Factor affecting severe atherothrombotic cerebral infarction in patients with type 2 diabetes mellitus: Large-scale claim database analysis of Japan

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation Pub Date : 2024-09-05 DOI:10.1111/jdi.14284

Takeshi Horii, Yoichi Oikawa, Kasumi Kidowaki, Akira Shimada, Kiyoshi Mihara

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Abstract

Aims

This study aimed to investigate the factors associated with the exacerbation of the severity of atherothrombotic brain infarction at discharge in patients with type 2 diabetes using a large-scale claims database.

Materials and Methods

This retrospective cross-sectional study utilized the Medical Data Vision administrative claims database, a nationwide database in Japan using acute care hospital data, and the Diagnosis Procedure Combination system. Diagnosis Procedure Combination data collected between April 1, 2008, and December 31, 2022, were extracted. Patients with type 2 diabetes were included. Severe atherothrombotic brain infarction was defined as a modified Rankin scale score of ≥3.

Results

Severe atherothrombotic brain infarction occurred in 43,916/99,864 (44.0%) patients with type 2 diabetes. The odds ratio for severe atherothrombotic brain infarction increased significantly per 10 year increments in age (odds ratio: 1.69, 95% confidence interval: 1.66–1.71). A body mass index of <25 kg/m², with a body mass index of ≥25 kg/m² as reference, also increased the risk for severe atherothrombotic brain infarction (odds ratio: 1.11, 95% confidence interval: 1.08–1.15). The odds ratios in insulin and dipeptidyl peptidase 4 inhibitor use were significantly higher than 1. In particular, statin use (odds ratio: 0.85, 95% confidence interval: 0.83–0.88), fibrate use (odds ratio: 0.68, 95% confidence interval: 0.59–0.78), aspirin use (odds ratio: 0.78, 95% confidence interval: 0.75–0.80), and P2Y12 inhibitor use (odds ratio: 0.88, 95% confidence interval: 0.85–0.91) were associated with a lower odds ratio for severe atherothrombotic brain infarction.

Conclusions

The active management of lipid levels using statins and fibrates may be beneficial in preventing the exacerbation of atherothrombotic brain infarction in type 2 diabetes patients.

Abstract Image

查看原文本刊更多论文

影响 2 型糖尿病患者严重动脉粥样硬化性脑梗塞的因素：日本大规模索赔数据库分析。

目的：本研究旨在利用大规模理赔数据库调查 2 型糖尿病患者出院时动脉粥样硬化性脑梗塞严重程度加剧的相关因素：这项回顾性横断面研究利用了 "Medical Data Vision "行政索赔数据库（日本利用急诊医院数据的全国性数据库）和 "诊断程序组合系统"。研究提取了 2008 年 4 月 1 日至 2022 年 12 月 31 日期间收集的诊断程序组合数据。研究对象包括 2 型糖尿病患者。重度动脉粥样硬化性脑梗死的定义为改良Rankin量表评分≥3分：43,916/99,864（44.0%）名 2 型糖尿病患者发生了严重的动脉粥样硬化性脑梗塞。年龄每增加 10 岁，发生严重动脉粥样硬化性脑梗塞的几率就会显著增加（几率比：1.69，95% 置信区间：1.66-1.71）。以体重指数≥25 kg/m2 为参照，体重指数为 2 也会增加严重动脉粥样硬化性脑梗死的风险（几率比：1.11，95% 置信区间：1.08-1.15）。使用胰岛素和二肽基肽酶 4 抑制剂的几率比明显高于 1，尤其是使用他汀类药物（几率比：0.85，95% 置信区间：0.83-0.88）、使用纤维酸盐（几率比：0.68，95% 置信区间：0.59-0.78）、使用阿司匹林（几率比：0.78，95% 置信区间：0.75-0.80）和使用 P2Y12 抑制剂（几率比：0.88，95% 置信区间：0.85-0.91）与较低的严重动脉粥样硬化性脑梗死几率相关：结论：使用他汀类药物和纤维素类药物积极控制血脂水平可能有利于预防2型糖尿病患者动脉粥样硬化性脑梗死的恶化。

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来源期刊

Journal of Diabetes Investigation ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

9.40%

发文量

218

审稿时长

6-12 weeks

期刊介绍： Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).