Fang Yi-Jen, Hsieh Hui-Hsia, Lin Cheng-Li, Lee Wan-Yi, Chen Chi-Hua, Tsai Fuu-Jen, You Bang-Jau, Tien Ni, Lim Yun-Ping
Department of Post-Baccalaureate Medicine, College of Medicine, National Chung-Hsing University, Taichung, Taiwan.
Digestive Disease Center, Show Chwan Memorial Hospital, Changhua, Taiwan.
Ther Adv Endocrinol Metab. 2025 Mar 19;16:20420188251323945. doi: 10.1177/20420188251323945. eCollection 2025.
The etiology of type 2 diabetes mellitus (T2DM) is complex, with environmental factors playing a significant role in its pathophysiology. Nonsteroidal anti-inflammatory drugs usage and infection are the two most frequent causes of peptic ulcer disease (PUD). The link between PUD and T2DM is unclear, and comprehensive analyses of anti-PUD medications' impact on T2DM risk, especially in Asian populations, are lacking. This study aimed to determine the relationship between PUD, anti-PUD medications, and the likelihood of developing T2DM.
Using a population-based cohort study conducted in Taiwan, we investigated the impact of PUD and anti-PUD medications on the risk of T2DM.
This is a retrospective, population-based cohort study using the largest database used in Taiwan.
An 18-year follow-up period study was conducted on a cohort of patients with PUD diagnosed between 2001 and 2018 using the Taiwan National Health Insurance Research Database. The risk of PUD as well as anti-PUD medications use were examined using Cox proportional regression model.
Based on multivariable Cox proportional hazards regression analysis, patients with PUD had a higher overall T2DM incidence (22.7 vs 21.3 per 1000 person-years) than patients without PUD. The adjusted hazard ratio was 1.12 (95% confidence interval = 1.10, 1.13). Patients with PUD have a higher risk of T2DM in both genders and age groups. Patients with anti-PUD medications, such as H2 receptor antagonists, proton-pump inhibitors, antibiotics, prostaglandin analogs, anticholinergics, and antacids usage, are associated with a lower risk of developing T2DM than those without. Patients with PUD who underwent surgery were found to have a higher risk of T2DM.
Patients with PUD are more likely to develop T2DM. Nevertheless, patients receiving anti-PUD medications have a lower incidence of T2DM.
2型糖尿病（T2DM）的病因复杂，环境因素在其病理生理学中起重要作用。非甾体类抗炎药的使用和感染是消化性溃疡疾病（PUD）最常见的两个病因。PUD与T2DM之间的联系尚不清楚，且缺乏对抗PUD药物对T2DM风险影响的全面分析，尤其是在亚洲人群中。本研究旨在确定PUD、抗PUD药物与发生T2DM可能性之间的关系。
通过在台湾进行的一项基于人群的队列研究，我们调查了PUD和抗PUD药物对T2DM风险的影响。
这是一项回顾性、基于人群的队列研究，使用台湾最大的数据库。
利用台湾国民健康保险研究数据库，对2001年至2018年期间诊断为PUD的患者队列进行了为期18年的随访研究。使用Cox比例回归模型检查PUD风险以及抗PUD药物的使用情况。
基于多变量Cox比例风险回归分析，PUD患者的总体T2DM发病率（每1000人年22.7例 vs 21.3例）高于无PUD患者。调整后的风险比为1.12（95%置信区间 = 1.10, 1.13）。PUD患者在男性和女性以及各个年龄组中患T2DM的风险都更高。使用抗PUD药物（如H2受体拮抗剂、质子泵抑制剂、抗生素、前列腺素类似物、抗胆碱能药物和抗酸剂）的患者发生T2DM的风险低于未使用的患者。接受手术的PUD患者被发现患T2DM的风险更高。
PUD患者更有可能发生T2DM。然而，接受抗PUD药物治疗的患者T2DM发病率较低。
