Department of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Division of Nephrology, China Medical University Hospital, Taichung, Taiwan.
Int Urol Nephrol. 2019 Apr;51(4):707-712. doi: 10.1007/s11255-019-02075-8. Epub 2019 Jan 28.
This study investigated whether people with chronic kidney disease (CKD) are at the risk of new-onset type 2 diabetes.
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.
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.
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.
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。
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。
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）。
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。
