Ethnic differences in risk of renal disease progression amongst young-onset type 2 diabetes in New Zealand

Kanchana Perera; John Baker; Kalpa Jayanatha; Karen Pickering; Richard Cutfield; Brandon Orr-Walker; Gerhard Sundborn; Andrew Heroy; Thomas Arnold ScM; Dahai Yu; David Simmons

doi:10.1016/j.diabres.2025.113018

Ethnic differences in risk of renal disease progression amongst young-onset type 2 diabetes in New Zealand

Kanchana Perera
, John Baker
, Kalpa Jayanatha
, Karen Pickering
, Richard Cutfield
, Brandon Orr-Walker
, Gerhard Sundborn
, Andrew Heroy
, Thomas Arnold ScM
, Dahai Yu
, David Simmons

School of Medicine

Uniformed Services University of the Health Sciences
The Metis Foundation
Diabetes Foundation Aotearoa
Middlemore Hospital
The University of Auckland
Brown University
Keele University

Research output: Contribution to journal › Article › peer-review

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Abstract

Aim: Māori and Pacific adults in New Zealand (NZ) with type 2 diabetes are at high risk of Diabetic Kidney Disease (DKD). This study assessed whether the same was true in young-onset type 2 diabetes. Methods: We conducted a secondary analysis of young adults 18–40 years enrolled in a (1994–2018) NZ primary care cohort. DKD risk was classified as minimal or elevated using Urine Albumin-Creatinine Ratio (UACR) and Estimated Glomerular Filtration Rate (eGFR), with hyperfiltration (eGFR ≥ 120 mL/min/1.73 m²) considered an early marker. Logistic regression identified predictors of elevated DKD risk. Results: Among 2,184 participants (46 % Pacific people, 31 % Māori, 23 % NZ European: 54 % female, mean age 33.9 ± 4.9 years, mean BMI 38.0 ± 8.7 kg/m², diabetes duration 1.7 years), elevated DKD risk was more common in Pacific People (37.4 %) and Māori (33.5 %) than NZE (23.3 %; p < 0.001) with adjusted odds ratio (vs NZE) of 1.96 (95 % CI: 1.50–2.57) and 1.41 (1.06–1.87) respectively. Māori had less risk than Pasifika (odds ratio 0.72 (0.58–0.89)). Independent predictors of DKD risk included ethnicity, triglyceride-HDL ratio, systolic blood pressure, antihypertensive use, and HbA_1c: BMI was not significant. Conclusions: Pacific and Māori with young-onset type 2 diabetes face a disproportionately higher DKD risk.

Original language	English
Article number	113018
Number of pages	7
Journal	Diabetes Research and Clinical Practice
Volume	231
DOIs	https://doi.org/10.1016/j.diabres.2025.113018
Publication status	Published - Jan 2026

UN SDGs

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

SDG 3 Good Health and Well-being

Keywords

Diabetic kidney disease
HbA
Microalbuminuria
Systolic blood pressure
Type 2 diabetes mellitus
Young-onset diabetes

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Cite this

@article{dca628cfac6a465ba4852c6d47530b7b,

title = "Ethnic differences in risk of renal disease progression amongst young-onset type 2 diabetes in New Zealand",

abstract = "Aim: Māori and Pacific adults in New Zealand (NZ) with type 2 diabetes are at high risk of Diabetic Kidney Disease (DKD). This study assessed whether the same was true in young-onset type 2 diabetes. Methods: We conducted a secondary analysis of young adults 18{\textendash}40 years enrolled in a (1994{\textendash}2018) NZ primary care cohort. DKD risk was classified as minimal or elevated using Urine Albumin-Creatinine Ratio (UACR) and Estimated Glomerular Filtration Rate (eGFR), with hyperfiltration (eGFR ≥ 120 mL/min/1.73 m2) considered an early marker. Logistic regression identified predictors of elevated DKD risk. Results: Among 2,184 participants (46 \% Pacific people, 31 \% Māori, 23 \% NZ European: 54 \% female, mean age 33.9 ± 4.9 years, mean BMI 38.0 ± 8.7 kg/m2, diabetes duration 1.7 years), elevated DKD risk was more common in Pacific People (37.4 \%) and Māori (33.5 \%) than NZE (23.3 \%; p < 0.001) with adjusted odds ratio (vs NZE) of 1.96 (95 \% CI: 1.50{\textendash}2.57) and 1.41 (1.06{\textendash}1.87) respectively. Māori had less risk than Pasifika (odds ratio 0.72 (0.58{\textendash}0.89)). Independent predictors of DKD risk included ethnicity, triglyceride-HDL ratio, systolic blood pressure, antihypertensive use, and HbA1c: BMI was not significant. Conclusions: Pacific and Māori with young-onset type 2 diabetes face a disproportionately higher DKD risk.",

keywords = "Diabetic kidney disease, HbA, Microalbuminuria, Systolic blood pressure, Type 2 diabetes mellitus, Young-onset diabetes",

author = "Kanchana Perera and John Baker and Kalpa Jayanatha and Karen Pickering and Richard Cutfield and Brandon Orr-Walker and Gerhard Sundborn and Andrew Heroy and ScM, \{Thomas Arnold\} and Dahai Yu and David Simmons",

year = "2026",

month = jan,

doi = "10.1016/j.diabres.2025.113018",

language = "English",

volume = "231",

journal = "Diabetes Research and Clinical Practice",

issn = "0168-8227",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Ethnic differences in risk of renal disease progression amongst young-onset type 2 diabetes in New Zealand

