Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan.
Eur J Clin Microbiol Infect Dis. 2014 Sep;33(9):1647-52. doi: 10.1007/s10096-014-2126-7. Epub 2014 May 7.
Chronic inflammation is a well-known risk factor for type 2 diabetes mellitus (T2DM). The influence of chronic osteomyelitis (COM), an inflammatory disease, on the risk of developing T2DM remains unknown. This study investigated the risk of developing T2DM among COM patients. Using a retrospective cohort study, we identified 20,641 patients with COM and 82,564 age- and sex-matched controls for comparison from the Taiwan National Health Insurance Database (NHIRD) from 1997 to 2010. We followed up the COM cohort and the comparison cohort to compare the incidences of diabetes (ICD-9-CM code 250) until the end of 2010 or until the patients were censored because of death or withdrawal from the insurance program. The diabetes risk was analyzed using the Cox proportional hazards regression model. The incidence of T2DM was 1.6-fold higher in the group of COM patients than in the comparison group (29.1 vs. 18.2 per 10,000 person-years). The COM patients exhibited a higher diabetes risk [adjusted hazard ratio (aHR) = 1.64, 95 % confidence interval (CI) = 1.44-1.87] after controlling for the baseline and comorbidities. Younger and higher income patients exhibited a higher COM-to-reference incidence rate ratio (IRR) for T2DM compared with that of their counterparts. We also observed an increased risk of T2DM in COM patients with comorbidities (aHR = 1.70, 95 % CI = 1.47-1.96) compared with that of their non-COM counterparts. This is the first study to report the association between COM and an increased risk of developing T2DM, particularly among younger and higher income patients.
慢性炎症是 2 型糖尿病（T2DM）的已知危险因素。慢性骨髓炎（COM）是一种炎症性疾病，其对发生 T2DM 的风险的影响尚不清楚。本研究调查了 COM 患者发生 T2DM 的风险。使用回顾性队列研究，我们从 1997 年至 2010 年从台湾国家健康保险数据库（NHIRD）中确定了 20641 例 COM 患者和 82564 例年龄和性别匹配的对照者进行比较。我们对 COM 队列和对照组进行随访，以比较糖尿病（ICD-9-CM 代码 250）的发病率，直至 2010 年底，或直至患者因死亡或退出保险计划而被删失。使用 Cox 比例风险回归模型分析糖尿病风险。与对照组相比，COM 患者的 T2DM 发病率高 1.6 倍（每 10000 人年 29.1 例 vs. 18.2 例）。在控制基线和合并症后，COM 患者发生糖尿病的风险更高[调整后的危险比（aHR）=1.64，95％置信区间（CI）=1.44-1.87]。与同龄人相比，年龄较小和收入较高的患者 COM 与对照的发病率比（IRR）更高。与非 COM 患者相比，我们还观察到合并症的 COM 患者发生 T2DM 的风险增加（aHR=1.70，95％CI=1.47-1.96）。这是第一项报告 COM 与发生 T2DM 风险增加之间存在关联的研究，尤其是在年龄较小和收入较高的患者中。
