Increased risk for diabetes mellitus in patients with carbon monoxide poisoning

Chien Cheng Huang, Chung Han Ho, Yi Chen Chen, Hung Jung Lin, Chien Chin Hsu, Jhi Joung Wang, Shih Bin Su, How-Ran Guo

Research output: Contribution to journalArticle

2 Citations (Scopus)

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 languageEnglish
Pages (from-to)63680-63690
Number of pages11
JournalOncotarget
Volume8
Issue number38
DOIs
Publication statusPublished - 2017 Jan 1

Fingerprint

Carbon Monoxide Poisoning
Diabetes Mellitus
Confidence Intervals
Poisoning
Comorbidity
Databases
Hyperuricemia
Polycystic Ovary Syndrome
Hyperthyroidism
Health Insurance
Hyperlipidemias
Taiwan
Pancreas
Cohort Studies
Heart Failure
Regression Analysis
Hypertension
Wounds and Injuries
Brain

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Huang, C. C., Ho, C. H., Chen, Y. C., Lin, H. J., Hsu, C. C., Wang, J. J., ... Guo, H-R. (2017). Increased risk for diabetes mellitus in patients with carbon monoxide poisoning. Oncotarget, 8(38), 63680-63690. https://doi.org/10.18632/oncotarget.18887
Huang, Chien Cheng ; Ho, Chung Han ; Chen, Yi Chen ; Lin, Hung Jung ; Hsu, Chien Chin ; Wang, Jhi Joung ; Su, Shih Bin ; Guo, How-Ran. / Increased risk for diabetes mellitus in patients with carbon monoxide poisoning. In: Oncotarget. 2017 ; Vol. 8, No. 38. pp. 63680-63690.
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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.",
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Huang, CC, Ho, CH, Chen, YC, Lin, HJ, Hsu, CC, Wang, JJ, Su, SB & Guo, H-R 2017, 'Increased risk for diabetes mellitus in patients with carbon monoxide poisoning', Oncotarget, vol. 8, no. 38, pp. 63680-63690. https://doi.org/10.18632/oncotarget.18887

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 journalArticle

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AU - Huang, Chien Cheng

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AU - Su, Shih Bin

AU - Guo, How-Ran

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Huang CC, Ho CH, Chen YC, Lin HJ, Hsu CC, Wang JJ et al. Increased risk for diabetes mellitus in patients with carbon monoxide poisoning. Oncotarget. 2017 Jan 1;8(38):63680-63690. https://doi.org/10.18632/oncotarget.18887