Yeh J-H, Chen H-J, Lin C-C, Chen Y-K, Chiu H-C, Kao C-H
Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
Acta Neurol Scand. 2015 Aug;132(2):132-8. doi: 10.1111/ane.12374. Epub 2015 Jan 28.
To determine the risk of diabetes mellitus (DM) in patients with myasthenia gravis (MG) in a large cohort representing 99% of the Taiwan population.
Data from the Taiwan National Health Insurance Database were used to conduct retrospective cohort analyses. The study cohort comprised 1520 patients with MG who were four-fold frequency matched to those without MG by age and sex, and assigned the same index year. Cox proportional hazard regression analysis was conducted to estimate the risk of DM.
The MG cohort had a 1.26-fold increased risk of developing DM compared with the comparison cohort (HR=1.26, 95% CI=1.04-1.53). MG patients without corticosteroids use had no increased risk of developing DM (HR=1.05, 95% CI=0.79-1.40), and MG patients with corticosteroids use had a 1.46-fold increased risk of developing DM (HR=1.46, 95%=1.15-1.86). In addition, patients with MG received aggressive treatment, associated thyroid diseases, and male patients had higher risk of DM.
This population-based retrospective cohort study demonstrates that MG is associated with a high risk of DM, which might be related to the adverse effect of corticosteroid and aggressive therapy.
在代表台湾99%人口的大型队列中确定重症肌无力（MG）患者患糖尿病（DM）的风险。
使用台湾国民健康保险数据库的数据进行回顾性队列分析。研究队列包括1520例MG患者，这些患者按年龄和性别与非MG患者进行四倍频率匹配，并指定相同的索引年份。进行Cox比例风险回归分析以估计DM的风险。
与对照组相比，MG队列患DM的风险增加了1.26倍（HR=1.26，95%CI=1.04-1.53）。未使用皮质类固醇的MG患者患DM的风险没有增加（HR=1.05，95%CI=0.79-1.40），而使用皮质类固醇的MG患者患DM的风险增加了1.46倍（HR=1.46，95%=1.15-1.86）。此外，接受积极治疗的MG患者、伴有甲状腺疾病的患者以及男性患者患DM的风险更高。
这项基于人群的回顾性队列研究表明，MG与患DM的高风险相关，这可能与皮质类固醇和积极治疗的不良反应有关。
