Graduate Institute of Food Safety, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan.
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Diabetes Res Clin Pract. 2018 Jun;140:97-106. doi: 10.1016/j.diabres.2018.03.020. Epub 2018 Mar 31.
This study was conducted to investigate potential link between type 2 diabetes mellitus (T2DM) and epilepsy, and the role of severe hypoglycaemia (SH) might play in the relationship.
This was a cohort study based on Taiwan's National Health insurance claims. Totally 751,792 people with T2DM and 824,253 matched controls were identified in 2002-2003 and followed to incidence of epilepsy or end of 2011. We used Cox proportional hazard model to relate epilepsy incidence to separate and joint effects of T2DM and SH. A possible mediation effect of SH on the association between T2DM and epilepsy was analyzed.
Over a 10-year follow-up, patients with T2DM had a higher incidence rate of epilepsy than controls (35.0 vs 21.9 per 10,000 person-years). After controlling for potential confounders including SH, T2DM increased the hazard of epilepsy by some 50%. The stratified analysis further indicated that T2DM (hazard ratio (HR)=1.44, 95% confidence interval (CI) = 1.40-1.47), and SH (HR = 2.22, 95% CI = 1.76-2.81) were both independent risk factors for epilepsy. SH did not modify but mediated 12% of the association between T2DM and epilepsy.
Our findings supported that SH may increase the risk of epilepsy, and that T2DM may increase risk of epilepsy independent of SH.
本研究旨在探讨 2 型糖尿病（T2DM）与癫痫之间的潜在关联，以及严重低血糖（SH）在其中可能扮演的角色。
这是一项基于台湾全民健康保险理赔数据的队列研究。于 2002-2003 年确定了 751792 例 T2DM 患者和 824253 例匹配对照者，并随访至癫痫发作或 2011 年底。我们使用 Cox 比例风险模型来分析 T2DM 和 SH 单独和联合作用与癫痫发生率之间的关系。分析了 SH 在 T2DM 和癫痫之间关联中的可能中介作用。
在 10 年的随访期间，T2DM 患者的癫痫发病率高于对照组（35.0/10000 人年比 21.9/10000 人年）。在控制了包括 SH 在内的潜在混杂因素后，T2DM 使癫痫的发病风险增加了约 50%。分层分析进一步表明，T2DM（风险比（HR）=1.44，95%置信区间（CI）=1.40-1.47）和 SH（HR=2.22，95%CI=1.76-2.81）均是癫痫的独立危险因素。SH 没有改变但中介了 T2DM 和癫痫之间 12%的关联。
我们的研究结果支持 SH 可能增加癫痫的风险，并且 T2DM 可能独立于 SH 增加癫痫的风险。
