Department of Public Health, Health Management and Policy, Nara Medical University, Nara, Japan.
Department of Diabetes and Endocrinology, Nara Medical University Hospital, Nara, Japan.
J Diabetes Investig. 2021 Oct;12(10):1797-1804. doi: 10.1111/jdi.13540. Epub 2021 Apr 3.
This study aimed to determine whether there is an association between influenza and new-onset type 1 diabetes.
This population-based retrospective cohort study used data from the National Database of Health Insurance Claims and Specific Health Check-ups of Japan. Influenza was defined based on drug prescriptions and the onset of type 1 diabetes was defined using specific medical codes indicating a diagnosis of type 1 diabetes. The incidence rate ratio of new-onset type 1 diabetes within 180 days after an influenza diagnosis was calculated and it was compared with that at other times using Poisson regression and generalized estimating equations. Sensitivity analyses were performed to confirm the robustness of this finding.
The data of 10,400 patients with new-onset type 1 diabetes were analyzed, including 2,196 (952 male 1,244 female) patients diagnosed with influenza between 1 September 2014 and 31 August 2017. Although only patients with type 1 diabetes were included, adjusted analysis showed that individuals had a 1.3-fold (95% confidence interval: 1.15-1.46) higher risk of developing type 1 diabetes in the first 180 days after influenza diagnosis than that at other times.
In this Japanese population-based cohort, the risk of new-onset type 1 diabetes may increase after the diagnosis of influenza. These results, which must be confirmed in other populations, suggest that influenza may be a causal factor for new-onset type 1 diabetes. The molecular mechanisms underlying the potential etiological relationship between influenza and type 1 diabetes should be elucidated.
本研究旨在确定流感与新发 1 型糖尿病之间是否存在关联。
本基于人群的回顾性队列研究使用了来自日本国民健康保险索赔和特定健康检查全国数据库的数据。流感的定义基于药物处方，1 型糖尿病的发病则根据特定的医疗代码来确定，这些代码表明 1 型糖尿病的诊断。使用泊松回归和广义估计方程计算了流感诊断后 180 天内新发 1 型糖尿病的发病率比，并与其他时间进行了比较。进行了敏感性分析以确认这一发现的稳健性。
分析了 10400 例新发 1 型糖尿病患者的数据，其中包括 2196 例（952 例男性，1244 例女性）在 2014 年 9 月 1 日至 2017 年 8 月 31 日期间诊断为流感的患者。尽管仅纳入了 1 型糖尿病患者，但调整分析显示，与其他时间相比，流感诊断后 180 天内发生 1 型糖尿病的风险增加了 1.3 倍（95%置信区间：1.15-1.46）。
在本日本基于人群的队列中，流感诊断后新发 1 型糖尿病的风险可能会增加。这些结果需要在其他人群中得到证实，表明流感可能是新发 1 型糖尿病的一个病因。应阐明流感与 1 型糖尿病之间潜在病因关系的分子机制。
