Early-Adulthood Cardiovascular Disease Risk Factor Profiles Among Individuals With andWithout Diabetes in the FraminghamHeart Study

OBJECTIVEdMany studies of diabetes have examined risk factors at the time of diabetes diagnosis instead of considering the lifetime burden of adverse risk factor levels. We examined the 30-year cardiovascular disease (CVD) risk factor burden that participants have up to the time of diabetes diagnosis. RESEARCH DESIGN ANDMETHODSdAmong participants free of CVD, incident di-abetes cases (fasting plasma glucose $126 mg/dL or treatment) occurring at examinations 2 through 8 (1979–2008) of the Framingham Heart Study Offspring cohort were age- and sex-matched 1:2 to controls. CVD risk factors (hypertension, high LDL cholesterol, low HDL cho-lesterol, high triglycerides, obesity) were measured at the time of diabetes diagnosis and at time points 10, 20, and 30 years prior. Conditional logistic regression was used to compare risk factor levels at each time point between diabetes cases and controls. RESULTSdWe identified 525 participants with new-onset diabetes who were matched to 1,049 controls (mean age, 60 years; 40 % women). Compared with those without diabetes, individuals who eventually developed diabetes had higher levels of hypertension (odds rati