Ervasti Jenni, Virtanen Marianna, Lallukka Tea, Pentti Jaana, Kjeldgård Linnea, Mittendorfer-Rutz Ellenor, Tinghög Petter, Alexanderson Kristina
Scand J Work Environ Health. 2016 May 1;42(3):209-16. doi: 10.5271/sjweh.3556. Epub 2016 Mar 1.
Using Swedish population-based register data, we examined the extent to which comorbid conditions contribute to the risk of disability pension among people with diabetes.
We carried out Cox proportional hazard analyses with comorbid conditions as time-dependent covariates among 14 198 people with newly diagnosed diabetes in 2006, and 39 204 people free from diabetes during the follow-up from 2007-2010. The average follow-up times were 46 and 48 months for those with and without diabetes, respectively.
For those with diabetes only, the incidence of all-cause disability pension was 9.5 per 1000 person-years. The highest incidence of disability pension were for those with: diabetes and depression (23.6); diabetes and musculoskeletal disorder (30.6), and those with diabetes and more than one comorbid condition (36.5). The incidence rate was 5.8 for those without diabetes. Diabetes was associated with a 2.30 times [95% confidence interval (95% CI) 2.09-2.54] higher risk of disability pension (adjusted for sociodemographic factors). This association attenuated by 41% after further adjustment for comorbid chronic conditions. While diabetes was a risk factor for disability pension due to musculoskeletal disorders and diseases of the circulatory system, even after accounting for the above-mentioned conditions, the association between disability pension due to mental disorders and diabetes was diluted after adjustment for mental disorders.
Although diabetes is an independent risk factor for disability pension, comorbid conditions contribute to this risk to a large degree.
利用瑞典基于人群的登记数据，我们研究了合并症在多大程度上导致糖尿病患者领取残疾抚恤金的风险。
我们对2006年新诊断为糖尿病的14198人以及2007 - 2010年随访期间无糖尿病的39204人进行了Cox比例风险分析，将合并症作为时间依存性协变量。糖尿病患者和非糖尿病患者的平均随访时间分别为46个月和48个月。
仅患有糖尿病的人群中，全因残疾抚恤金的发病率为每1000人年9.5例。残疾抚恤金发病率最高的是患有以下疾病的人群：糖尿病合并抑郁症（23.6）；糖尿病合并肌肉骨骼疾病（30.6），以及患有糖尿病且合并一种以上合并症的人群（36.5）。无糖尿病者的发病率为5.8。糖尿病与领取残疾抚恤金的风险高出2.30倍[95%置信区间（95%CI）2.09 - 2.54]相关（经社会人口学因素调整）。在进一步调整合并慢性病后，这种关联减弱了41%。虽然糖尿病是因肌肉骨骼疾病和循环系统疾病领取残疾抚恤金的风险因素，但即使考虑了上述情况，在调整精神障碍后，因精神障碍领取残疾抚恤金与糖尿病之间的关联也被削弱了。
虽然糖尿病是领取残疾抚恤金的独立风险因素，但合并症在很大程度上导致了这种风险。
