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犬猫主人及其宠物糖尿病共患病风险:基于登记的队列研究。

The shared risk of diabetes between dog and cat owners and their pets: register based cohort study.

机构信息

Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, 751 85 Uppsala, Sweden.

Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.

出版信息

BMJ. 2020 Dec 10;371:m4337. doi: 10.1136/bmj.m4337.

Abstract

OBJECTIVE

To investigate whether dog and cat owners and their pets share a risk of developing diabetes.

DESIGN

Cohort study.

SETTING

Register based longitudinal study, Sweden.

PARTICIPANTS

208 980 owner-dog pairs and 123 566 owner-cat pairs identified during a baseline assessment period (1 January 2004 to 31 December 2006).

MAIN OUTCOME MEASURES

Type 2 diabetes events in dog and cat owners and diabetes events in their pets, including date of diagnosis during the follow-up period (1 January 2007 to 31 December 2012). Owners with type 2 diabetes were identified by combining information from the National Patient Register, the Cause of Death Register, and the Swedish Prescribed Drug Register. Information on diabetes in the pets was extracted from veterinary care insurance data. Multi-state models were used to assess the hazard ratios with 95% confidence intervals and to adjust for possible shared risk factors, including personal and socioeconomic circumstances.

RESULTS

The incidence of type 2 diabetes during follow-up was 7.7 cases per 1000 person years at risk in dog owners and 7.9 cases per 1000 person years at risk in cat owners. The incidence of diabetes in the pets was 1.3 cases per 1000 dog years at risk and 2.2 cases per 1000 cat years at risk. The crude hazard ratio for type 2 diabetes in owners of a dog with diabetes compared with owners of a dog without diabetes was 1.38 (95% confidence interval 1.10 to 1.74), with a multivariable adjusted hazard ratio of 1.32 (1.04 to 1.68). Having an owner with type 2 diabetes was associated with an increased hazard of diabetes in the dog (crude hazard ratio 1.28, 1.01 to 1.63), which was attenuated after adjusting for owner's age, with the confidence interval crossing the null (1.11, 0.87 to 1.42). No association was found between type 2 diabetes in cat owners and diabetes in their cats (crude hazard ratio 0.99, 0.74 to 1.34, and 1.00, 0.78 to 1.28, respectively).

CONCLUSIONS

Data indicated that owners of a dog with diabetes were more likely to develop type 2 diabetes during follow-up than owners of a dog without diabetes. It is possible that dogs with diabetes could serve as a sentinel for shared diabetogenic health behaviours and environmental exposures.

摘要

目的

探讨犬猫主人及其宠物是否存在罹患糖尿病的风险。

设计

队列研究。

地点

基于注册的纵向研究,瑞典。

参与者

208980 对犬主-犬配对和 123566 对猫主-猫配对,这些配对在基线评估期间(2004 年 1 月 1 日至 2006 年 12 月 31 日)被确定。

主要结局指标

犬猫主人的 2 型糖尿病事件和其宠物的糖尿病事件,包括随访期间(2007 年 1 月 1 日至 2012 年 12 月 31 日)的诊断日期。2 型糖尿病患者由国家患者登记处、死因登记处和瑞典处方药物登记处的信息结合确定。宠物的糖尿病信息从兽医护理保险数据中提取。多状态模型用于评估风险比及其 95%置信区间,并调整可能的共同风险因素,包括个人和社会经济情况。

结果

在随访期间,犬主的 2 型糖尿病发病率为每 1000 人年风险 7.7 例,猫主的发病率为每 1000 人年风险 7.9 例。宠物的糖尿病发病率为每 1000 只犬年风险 1.3 例,每 1000 只猫年风险 2.2 例。与无糖尿病犬的主人相比,患有糖尿病犬的主人患 2 型糖尿病的风险比为 1.38(95%置信区间 1.10 至 1.74),多变量调整后的风险比为 1.32(1.04 至 1.68)。有 2 型糖尿病患者的主人患有糖尿病的风险增加(风险比 1.28,1.01 至 1.63),在调整了主人年龄后,风险比减弱,置信区间越过了零值(1.11,0.87 至 1.42)。猫主的 2 型糖尿病与猫的糖尿病之间没有发现关联(风险比分别为 0.99,0.74 至 1.34 和 1.00,0.78 至 1.28)。

结论

数据表明,患有糖尿病犬的主人在随访期间更有可能患上 2 型糖尿病,而没有糖尿病犬的主人则不然。糖尿病犬可能是共同致糖尿病的健康行为和环境暴露的一个信号。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7ab/7726310/048d203eee4a/delr059840.f1.jpg

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