Divison of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Diabetes Metab J. 2019 Dec;43(6):815-829. doi: 10.4093/dmj.2018.0167. Epub 2019 Jan 21.
A latent cytomegalovirus (CMV) cause chronic inflammation through undesirable inflation of cell-mediated immune response. CMV immunoglobulin G has been associated with cardiovascular disease and type 1 diabetes mellitus. We evaluated impact of CMV diseases on new-onset type 2 diabetes mellitus (T2DM).
From the Korean Health Insurance Review and Assessment Service claim database of entire population with 50 million, we retrieved 576 adult case group with CMV diseases diagnosed with International Statistical Classification of Diseases and Related-Health Problems 10th Revision (ICD-10) B25 code between 2010 and 2014 after exclusion of patients with T2DM to 2006. The 2,880 control patients without T2DM from 2006 to cohort entry point were selected between 2010 and 2014 by age, sex matching with case group. The subjects without new-onset T2DM were followed until 2015. T2DM, hypertension (HTN), dyslipidemia (DYS), and end-stage renal disease (ESRD) were coded as ICD-10.
The frequency of new-onset T2DM in case group was significantly higher than that in control (5.6% vs. 2.2%, <0.001). The group with T2DM (n=95) had higher incidence of CMV diseases than the group without T2DM (=3,361) (33.7% vs. 16.2%, <0.001). In multivariate regression model adjusted by age, sex, lower income, HTN, and DYS, the incidence rate (IR) of T2DM in case group was significantly higher than that in the control group (IR per 1,000, 19.0 vs. 7.3; odds ratio, 2.1; 95% confidence interval, 1.3 to 3.2). The co-existence of HTN, DYS, and ESRD with CMV diseases did not influence the IR of T2DM.
CMV diseases increase the patients' risk of developing T2DM.
潜伏性巨细胞病毒 (CMV) 通过引起细胞介导的免疫反应不当膨胀而导致慢性炎症。CMV 免疫球蛋白 G 与心血管疾病和 1 型糖尿病有关。我们评估了 CMV 疾病对新发 2 型糖尿病 (T2DM) 的影响。
我们从韩国健康保险审查和评估服务的整个人群索赔数据库中检索了 576 名成年病例组,这些患者在 2010 年至 2014 年间被诊断出患有 CMV 疾病(国际疾病分类和相关健康问题第 10 次修订版 [ICD-10] B25 代码),并排除了 2006 年之前患有 T2DM 的患者。2010 年至 2014 年间,我们从 2006 年至队列入组点选择了 2880 名无 T2DM 的对照组患者,这些患者与病例组按年龄和性别匹配。无新发 T2DM 的受试者随访至 2015 年。T2DM、高血压 (HTN)、血脂异常 (DYS) 和终末期肾病 (ESRD) 均被编码为 ICD-10。
病例组新发 T2DM 的频率明显高于对照组(5.6% vs. 2.2%,<0.001)。患有 T2DM 的组(n=95)发生 CMV 疾病的发生率高于未患有 T2DM 的组(n=3361)(33.7% vs. 16.2%,<0.001)。在调整年龄、性别、低收入、HTN 和 DYS 后,病例组的 T2DM 发病率(IR)明显高于对照组(IR/1000,19.0 vs. 7.3;比值比,2.1;95%置信区间,1.3 至 3.2)。CMV 疾病合并 HTN、DYS 和 ESRD 并不影响 T2DM 的 IR。
CMV 疾病会增加患者发生 T2DM 的风险。