Abstract
Carbon monoxide poisoning (COP) causes hypoxic injury and inflammatory and immunological reactions in the brain and local organs including the pancreas. Therefore, it is plausible that COP may increase the risk for developing diabetes mellitus (DM), but studies on this possible association are limited. We conducted a nationwide study in Taiwan to fill the data gap. We used the Nationwide Poisoning Database and the Longitudinal Health Insurance Database 2000 to identify all COP patients diagnosed between 1999 and 2012 (the study cohort) and then construct a comparison cohort of patients without COP through matching at 1:3 by the index date and age. The risk for DM between the two cohorts was compared by following up until 2013. We also investigated the independent predictors for DM in all the patients. During the study period, 22,308 COP patients were identified, and 66,924 non-COP patients were included in the comparison cohort accordingly. Patients with COP had an increased risk for DM with an adjusted hazard ratio (AHR) of 1.92 (95% confidence interval [CI]: 1.79-2.06) after adjusting for age, sex, comorbidities, and monthly income, especially in the subgroups of age < 35 years, age = 65 years, female sex, and comorbidities with congestive heart failure, hyperthyroidism, and polycystic ovary syndrome. Cox proportional hazard regression analysis showed that the increased risk for DM was highest in the first month after COP (AHR= 3.38; 95% CI: 2.29-4.99) and lasted even after 4 years (AHR= 1.82; 95% CI: 1.62-2.04). We found that COP, older age, male sex, hypertension, hyperlipidemia, hyperuricemia, and low monthly income were independent predictors for DM. Intervention studies are needed to validate the results and delineate the detailed mechanisms.
| Original language | English |
|---|---|
| Pages (from-to) | 63680-63690 |
| Number of pages | 11 |
| Journal | Oncotarget |
| Volume | 8 |
| Issue number | 38 |
| DOIs | |
| Publication status | Published - 2017 Jan 1 |
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All Science Journal Classification (ASJC) codes
- Oncology
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Increased risk for diabetes mellitus in patients with carbon monoxide poisoning. / Huang, Chien Cheng; Ho, Chung Han; Chen, Yi Chen; Lin, Hung Jung; Hsu, Chien Chin; Wang, Jhi Joung; Su, Shih Bin; Guo, How-Ran.
In: Oncotarget, Vol. 8, No. 38, 01.01.2017, p. 63680-63690.Research output: Contribution to journal › Article
TY - JOUR
T1 - Increased risk for diabetes mellitus in patients with carbon monoxide poisoning
AU - Huang, Chien Cheng
AU - Ho, Chung Han
AU - Chen, Yi Chen
AU - Lin, Hung Jung
AU - Hsu, Chien Chin
AU - Wang, Jhi Joung
AU - Su, Shih Bin
AU - Guo, How-Ran
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Carbon monoxide poisoning (COP) causes hypoxic injury and inflammatory and immunological reactions in the brain and local organs including the pancreas. Therefore, it is plausible that COP may increase the risk for developing diabetes mellitus (DM), but studies on this possible association are limited. We conducted a nationwide study in Taiwan to fill the data gap. We used the Nationwide Poisoning Database and the Longitudinal Health Insurance Database 2000 to identify all COP patients diagnosed between 1999 and 2012 (the study cohort) and then construct a comparison cohort of patients without COP through matching at 1:3 by the index date and age. The risk for DM between the two cohorts was compared by following up until 2013. We also investigated the independent predictors for DM in all the patients. During the study period, 22,308 COP patients were identified, and 66,924 non-COP patients were included in the comparison cohort accordingly. Patients with COP had an increased risk for DM with an adjusted hazard ratio (AHR) of 1.92 (95% confidence interval [CI]: 1.79-2.06) after adjusting for age, sex, comorbidities, and monthly income, especially in the subgroups of age < 35 years, age = 65 years, female sex, and comorbidities with congestive heart failure, hyperthyroidism, and polycystic ovary syndrome. Cox proportional hazard regression analysis showed that the increased risk for DM was highest in the first month after COP (AHR= 3.38; 95% CI: 2.29-4.99) and lasted even after 4 years (AHR= 1.82; 95% CI: 1.62-2.04). We found that COP, older age, male sex, hypertension, hyperlipidemia, hyperuricemia, and low monthly income were independent predictors for DM. Intervention studies are needed to validate the results and delineate the detailed mechanisms.
AB - Carbon monoxide poisoning (COP) causes hypoxic injury and inflammatory and immunological reactions in the brain and local organs including the pancreas. Therefore, it is plausible that COP may increase the risk for developing diabetes mellitus (DM), but studies on this possible association are limited. We conducted a nationwide study in Taiwan to fill the data gap. We used the Nationwide Poisoning Database and the Longitudinal Health Insurance Database 2000 to identify all COP patients diagnosed between 1999 and 2012 (the study cohort) and then construct a comparison cohort of patients without COP through matching at 1:3 by the index date and age. The risk for DM between the two cohorts was compared by following up until 2013. We also investigated the independent predictors for DM in all the patients. During the study period, 22,308 COP patients were identified, and 66,924 non-COP patients were included in the comparison cohort accordingly. Patients with COP had an increased risk for DM with an adjusted hazard ratio (AHR) of 1.92 (95% confidence interval [CI]: 1.79-2.06) after adjusting for age, sex, comorbidities, and monthly income, especially in the subgroups of age < 35 years, age = 65 years, female sex, and comorbidities with congestive heart failure, hyperthyroidism, and polycystic ovary syndrome. Cox proportional hazard regression analysis showed that the increased risk for DM was highest in the first month after COP (AHR= 3.38; 95% CI: 2.29-4.99) and lasted even after 4 years (AHR= 1.82; 95% CI: 1.62-2.04). We found that COP, older age, male sex, hypertension, hyperlipidemia, hyperuricemia, and low monthly income were independent predictors for DM. Intervention studies are needed to validate the results and delineate the detailed mechanisms.
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U2 - 10.18632/oncotarget.18887
DO - 10.18632/oncotarget.18887
M3 - Article
VL - 8
SP - 63680
EP - 63690
JO - Oncotarget
JF - Oncotarget
SN - 1949-2553
IS - 38
ER -