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在无结直肠癌患者中,结肠切除术与2型糖尿病风险相关吗?一项基于人群的队列研究。

Is Colectomy Associated with the Risk of Type 2 Diabetes in Patients without Colorectal Cancer? A Population-Based Cohort Study.

作者信息

Wu Chin-Chia, Lee Cheng-Hung, Hsu Ta-Wen, Yeh Chia-Chou, Lin Mei-Chen, Chang Chun-Ming, Tsai Jui-Hsiu

机构信息

Division of Colorectal Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622, Taiwan.

School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien 970, Taiwan.

出版信息

J Clin Med. 2021 Nov 15;10(22):5313. doi: 10.3390/jcm10225313.

Abstract

Type 2 diabetes might be influenced by colonic disease; however, the association between colonic resection and type 2 diabetes has rarely been discussed. This population-based cohort study explored the association between colectomy and type 2 diabetes in patients without colorectal cancer. A total of 642 patients who underwent colectomy for noncancerous diseases at any time between 2000 and 2012 in the National Health Insurance Research Database of Taiwan were enrolled. The enrolled patients were matched with 2568 patients without colectomy at a 1:4 ratio using a propensity score that covered age, sex, and comorbidities. The risk of type 2 diabetes was assessed using a Cox proportional hazards model. The mean (standard deviation) follow-up durations in colectomy cases and non-colectomy controls were 4.9 (4.0) and 5.6 (3.6) years, respectively; 65 (10.1%) colectomy cases and 342 (15.5%) non-colectomy controls developed type 2 diabetes. After adjustment, colectomy cases still exhibited a decreased risk of type 2 diabetes (adjusted HR = 0.80, 95% CI: 0.61-1.04). A stratified analysis for colectomy type indicated that patients who underwent right or transverse colectomy had a significantly lower risk of developing type 2 diabetes (adjusted HR = 0.57, 95% CI: 0.34-0.98). In the present study, colectomy tended to be at a reduced risk of type 2 diabetes in patients without colorectal cancer, and right or transverse colectomies were especially associated with a significantly reduced risk of type 2 diabetes.

摘要

2型糖尿病可能受结肠疾病影响;然而,结肠切除术与2型糖尿病之间的关联鲜有讨论。这项基于人群的队列研究探讨了无结直肠癌患者中结肠切除术与2型糖尿病之间的关联。纳入了2000年至2012年期间在台湾国民健康保险研究数据库中因非癌性疾病随时接受结肠切除术的642例患者。使用涵盖年龄、性别和合并症的倾向评分,将纳入的患者与2568例未接受结肠切除术的患者按1:4的比例进行匹配。使用Cox比例风险模型评估2型糖尿病风险。结肠切除术病例组和非结肠切除术对照组的平均(标准差)随访时间分别为4.9(4.0)年和5.6(3.6)年;65例(10.1%)结肠切除术病例和342例(15.5%)非结肠切除术对照发生了2型糖尿病。调整后,结肠切除术病例发生2型糖尿病的风险仍然降低(调整后HR = 0.80,95%CI:0.61 - 1.04)。结肠切除术类型的分层分析表明,接受右半结肠或横结肠切除术的患者发生2型糖尿病的风险显著降低(调整后HR = 0.57,95%CI:0.34 - 0.98)。在本研究中,无结直肠癌患者接受结肠切除术后发生2型糖尿病的风险倾向于降低,尤其是右半结肠或横结肠切除术与发生2型糖尿病的风险显著降低相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbb3/8622203/d9bb4f366222/jcm-10-05313-g001.jpg

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