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

Research output: Contribution to journalArticlepeer-review

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 HbA1c: BMI was not significant. Conclusions: Pacific and Māori with young-onset type 2 diabetes face a disproportionately higher DKD risk.

Original languageEnglish
Article number113018
JournalDiabetes Research and Clinical Practice
Volume231
DOIs
Publication statusPublished - Jan 2026

Bibliographical note

Publisher Copyright:
© 2025 The Author(s)

Keywords

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

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