Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, Taipei, Taiwan.
J Urol. 2011 Nov;186(5):1888-93. doi: 10.1016/j.juro.2011.07.011. Epub 2011 Sep 23.
No prospective followup study to date to our knowledge has evaluated the relationship between stone disease and the subsequent risk of diabetes mellitus. In this population based study we examine the relationship between a history of urinary calculi and the risk of diabetes mellitus in Taiwan.
A total of 23,569 adult patients with new diagnoses of urinary calculi from 2001 to 2003 were recruited together with 70,707 matched enrollees as a comparison cohort. All patients were tracked for a 5-year period from the index health care encounter to identify those who had a subsequent diagnosis of diabetes mellitus. Cox proportional hazards models were used to compute the risk of diabetes mellitus for the study and comparison cohorts.
Of a total of 94,276 patients 2,921 (12.39%) from the urinary calculi group and 6,171 (8.73%) from the comparison group received a subsequent diagnosis of diabetes mellitus during the followup period. The stratified Cox proportional analysis showed that, after censoring individuals who died during followup, and adjusting for patient monthly income, geographic location, urbanization level, hypertension, hyperlipidemia and obesity, the hazard of receiving a first diagnosis of diabetes during the 5-year followup was 1.32 times greater for patients with urinary calculi than for those in the comparison cohort (95% CI 1.26-1.39, p <0.001).
Our results suggest that patients who receive a diagnosis of urinary calculi are at increased risk for diabetes mellitus at 5-year followup.
据我们所知，目前尚无前瞻性随访研究评估结石病与随后发生糖尿病之间的关系。在这项基于人群的研究中，我们研究了台湾尿路结石病史与糖尿病风险之间的关系。
共招募了 2001 年至 2003 年间新诊断为尿路结石的 23569 例成年患者，并与 70707 例匹配的参与者作为对照队列。所有患者均从指数保健就诊开始进行了为期 5 年的跟踪，以确定随后是否诊断出糖尿病。使用 Cox 比例风险模型计算研究和对照队列的糖尿病风险。
在总共 94276 例患者中，2921 例（12.39%）来自尿路结石组，6171 例（8.73%）来自对照组在随访期间被诊断出患有糖尿病。分层 Cox 比例分析表明，在随访期间对死亡患者进行删失，并调整患者月收入、地理位置、城市化水平、高血压、高血脂和肥胖后，与对照组相比，尿路结石患者在 5 年随访期间首次诊断为糖尿病的风险增加了 1.32 倍（95%CI 1.26-1.39，p<0.001）。
我们的研究结果表明，接受尿路结石诊断的患者在 5 年随访时发生糖尿病的风险增加。
