Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
Department of Clinical Pharmacology, Aalborg University Hospital, Aalborg, Denmark.
BMJ Open. 2022 Feb 21;12(2):e059852. doi: 10.1136/bmjopen-2021-059852.
To investigate the association between type 2 diabetes and risk of diverticular disease. Unlike previous studies, which have found conflicting results, we aimed to distinguish between diabetes types and adjust for modifiable risk factors.
Observational cohort study.
Population-based Danish medical databases, covering the period 2005-2018.
Respondents of the 2010 or the 2013 Danish National Health Survey, of which there were 15 047 patients with type 2 diabetes and 210 606 patients without diabetes.
Hazard ratios (HRs) for incident hospital diagnosis of diverticular disease adjusted for survey year, sex, age, body mass index (BMI), physical activity intensity, smoking behaviour, diet and education based on Cox regression analysis. As latency may affect the association between type 2 diabetes and diverticular disease, patients with type 2 diabetes were stratified into those with <2.5, 2.5-4.9 and ≥5 years duration of diabetes prior to cohort entry.
For patients with and without diabetes the incidence rates of diverticular disease were 0.76 and 0.54 events per 1000 person years, corresponding to a crude HR of 1.08 (95% CI 1.00 to 1.16) and an adjusted HR of 0.88 (95% CI 0.80 to 0.96). The HR was lower among patients with ≥5 years duration of diabetes (adjusted HR: 0.76, 95% CI 0.67 to 0.87) than among those with 2.5-4.9 years or <2.5 years duration.
We found that patients with type 2 diabetes had a higher incidence rate of diverticular disease compared with patients without diabetes. However, after adjustment for modifiable risk factors, driven by BMI, type 2 diabetes appeared to be associated with a slightly lower risk of diverticular disease. Lack of adjustment for BMI may partially explain the conflicting findings of previous studies.
探讨 2 型糖尿病与憩室病风险的关系。与之前研究结果存在冲突不同，我们旨在区分糖尿病类型并调整可改变的危险因素。
观察性队列研究。
基于人群的丹麦医学数据库，涵盖 2005-2018 年期间。
2010 年或 2013 年丹麦全国健康调查的应答者，其中 15047 例患者患有 2 型糖尿病，210606 例患者无糖尿病。
基于 Cox 回归分析，通过调整调查年份、性别、年龄、体重指数（BMI）、身体活动强度、吸烟行为、饮食和教育，对 2 型糖尿病患者的憩室病住院诊断发生率进行校正的风险比（HR）。由于潜伏期可能会影响 2 型糖尿病与憩室病之间的关联，因此将 2 型糖尿病患者分为病程<2.5 年、2.5-4.9 年和≥5 年的队列入组前。
在有和无糖尿病的患者中，憩室病的发生率分别为 0.76 和 0.54 例/1000 人年，对应的粗 HR 为 1.08（95%CI 1.00 至 1.16）和调整后的 HR 为 0.88（95%CI 0.80 至 0.96）。病程≥5 年的患者的 HR 低于病程 2.5-4.9 年或<2.5 年的患者（调整后的 HR：0.76，95%CI 0.67 至 0.87）。
我们发现与无糖尿病患者相比，2 型糖尿病患者憩室病的发生率更高。然而，在调整 BMI 等可改变的危险因素后，2 型糖尿病似乎与憩室病的风险略低相关。缺乏对 BMI 的调整可能部分解释了之前研究结果的冲突。
