Multivariate Trajectories of Cardiometabolic Risk Factors and Complications in Elderly Chinese Patients With Type 2 Diabetes: A Retrospective Cohort Study
- 1Nanjing Municipal Center for Disease Control and Prevention
- 2Huadong Hospital, Fudan University
- 3Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University
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.
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BibTeX
@article{chen2026multivariate,
title = {{Multivariate Trajectories of Cardiometabolic Risk Factors and Complications in Elderly Chinese Patients With Type 2 Diabetes: A Retrospective Cohort Study}},
author = {Yijia Chen and Yichao Chen and Weiwei Wang and Hairong Zhou and Huafeng Yang and Qiannan Sun and Jun Tang and Dong Hang and Xin Hong},
journal = {Journal of the American Heart Association},
year = {2026},
month = oct,
doi = {10.1161/jaha.125.047911},
url = {https://www.ahajournals.org/doi/10.1161/JAHA.125.047911},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Multivariate Trajectories of Cardiometabolic Risk Factors and Complications in Elderly Chinese Patients With Type 2 Diabetes: A Retrospective Cohort Study
AU - Yijia Chen
AU - Yichao Chen
AU - Weiwei Wang
AU - Hairong Zhou
AU - Huafeng Yang
AU - Qiannan Sun
AU - Jun Tang
AU - Dong Hang
AU - Xin Hong
PY - 2026
DA - 2026/10/23
JO - Journal of the American Heart Association
DO - 10.1161/jaha.125.047911
UR - https://www.ahajournals.org/doi/10.1161/JAHA.125.047911
AB - 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.
SN - 2047-9980
ER -