Department of Endocrinology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
School of Medicine and Department of Public Health, College of Medicine, Fujen Catholic University, New Taipei City, Taiwan.
Cardiovasc Diabetol. 2020 Oct 14;19(1):177. doi: 10.1186/s12933-020-01144-y.
The epidemiology of diabetes and idiopathic cardiomyopathy have limited data. We investigated the overall and the age-, sex-, and urbanization-specific incidence and relative hazard of idiopathic cardiomyopathy in association with type 2 diabetes and various anti-diabetic medications used in Taiwan.
A total of 474,268 patients with type 2 diabetes were identified from ambulatory care and inpatient claims in 2007-2009 from Taiwan's National Health Insurance (NHI) database. We randomly selected 474,266 age-, sex-, and diagnosis date-matched controls from the registry of NHI beneficiaries. All study subjects were linked to ambulatory care and inpatient claims (up to the end of 2016) to identify the possible diagnosis of idiopathic cardiomyopathy. The person-year approach with Poisson assumption was used to estimate the incidence, and Cox proportional hazard regression model with Fine and Gray's method was used to estimate the relative hazards of idiopathic cardiomyopathy in relation to type 2 diabetes.
The overall incidence of idiopathic cardiomyopathy for men and women patients, respectively, was 3.83 and 2.94 per 10,000 person-years, which were higher than the corresponding men and women controls (2.00 and 1.34 per 10,000 person-years). Compared with the control group, patients with type 2 diabetes were significantly associated with an increased hazard of idiopathic cardiomyopathy (adjusted hazard ratio [aHR]: 1.60, 95% confidence interval [CI]: 1.45-1.77] in all age and sex stratifications except in those men aged > 64 years. Patients with type 2 diabetes aged < 45 years confronted the greatest increase in the hazard of idiopathic cardiomyopathy, with an aHR of 3.35 (95% CI 2.21-5.06) and 3.48 (95% CI 1.60-7.56) for men and women, respectively. The usage of some anti-diabetic medications revealed lower risks of idiopathic cardiomyopathy.
In Taiwan, diabetes increased the risk of idiopathic cardiomyopathy in both sexes and in all age groups, except in men aged > 64 years. Younger patients were vulnerable to have higher HRs of idiopathic cardiomyopathy. Some anti-diabetic medications may reduce the risks of cardiomyopathy.
糖尿病和特发性心肌病的流行病学数据有限。我们研究了 2007-2009 年台湾全民健康保险（NHI）数据库中 2 型糖尿病患者中特发性心肌病的总体发病率、年龄、性别和城市化特异性发病率，以及与 2 型糖尿病相关的各种抗糖尿病药物的相对危险度。
从台湾 NHI 数据库的门诊和住院理赔中确定了 474268 例 2 型糖尿病患者。我们从 NHI 受益人的登记处随机选择了 474266 名年龄、性别和诊断日期匹配的对照。所有研究对象都与门诊和住院理赔（截至 2016 年底）相关联，以确定特发性心肌病的可能诊断。采用泊松假设的人年法估计发病率，采用 Fine 和 Gray 法的 Cox 比例风险回归模型估计特发性心肌病与 2 型糖尿病的相对危险度。
男性和女性患者的特发性心肌病总发病率分别为每 10000 人年 3.83 和 2.94，高于相应的男性和女性对照组（每 10000 人年 2.00 和 1.34）。与对照组相比，2 型糖尿病患者发生特发性心肌病的危险明显增加（所有年龄和性别分层的调整后危险比[aHR]：1.60，95%置信区间[CI]：1.45-1.77），除了年龄>64 岁的男性。年龄<45 岁的 2 型糖尿病患者发生特发性心肌病的危险增加最大，男性和女性的 aHR 分别为 3.35（95% CI 2.21-5.06）和 3.48（95% CI 1.60-7.56）。一些抗糖尿病药物的使用显示出较低的特发性心肌病风险。
在台湾，糖尿病增加了两性和所有年龄组发生特发性心肌病的风险，年龄>64 岁的男性除外。年轻患者更容易发生特发性心肌病，风险更高。一些抗糖尿病药物可能降低心肌病的风险。
