慢性肾脏病患者发生 2 型糖尿病新发病例的风险增加。
Increased risk of new-onset type 2 diabetes in people with chronic kidney disease.
机构信息
Department of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Division of Nephrology, China Medical University Hospital, Taichung, Taiwan.
出版信息
Int Urol Nephrol. 2019 Apr;51(4):707-712. doi: 10.1007/s11255-019-02075-8. Epub 2019 Jan 28.
PURPOSE
This study investigated whether people with chronic kidney disease (CKD) are at the risk of new-onset type 2 diabetes.
METHODS
A cohort comprising 16,624 people with CKD, and an age- and sex-matched control cohort of 66,496 persons without any clinical kidney disease were identified from the Taiwan National Health Insurance Database during the period of 2000-2010. Both cohorts were followed up to 2011 to evaluate the incidence and hazard ratio (HR) of developing new-onset type 2 diabetes. Diseases were identified based on diagnosis coding.
RESULTS
The incidence of type 2 diabetes was 1.51-fold higher in the CKD cohort than in the control cohort (16.9 versus 11.2 per 1,000 person-years) with an adjusted hazard ratio of 1.17 (95% confidence interval, (CI)1.10-1.24). In the multivariate Cox regression model considering the competing-risk death, the adjusted subhazard ratio of type 2 diabetes was 1.30 (95% CI1.22-1.38) for the CKD cohort compared to the control cohort.
CONCLUSIONS
People with CKD patients are at an increased risk of developing new-onset type 2 diabetes. Close surveillance for diabetes should be considered for these people.
目的
本研究旨在探讨慢性肾脏病（CKD）患者是否存在新发 2 型糖尿病的风险。
方法
本研究从 2000 年至 2010 年的台湾全民健康保险数据库中，确定了一个包含 16624 名 CKD 患者的队列，以及一个年龄和性别相匹配的、无任何临床肾脏疾病的 66496 名对照队列。在 2011 年之前对两个队列进行随访，以评估新发 2 型糖尿病的发病率和风险比（HR）。疾病通过诊断编码进行确定。
结果
与对照组相比，CKD 队列的 2 型糖尿病发病率高出 1.51 倍（每 1000 人年为 16.9 例与 11.2 例），调整后的 HR 为 1.17（95%置信区间（CI）1.10-1.24）。在考虑竞争风险死亡的多变量 Cox 回归模型中，与对照组相比，CKD 队列的 2 型糖尿病校正亚风险比为 1.30（95%CI1.22-1.38）。
结论
CKD 患者发生新发 2 型糖尿病的风险增加。应考虑对这些患者进行密切的糖尿病监测。
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