Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, 03082, Korea.
Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
Sci Rep. 2021 Nov 4;11(1):21681. doi: 10.1038/s41598-021-01125-5.
Numerous studies have reported that antibiotics could lead to diabetes, even after adjusting for confounding variables. This study aimed to determine the causal relationship between antibiotics use and diabetes in a nationally representative cohort. This retrospective cohort study included adults aged 40 years or older who were enrolled in the Korean National Health Insurance Service-Health Screening Cohort. Antibiotic exposure was assessed from 2002 to 2005 and newly diagnosed diabetes mellitus was determined based on diagnostic codes and history of antidiabetic medication use from 2006 to 2015. Multivariate Cox proportional hazards model was used to assess the association between antibiotic use and diabetes incidence. The mean age of the 201,459 study subjects was 53.2 years. People who used antibiotics for 90 or more days had a higher risk of diabetes (adjusted hazard ratio [aHR] 1.16, 95% confidence interval [CI] 1.07-1.26) compared to non-users. Those who used five or more classes of antibiotics had a higher risk of diabetes than those who used one antibiotic class (aHR 1.14; 95% CI 1.06-1.23). The clear dose-dependent association between antibiotics and diabetes incidence supports the judicious use of antibiotics in the future.
大量研究报告称，即使在调整了混杂变量后，抗生素也可能导致糖尿病。本研究旨在确定全国代表性队列中抗生素使用与糖尿病之间的因果关系。这项回顾性队列研究纳入了年龄在 40 岁及以上、参加韩国国家健康保险服务-健康筛查队列的成年人。从 2002 年至 2005 年评估抗生素暴露情况，根据 2006 年至 2015 年的诊断代码和抗糖尿病药物使用史确定新诊断的糖尿病。多变量 Cox 比例风险模型用于评估抗生素使用与糖尿病发病率之间的关联。201459 名研究对象的平均年龄为 53.2 岁。与非使用者相比，使用抗生素 90 天或以上的人患糖尿病的风险更高（调整后的危险比[aHR] 1.16，95%置信区间[CI] 1.07-1.26）。与使用一种抗生素类别相比，使用五种或更多种抗生素类别的人患糖尿病的风险更高（aHR 1.14；95% CI 1.06-1.23）。抗生素与糖尿病发病率之间存在明确的剂量依赖性关联，这支持未来合理使用抗生素。
