Diabetes is an independent risk factor for peptic ulcer bleeding: A nationwide population‐based cohort study

Journal of Gastroenterology and Hepatology (Australia) - Tập 28 Số 8 - Trang 1295-1299 - 2013
Yen‐Ling Peng1,2, Hsin‐Bang Leu1,3,4, Jiing‐Chyuan Luo1,2, Chin‐Chou Huang5,1,3, Ming‐Chih Hou1,2, Han‐Chieh Lin1,2, Fa‐Yauh Lee1,2
1Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
2Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
3Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
4Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
5Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan

Tóm tắt

AbstractBackground and Aims

Diabetic patients reportedly have a higher incidence of peptic ulcer disease. The aim of this study was to investigate if type II diabetic patients have higher risk of developing peptic ulcer bleeding (PUB) and to identify possible risk factors of PUB in diabetic patients.

Methods

Using the National Health Insurance Research Database of Taiwan, records of 5699 type II diabetic patients and 11 226 age‐ and sex‐matched non‐diabetic patients in a 1:2 ratio were extracted for comparison from a cohort dataset of 1 000 000 randomly sampled subjects. Log‐rank test was used to analyze differences in cumulative hazard of PUB between the two groups. Cox proportional hazard regressions were used to evaluate independent risk factors for PUB in all patients and identified risk factors of PUB in type II diabetic patients.

Results

In a 7‐year follow‐up period, type II diabetic patients had significantly higher cumulative hazard of PUB than the controls (P < 0.001, log‐rank test). By Cox proportional hazard regression analysis, diabetes was independently associated with increased risk of PUB (hazard ratio 1.44, 95% confidence interval 1.11–1.86; P < 0.001) after adjusting for age, sex, comorbidities (e.g. hypertension, coronary heart disease, heart failure, chronic renal disease, cirrhosis, and peptic ulcer disease), and ulcerogenic medication. Age, chronic renal disease, history of peptic ulcer disease, and use of non‐steroidal anti‐inflammatory drugs were risk factors for PUB in diabetic patients.

Conclusions

Type II diabetic patients have significantly higher risk of PUB even after adjustments for possible confounding factors like age, sex, underlying comorbidities, and ulcerogenic medication.

Từ khóa


Tài liệu tham khảo

10.1503/cmaj.110299

10.1111/j.1365-2036.2012.05028.x

10.1111/j.1365-2036.2012.05225.x

10.2337/dc11-1596

Konturek PC, 2010, Gastric ulcer healing and stress‐lesion preventive properties of pioglitazone are attenuated in diabetic rats, J. Physiol. Pharmacol., 61, 429

10.1016/j.ejphar.2003.09.019

Podvigina TT, 2011, Gastric mucosal susceptibility for ulcerogenic effect of indometacin at different time points of streptozotocin‐induced diabetes development, Ross. Fiziol. Zh. Im. I M Sechenova, 97, 957

10.1016/j.amjmed.2012.09.010

10.3748/wjg.15.280

10.1053/j.ajkd.2012.07.017

10.1016/j.jcma.2012.09.004

10.1136/gut.46.1.27

10.1016/j.bcp.2008.07.010

Naito Y, 2009, Impaired gastric ulcer healing in diabetic mice: role of methylglyoxal, J. Physiol. Pharmacol., 60, 123

10.2337/diacare.29.04.06.dc05-1748

10.1016/S0140-6736(02)07273-2

10.1111/j.1523-5378.2011.00822.x

10.1111/j.1523-5378.2011.00883.x

10.2337/dc11-1043

10.1111/j.1464-5491.2008.02637.x

10.1111/j.1440-1681.2009.05250.x

10.1136/gut.2010.224329