Thorsted A, Lehn S F, Kofoed-Enevoldsen A, Andersen A, Heltberg A, Michelsen S I, Thygesen L C
National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
Steno Diabetes Center Sjaelland, Holbæk, Denmark.
J Intellect Disabil Res. 2025 Jan;69(1):90-102. doi: 10.1111/jir.13190. Epub 2024 Oct 2.
Previous research shows that obesity, unhealthy eating, physical inactivity and a high use of psychotropic medications are prevalent among persons with intellectual disability (ID), which might increase the risk of type 2-diabetes (T2DM). This study aims to investigate: (1) whether persons with ID have an increased risk of T2DM compared with an age- and sex-matched reference group and (2) differences in T2DM risk by sex, birth year, ID inclusion diagnosis and ID severity.
This study is a nationwide cohort study, including 65 293 persons with ID and 659 723 persons in an age- and sex-matched reference group without ID. Incidence rates for T2DM were calculated and Cox proportional regression models were used to estimate adjusted hazard ratios (aHRs) for the association between ID and T2DM. Follow-up began from the 1 January 1977 (when T2DM data were available), participants' 22nd birthday or from the date the participants immigrated to Denmark, whichever came last and continued until the onset of T2DM, emigration, death or end of follow-up (31 December 2021), whichever came first.
Persons with ID had more than double risk of T2DM compared with the reference group [aHR = 2.15, 95% confidence interval (CI): 2.09-2.20]. The strongest associations were found among women, persons born between 1980 and 1999 and among persons with mild ID.
Persons with ID have an increased risk of T2DM. This knowledge is important in relation to the development and prioritising of preventive initiatives among persons with ID in the healthcare sector. Future research should focus on the underlying mechanisms that can explain the possible association between ID and T2DM as it allows a more targeted prevention strategy.
先前的研究表明，肥胖、不健康饮食、缺乏身体活动以及大量使用精神药物在智力残疾（ID）患者中很普遍，这可能会增加2型糖尿病（T2DM）的风险。本研究旨在调查：（1）与年龄和性别匹配的参照组相比，ID患者患T2DM的风险是否增加；（2）T2DM风险在性别、出生年份、ID纳入诊断和ID严重程度方面的差异。
本研究是一项全国性队列研究，包括65293名ID患者和659723名年龄和性别匹配的无ID参照组人员。计算T2DM的发病率，并使用Cox比例回归模型估计ID与T2DM之间关联的调整后风险比（aHRs）。随访从1977年1月1日（有T2DM数据时）、参与者22岁生日或参与者移民到丹麦的日期开始，以最晚者为准，并持续到T2DM发病、移民、死亡或随访结束（2021年12月31日），以最早者为准。
与参照组相比，ID患者患T2DM的风险增加了一倍多[aHR = 2.15，95%置信区间（CI）：2.09 - 2.20]。在女性、1980年至1999年出生的人群以及轻度ID患者中发现了最强的关联。
ID患者患T2DM的风险增加。这一认识对于医疗保健部门制定ID患者的预防措施及确定其优先顺序具有重要意义。未来的研究应关注能够解释ID与T2DM之间可能关联的潜在机制，因为这有助于制定更具针对性的预防策略。
