1型和2型糖尿病患者中系统性硬化症及其他自身免疫性结缔组织病的患病率降低及临床表型改变：一项横断面观察性研究。
Decreased prevalence and altered clinical phenotype of systemic sclerosis and other autoimmune connective tissue diseases in type 1 and type 2 diabetes: A cross-sectional observational study.
作者信息
Abugharbyeh Aya, Khuder Sadik, Kahaleh Bashar
机构信息
Department of Medicine, University of Toledo Medical Center, Toledo, OH, USA.
出版信息
J Scleroderma Relat Disord. 2024 Dec 3:23971983241301231. doi: 10.1177/23971983241301231.
INTRODUCTION
Evidence has demonstrated that autoimmune diseases tend to coexist at a higher rate than expected, reflecting a common pathogenic pathway. In this study, we investigate the co-occurrence of systemic sclerosis, systemic lupus erythematosus, and Sjogren syndrome in patients with type 1 and type 2 diabetes mellitus.
METHODS
Our data were obtained using the 2019 Healthcare Cost and Utilization Project, and International Classification of Diseases, 10th Revision diagnosis codes were used to identify patients with systemic sclerosis, systemic lupus erythematosus, lupus nephritis, and Sjogren syndrome, as well as patients with type 1 and type 2 diabetes. We utilized Statistical Analysis System 9.4 for all analyses and included designated weight values to produce nationally representative estimates.
RESULTS
The prevalence of systemic sclerosis among patients with type 1 diabetes mellitus and type 2 diabetes mellitus was significantly lower than that for the non-diabetes mellitus control group (0.0007% vs 0.09%, p-value = 0.0064 and 0.01% vs 0.07%, p-value < 0.0001), respectively. Similarly, there was a significant decrease in the prevalence of systemic sclerosis with lung involvement in patients with type 1 and type 2 diabetes mellitus, with a statically significant difference in type 2 diabetes mellitus versus nondiabetic group (0.001% vs 0.006%, p-value < 0.0001). We noted a similar pattern regarding the prevalence of systemic lupus erythematosus and lupus nephritis in patients with type 1 and 2 diabetes. Similarly, there was a significant decrease in the prevalence of Sjogren syndrome in patients with type 1 diabetes and type 2 diabetes.
CONCLUSION
The collected data demonstrates an inverse relation between some autoimmune connective tissue diseases and diabetes. This suggests that these diseases and diabetes mellitus may have different immune pathogenesis. There was also a significantly lower incidence of organ complications such as lupus nephritis and systemic sclerosis lung disease among patients with diabetes, suggesting that diabetes and treatment of diabetes may alter the clinical expression of these disorders.
引言
有证据表明，自身免疫性疾病往往比预期的更易共存，这反映了一条共同的致病途径。在本研究中，我们调查了1型和2型糖尿病患者中系统性硬化症、系统性红斑狼疮和干燥综合征的共病情况。
方法
我们的数据来自2019年医疗成本与利用项目，使用国际疾病分类第10版诊断代码来识别系统性硬化症、系统性红斑狼疮、狼疮性肾炎和干燥综合征患者，以及1型和2型糖尿病患者。我们使用统计分析系统9.4进行所有分析，并纳入指定权重值以得出具有全国代表性的估计值。
结果
1型糖尿病和2型糖尿病患者中系统性硬化症的患病率显著低于非糖尿病对照组（分别为0.0007%对0.09%，p值 = 0.0064；以及0.01%对0.07%，p值 < 0.0001）。同样，1型和2型糖尿病患者中伴有肺部受累的系统性硬化症患病率显著降低，2型糖尿病患者与非糖尿病组之间存在统计学显著差异（0.001%对0.006%，p值 < 0.0001）。我们注意到1型和2型糖尿病患者中系统性红斑狼疮和狼疮性肾炎的患病率也有类似模式。同样，1型糖尿病和2型糖尿病患者中干燥综合征的患病率显著降低。
结论
收集的数据表明某些自身免疫性结缔组织疾病与糖尿病之间存在负相关关系。这表明这些疾病和糖尿病可能具有不同的免疫发病机制。糖尿病患者中狼疮性肾炎和系统性硬化症肺部疾病等器官并发症的发生率也显著较低，这表明糖尿病及其治疗可能会改变这些疾病的临床表现。
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