AU - Perera, Kanchana

AU - Baker, John

AU - Jayanatha, Kalpa

AU - Pickering, Karen

AU - Cutfield, Richard

AU - Orr-Walker, Brandon

AU - Sundborn, Gerhard

AU - Heroy, Andrew

AU - ScM, Thomas Arnold

AU - Yu, Dahai

AU - Simmons, David

PY - 2026/1

Y1 - 2026/1

N2 - Aim: Māori and Pacific adults in New Zealand (NZ) with type 2 diabetes are at high risk of Diabetic Kidney Disease (DKD). This study assessed whether the same was true in young-onset type 2 diabetes. Methods: We conducted a secondary analysis of young adults 18–40 years enrolled in a (1994–2018) NZ primary care cohort. DKD risk was classified as minimal or elevated using Urine Albumin-Creatinine Ratio (UACR) and Estimated Glomerular Filtration Rate (eGFR), with hyperfiltration (eGFR ≥ 120 mL/min/1.73 m2) considered an early marker. Logistic regression identified predictors of elevated DKD risk. Results: Among 2,184 participants (46 % Pacific people, 31 % Māori, 23 % NZ European: 54 % female, mean age 33.9 ± 4.9 years, mean BMI 38.0 ± 8.7 kg/m2, diabetes duration 1.7 years), elevated DKD risk was more common in Pacific People (37.4 %) and Māori (33.5 %) than NZE (23.3 %; p < 0.001) with adjusted odds ratio (vs NZE) of 1.96 (95 % CI: 1.50–2.57) and 1.41 (1.06–1.87) respectively. Māori had less risk than Pasifika (odds ratio 0.72 (0.58–0.89)). Independent predictors of DKD risk included ethnicity, triglyceride-HDL ratio, systolic blood pressure, antihypertensive use, and HbA1c: BMI was not significant. Conclusions: Pacific and Māori with young-onset type 2 diabetes face a disproportionately higher DKD risk.

AB - Aim: Māori and Pacific adults in New Zealand (NZ) with type 2 diabetes are at high risk of Diabetic Kidney Disease (DKD). This study assessed whether the same was true in young-onset type 2 diabetes. Methods: We conducted a secondary analysis of young adults 18–40 years enrolled in a (1994–2018) NZ primary care cohort. DKD risk was classified as minimal or elevated using Urine Albumin-Creatinine Ratio (UACR) and Estimated Glomerular Filtration Rate (eGFR), with hyperfiltration (eGFR ≥ 120 mL/min/1.73 m2) considered an early marker. Logistic regression identified predictors of elevated DKD risk. Results: Among 2,184 participants (46 % Pacific people, 31 % Māori, 23 % NZ European: 54 % female, mean age 33.9 ± 4.9 years, mean BMI 38.0 ± 8.7 kg/m2, diabetes duration 1.7 years), elevated DKD risk was more common in Pacific People (37.4 %) and Māori (33.5 %) than NZE (23.3 %; p < 0.001) with adjusted odds ratio (vs NZE) of 1.96 (95 % CI: 1.50–2.57) and 1.41 (1.06–1.87) respectively. Māori had less risk than Pasifika (odds ratio 0.72 (0.58–0.89)). Independent predictors of DKD risk included ethnicity, triglyceride-HDL ratio, systolic blood pressure, antihypertensive use, and HbA1c: BMI was not significant. Conclusions: Pacific and Māori with young-onset type 2 diabetes face a disproportionately higher DKD risk.

KW - Diabetic kidney disease

KW - HbA

KW - Microalbuminuria

KW - Systolic blood pressure

KW - Type 2 diabetes mellitus

KW - Young-onset diabetes

UR - https://www.scopus.com/pages/publications/105024869451

U2 - 10.1016/j.diabres.2025.113018

DO - 10.1016/j.diabres.2025.113018

M3 - Article

C2 - 41297857

AN - SCOPUS:105024869451

SN - 0168-8227

VL - 231

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

M1 - 113018

ER -

Ethnic differences in risk of renal disease progression amongst young-onset type 2 diabetes in New Zealand

Abstract

UN SDGs

Keywords

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