Yang Xue, Xie Yue, Wang Yi, Yu Yong, Jin Xingzhong, Xiu Peng, Wu Jason H Y, Yu Danxia, Pan An, Zhao Jian, Yang Chun-Xia, Pan Xiong-Fei
Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Diabetes Metab Res Rev. 2022 Feb;38(2):e3487. doi: 10.1002/dmrr.3487. Epub 2021 Aug 3.
To prospectively examine the association between arthritis and type 2 diabetes (T2D) in the Chinese population and confirm this association through a comprehensive meta-analysis of cohort studies.
Data were from the China Health and Retirement Longitudinal Study which was started in 2011-2013 and followed up in 2013-2014 and 2015-2016. Arthritis was defined as self-reported physician diagnosis at baseline, and incident T2D was determined by self-reported physician diagnosis, fasting blood glucose ≥7.0 mmol/L or glycosylated haemoglobin ≥6.5% during the follow-ups. Cox proportional hazards regression models were used to assess the association between arthritis and risk for T2D. A meta-analysis was conducted to pool our effect estimate and those from other cohort studies using a random-effects model.
Eleven thousand four hundred and eight participants (47.9% men; mean age: 59.3 years) were included in final analyses. During a 4-year follow-up, 981 participants reported incident T2D. Compared with individuals without arthritis, those with arthritis at baseline had an 18% higher risk for incident T2D (multivariable-adjusted hazard ratio: 1.18; 95% confidence interval: 1.04, 1.34). In the meta-analysis of 13 cohort studies including ours, a total of 2,473,514 participants were included with 121,851 incident diabetes. The pooling HR was 1.32 (95% CI: 1.21, 1.44) for the association between arthritis and diabetes.
Arthritis was associated with an increased risk of incident diabetes in Chinese adults, and the positive association was confirmed in the meta-analysis of cohort studies. Our work can inform clinical trials to assess the effectiveness of arthritis treatments in reducing risk of diabetes.
前瞻性研究中国人群中关节炎与2型糖尿病(T2D)之间的关联,并通过对队列研究的综合荟萃分析来证实这种关联。
数据来自中国健康与养老追踪调查,该调查于2011 - 2013年启动,并在2013 - 2014年和2015 - 2016年进行随访。关节炎定义为基线时自我报告的医生诊断,随访期间新发T2D通过自我报告的医生诊断、空腹血糖≥7.0 mmol/L或糖化血红蛋白≥6.5%来确定。采用Cox比例风险回归模型评估关节炎与T2D风险之间的关联。使用随机效应模型进行荟萃分析,汇总我们的效应估计值和其他队列研究的结果。
最终分析纳入了11408名参与者(47.9%为男性;平均年龄:59.3岁)。在4年的随访期间,981名参与者报告新发T2D。与无关节炎的个体相比,基线时有关节炎的个体发生T2D的风险高18%(多变量调整风险比:1.18;95%置信区间:1.04,1.34)。在包括我们研究在内的13项队列研究的荟萃分析中,共纳入2473514名参与者,其中121851人新发糖尿病。关节炎与糖尿病之间关联的汇总风险比为1.32(95%置信区间:1.21,1.44)。
关节炎与中国成年人新发糖尿病风险增加相关,队列研究的荟萃分析证实了这种正相关。我们的工作可为评估关节炎治疗在降低糖尿病风险方面有效性的临床试验提供参考。