The association of early-onset diabetes mellitus with early-onset hypertension and premature all-cause mortality: a study based on NHANES

BACKGROUND: Currently, the prevalence of early-onset hypertension is high, with a high risk of premature mortality. Consequently, this research intended to ascertain the association of early-onset diabetes mellitus (DM) with early-onset hypertension and premature all-cause mortality. METHODS: This research utilized NHANES data from six cycles between 2007 and 2018. Weighted logistic regression was employed to explore the association between early-onset DM and early-onset hypertension, while weighted Cox regression was adopted to analyze the association between early-onset DM and premature all-cause mortality. Kaplan-Meier survival curves were leveraged to elucidate the trends in survival probability over time between individuals with and without DM. Subgroup analysis was implemented to ascertain potentially vulnerable populations who were at high risk of early-onset hypertension and premature all-cause mortality. RESULTS: In the analysis of the association between early-onset hypertension and early-onset DM, 22,053 participants were included, with a positive rate of 1.17% for early-onset hypertension. In the analysis of the association between early-onset DM and premature all-cause mortality, 23,434 participants were included, with a premature all-cause mortality rate of 5.79%. Weighted logistic regression showed that early-onset DM was significantly associated with early-onset hypertension (OR = 4.252, 95% CI: 3.326, 5.437). Weighted Cox regression indicated that early-onset DM was significantly associated with premature all-cause mortality (HR = 3.017, 95% CI: 2.296, 3.963). Subgroup analysis suggested significant interaction effects of poverty income ratio (PIR) and drinking status on the association between early-onset DM and early-onset hypertension. A significant interaction between PIR and the association between early-onset DM and premature all-cause mortality was noted. CONCLUSION: Early-onset DM is associated with a higher prevalence of early-onset hypertension and premature all-cause mortality in the study population.This finding provides crucial theoretical support for understanding the accelerated progression of the disease in younger populations, and further guides the development of early, proactive, and multidimensional intervention strategies.