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脊髓损伤后神经源性下尿路功能障碍患者患2型糖尿病的风险增加:一项基于人群的队列研究。

Patients With Neurogenic Lower Urinary Tract Dysfunction Following Spinal Cord Injury Are at Increased Risk of Developing Type 2 Diabetes Mellitus: A Population-Based Cohort Study.

作者信息

Lien Wei-Chih, Kuan Ta-Shen, Lin Yu-Ching, Liang Fu-Wen, Hsieh Pei-Chun, Li Chung-Yi

机构信息

From the Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital (W-CL, T-SK, Y-CL, P-CH); Department of Physical Medicine and Rehabilitation, College of Medicine (T-SK, Y-CL); NCKU Research Center for Health Data (F-WL); Department and Graduate Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan (F-WL, C-YL); and Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan (C-YL).

出版信息

Medicine (Baltimore). 2016 Jan;95(2):e2518. doi: 10.1097/MD.0000000000002518.

Abstract

To investigate whether patients with neurogenic lower urinary tract dysfunction (NLUTD) following spinal cord injury (SCI) are at increased risk of developing type 2 diabetes mellitus (T2DM).The retrospective cohort study used a subset of the Taiwan National Health Insurance Research Database (NHIRD) comprising information on 2 million beneficiaries randomly sampled from the general population. A total of 3515 patients with newly diagnosed SCI were identified during the period of 2001 to 2008. Among them, 170 developed NLUTD following SCI. The control group was consisted of 656 patients without NLUTD over the study period randomly selected by matching NLUTD cases on the date of NLUTD incidence, age, sex, and duration since diagnosis of SCI. The study groups were then followed to the end of 2009. T2DM was the end-point.The incidence rate ratios of T2DM were higher in the NLUTD group than in the control group (4.94 vs. 2.61 per 10,000 person-years), representing an adjusted hazard ratio (AHR) of 1.70 (95% confidence interval [CI] 1.11-2.61). Age-specific AHR was significantly elevated only in patients aged > = 60 years (AHR = 2.52 (95% CI 1.35-4.70)).This study showed that the NLUTD following SCI may significantly increase the risk of developing T2DM.

摘要

为了研究脊髓损伤(SCI)后神经源性下尿路功能障碍(NLUTD)患者患2型糖尿病(T2DM)的风险是否增加。这项回顾性队列研究使用了台湾国民健康保险研究数据库(NHIRD)的一个子集,该子集包含从普通人群中随机抽取的200万受益人的信息。在2001年至2008年期间,共确定了3515例新诊断的SCI患者。其中,170例在SCI后发生了NLUTD。对照组由656例在研究期间未发生NLUTD的患者组成,这些患者是通过在NLUTD发病日期、年龄、性别和自SCI诊断以来的病程方面与NLUTD病例匹配而随机选择的。然后对研究组进行随访至2009年底。T2DM为终点。NLUTD组的T2DM发病率比高于对照组(每10000人年4.94比2.61),调整后的风险比(AHR)为1.70(95%置信区间[CI]1.11 - 2.61)。仅在年龄≥60岁的患者中,年龄特异性AHR显著升高(AHR = 2.52(95%CI 1.35 - 4.70))。这项研究表明,SCI后的NLUTD可能会显著增加患T2DM的风险。

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