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胰腺炎后糖尿病的特定病因死亡率、性别和年龄差异及预期寿命。

Risk of cause-specific death, its sex and age differences, and life expectancy in post-pancreatitis diabetes mellitus.

机构信息

School of Medicine, University of Auckland, Auckland, New Zealand.

Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

出版信息

Acta Diabetol. 2021 Jun;58(6):797-807. doi: 10.1007/s00592-021-01683-0. Epub 2021 Feb 15.

Abstract

AIMS

The aim was to investigate sex- and age-stratified risks of cause-specific death and life expectancy in individuals with post-pancreatitis diabetes mellitus (PPDM).

METHODS

Nationwide data on mortality in New Zealand were obtained. For two head-to-head comparisons (PPDM versus type 2 diabetes mellitus [T2DM]; PPDM versus type 1 diabetes mellitus [T1DM]), the groups were matched on age, sex, and calendar year of diabetes diagnosis. Multivariable Cox regression analyses were conducted to estimate risks of vascular, cancer, and non-vascular non-cancer mortality. Remaining life expectancy at age of diabetes diagnosis was estimated using the Chiang II method.

RESULTS

A total of 15,848 individuals (1,132 PPDM, 3,396 T1DM, and 11,320 T2DM) were included. The risks of vascular mortality and non-vascular non-cancer mortality did not differ significantly between PPDM and T2DM or T1DM. PPDM was associated with a significantly higher risk of cancer mortality compared with T2DM (adjusted hazard ratio, 1.32; 95% confidence interval, 1.08-1.63) or T1DM (adjusted hazard ratio, 1.65; 95% confidence interval, 1.27-2.13). The risk of cancer mortality associated with PPDM (versus T2DM) was significantly higher in women than in men (p for interaction = 0.003). This sex difference in cancer mortality risk was also significant in the comparison between PPDM and T1DM (p for interaction = 0.006). Adults of both sexes with PPDM had the lowest remaining life expectancy (in comparison with T2DM or T1DM) up to 64 years of age.

CONCLUSIONS

People with PPDM have a higher risk of cancer mortality compared with those with T2DM or T1DM. This is especially pronounced in women. Young and middle-aged adults with PPDM have a lower life expectancy compared with their counterparts with T2DM or T1DM.

摘要

目的

旨在研究胰腺炎后糖尿病(PPDM)患者特定病因死亡和预期寿命的性别和年龄分层风险。

方法

从新西兰全国获得死亡率数据。对于两个头对头的比较(PPDM 与 2 型糖尿病[T2DM];PPDM 与 1 型糖尿病[T1DM]),根据年龄、性别和糖尿病诊断的日历年份对两组进行匹配。采用多变量 Cox 回归分析来估计血管、癌症和非血管非癌症死亡率的风险。使用 Chiang II 法估计糖尿病诊断时的剩余预期寿命。

结果

共纳入 15848 人(1132 例 PPDM、3396 例 T1DM 和 11320 例 T2DM)。PPDM 与 T2DM 或 T1DM 之间的血管死亡率和非血管非癌症死亡率的风险无显著差异。与 T2DM(调整后的危险比,1.32;95%置信区间,1.08-1.63)或 T1DM(调整后的危险比,1.65;95%置信区间,1.27-2.13)相比,PPDM 与癌症死亡率的风险显著更高。PPDM (与 T2DM 相比)与女性的癌症死亡率风险较高相关(交互作用的 p 值为 0.003)。在 PPDM 与 T1DM 之间的比较中,这种癌症死亡率风险的性别差异也具有统计学意义(交互作用的 p 值为 0.006)。与 T2DM 或 T1DM 相比,患有 PPDM 的男女成年人的剩余预期寿命(直至 64 岁)最低。

结论

与 T2DM 或 T1DM 相比,PPDM 患者的癌症死亡率风险更高。在女性中更为明显。与 T2DM 或 T1DM 相比,患有 PPDM 的年轻和中年成年人的预期寿命更低。

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