Movahed Mohammad Reza, Hashemzadeh Mehrtash, Jamal M Mazen
Department of Medicine, Section of Cardiology, University of Arizona Sarver Heart Center, Tucson, AZ 85724, USA.
J Diabetes Complications. 2007 Nov-Dec;21(6):403-6. doi: 10.1016/j.jdiacomp.2007.07.003.
Patients with diabetes mellitus (DM) are at increased risk of infection. However, there are controversial reports about DM association with infectious endocarditis (IE). We evaluated the occurrence of IE in DM patients compared to a matched control.
Treatment files of inpatients' admission that contained discharge diagnosis (ICD-9 codes) from Veterans Health Administration hospitals were used for this study. ICD-9 codes for DM (n=293,124) and a control group with ICD-9 codes for hypertension without DM (n=552,623) were utilized for comparison. The prevalence of IE was studied using ICD-9 codes for IE. Multivariate analysis was performed adjusting for chronic and acute renal failure and aortic and mitral valve disease. Continuous variables were analyzed by unpaired t tests. Binary variables were analyzed using the chi-square test and Fisher's Exact Tests.
IE was present in 1340 (0.5%) DM patients versus 1412 (0.3%) patients from the control group (relative increase of 40%). Using multivariate analysis adjusting for renal failure and valvular abnormalities, DM remained independently associated with IE (odds ratio=1.9; 95% confidence interval=1.8-2.1; P<.0001).
Patients with type II DM have significantly higher prevalence of IE independent of renal failure or valvular abnormalities consistent with increased vulnerability of DM patients for infections.
糖尿病(DM)患者感染风险增加。然而,关于DM与感染性心内膜炎(IE)的关联存在有争议的报道。我们将DM患者与匹配的对照组进行比较,评估IE的发生率。
本研究使用了退伍军人健康管理局医院住院患者的治疗档案,其中包含出院诊断(ICD - 9编码)。使用DM的ICD - 9编码(n = 293,124)和无DM的高血压ICD - 9编码对照组(n = 552,623)进行比较。使用IE的ICD - 9编码研究IE的患病率。进行多变量分析,对慢性和急性肾衰竭以及主动脉和二尖瓣疾病进行校正。连续变量采用非配对t检验进行分析。二元变量采用卡方检验和Fisher精确检验进行分析。
1340名(0.5%)DM患者存在IE,而对照组为1412名(0.3%)患者(相对增加40%)。在对肾衰竭和瓣膜异常进行校正的多变量分析中,DM仍与IE独立相关(优势比 = 1.9;95%置信区间 = 1.8 - 2.1;P <.0001)。
II型DM患者IE的患病率显著更高,独立于肾衰竭或瓣膜异常,这与DM患者感染易感性增加一致。