-stage renal disease (ESRD) than cardiovascular disease and stroke: a retrospective cohort study of UK Biobank

AU - Kar, Debasish

AU - Byng, Richard

AU - Spicer, Stuart

AU - Farina, Nicolas

AU - Pinkney, Jonathan

AU - Song, Soon

AU - Zabeen, Bedowra

AU - Kar, Shubharthi

AU - Jonnagaddala, Jitendra

AU - Liaw, Siaw-Teng

AU - El-Wazir, Aya

AU - Nath, Mintu

AU - Khan, Moein AB

AU - Sheikh, Aziz

AU - de Lusignan, Simon

PY - 2025/2/14

Y1 - 2025/2/14

N2 - Background In the last three decades, in people with diabetes, while the mortality and morbidity due to cardiovascular disease (CVD) and stroke have declined, the incidence of end-stage renal disease (ESRD) has crept up. The precise cause for this shift is unknown. Intriguingly, during the same period, the incidence of diabetes in younger people has almost tripled worldwide. This study examines whether young-onset diabetes is a greater risk for ESRD compared to CVD and stroke. Methods We conducted this retrospective cohort study using data from volunteers (n = 502,408) aged 40–69 years recruited in UK Biobank between 2006 and 2010. The exposure variable was the age of diabetes diagnosis, while the outcomes of interest were ESRD, myocardial infarction, angina, and stroke. The cumulative follow-up period from the mean age of diabetes to the mean age of the outcomes of interest was 838,592 person-years. Univariate and multivariate logistic regression models were fitted to assess odds ratios (ORs) and 95% confidence intervals (CIs). Model performance was evaluated using receiver operating characteristics (ROC) analysis and calibration plots. Findings: Out of 26,206 people with diabetes, 1.16% (n = 303) had ESRD, 8.58% (n = 2250) had a myocardial infarction, 7.47% (n = 1958) had angina, and 2.94% (n = 771) had a stroke. Compared to later-onset, young-onset diabetes is linked with an earlier onset of ESRD. Based on the age of diabetes diagnosis, the univariate logistic regression showed that compared to those diagnosed after the age of 60, the odds of ESRD for those diagnosed at ages < 20, 20–40, and 41–60 years were OR [2.33 (95% CI 1.50–3.84), 7.78 (95% CI 4.81–13.16), and 5.26 (95% CI 3.00–9.40)], respectively. Myocardial infarction and stroke did not have a statistically significant relationship with diabetes diagnosis age. Multivariate models adjusted for sex and albuminuria confirmed the increased odds of ESRD in people with younger onset and longer duration of diabetes. Interpretation: People with younger onset and longer duration of diabetes are at a higher risk of ESRD than CVD and stroke.

AB - Background In the last three decades, in people with diabetes, while the mortality and morbidity due to cardiovascular disease (CVD) and stroke have declined, the incidence of end-stage renal disease (ESRD) has crept up. The precise cause for this shift is unknown. Intriguingly, during the same period, the incidence of diabetes in younger people has almost tripled worldwide. This study examines whether young-onset diabetes is a greater risk for ESRD compared to CVD and stroke. Methods We conducted this retrospective cohort study using data from volunteers (n = 502,408) aged 40–69 years recruited in UK Biobank between 2006 and 2010. The exposure variable was the age of diabetes diagnosis, while the outcomes of interest were ESRD, myocardial infarction, angina, and stroke. The cumulative follow-up period from the mean age of diabetes to the mean age of the outcomes of interest was 838,592 person-years. Univariate and multivariate logistic regression models were fitted to assess odds ratios (ORs) and 95% confidence intervals (CIs). Model performance was evaluated using receiver operating characteristics (ROC) analysis and calibration plots. Findings: Out of 26,206 people with diabetes, 1.16% (n = 303) had ESRD, 8.58% (n = 2250) had a myocardial infarction, 7.47% (n = 1958) had angina, and 2.94% (n = 771) had a stroke. Compared to later-onset, young-onset diabetes is linked with an earlier onset of ESRD. Based on the age of diabetes diagnosis, the univariate logistic regression showed that compared to those diagnosed after the age of 60, the odds of ESRD for those diagnosed at ages < 20, 20–40, and 41–60 years were OR [2.33 (95% CI 1.50–3.84), 7.78 (95% CI 4.81–13.16), and 5.26 (95% CI 3.00–9.40)], respectively. Myocardial infarction and stroke did not have a statistically significant relationship with diabetes diagnosis age. Multivariate models adjusted for sex and albuminuria confirmed the increased odds of ESRD in people with younger onset and longer duration of diabetes. Interpretation: People with younger onset and longer duration of diabetes are at a higher risk of ESRD than CVD and stroke.

UR - https://pearl.plymouth.ac.uk/pms-research/1809

U2 - 10.21203/rs.3.rs-5951257/v1

DO - 10.21203/rs.3.rs-5951257/v1

M3 - Preprint

BT - Young-onset diabetes poses a greater risk of end-stage renal disease (ESRD) than cardiovascular disease and stroke: a retrospective cohort study of UK Biobank

PB - Research Square Platform LLC

ER -

Young-onset diabetes poses a greater risk of end-stage renal disease (ESRD) than cardiovascular disease and stroke: a retrospective cohort study of UK Biobank

Abstract

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Young-onset diabetes poses a greater risk of end-stage kidney disease than myocardial infarction and stroke: a retrosepctive cohort study of UK Biobank

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