Risk of End-Stage Kidney Disease in Individuals with Diabetes Living Alone: A Large-Scale Population-Based Study.

IF 6.8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Kyunghun Sung, Jae-Seung Yun, Bongseong Kim, Hun-Sung Kim, Jae-Hyoung Cho, Yong-Moon Mark Park, Kyungdo Han, Seung-Hwan Lee
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Abstract

Background: Previous research has linked solitary living to various adverse health outcomes, but its association with diabetic complications among individuals with type 2 diabetes mellitus (T2DM) remains underexplored. We examined the risk of endstage kidney disease (ESKD) in individuals with diabetes living alone (IDLA).

Methods: This population-based cohort study used the National Health Information Database of Korea, which included 2,432,613 adults with T2DM. Household status was determined based on the number of registered family members. IDLA was defined as continuously living alone for 5 years or more. A multivariable Cox proportional hazards model was used to evaluate the association between living alone and the risk of developing ESKD.

Results: During a median follow-up of 6.0 years, 26,691 participants developed ESKD, with a higher incidence observed in the IDLA group than in the non-IDLA group. After adjusting for confounding variables, the hazard ratio for ESKD in the IDLA group was 1.10 (95% confidence interval, 1.06 to 1.14). The risk of ESKD was particularly elevated in younger individuals, those without underlying chronic kidney disease, with longer durations of living alone, and with low household income. Adherence to favorable lifestyle behaviors (no smoking, no alcohol consumption, and engaging in regular exercise) was associated with a significantly lower risk of ESKD, with a more pronounced effect in the IDLA group.

Conclusion: Living alone was associated with a higher risk of ESKD in individuals with T2DM. Tailored medical interventions and social support for IDLA are crucial for the prevention of diabetic complications.

糖尿病独居患者终末期肾病的风险:一项大规模人群研究
背景:先前的研究已经将独居生活与各种不良健康结果联系起来,但其与2型糖尿病(T2DM)患者糖尿病并发症的关系仍未得到充分探讨。我们研究了糖尿病独居患者(IDLA)发生终末期肾病(ESKD)的风险。方法:这项基于人群的队列研究使用了韩国国家健康信息数据库,其中包括2,432,613名患有T2DM的成年人。家庭状况是根据登记家庭成员的数量来确定的。IDLA被定义为连续独自生活5年或更长时间。采用多变量Cox比例风险模型评估独居与ESKD发病风险之间的关系。结果:在中位随访6.0年期间,26,691名参与者发生ESKD, IDLA组的发生率高于非IDLA组。在调整混杂变量后,IDLA组ESKD的风险比为1.10(95%可信区间为1.06 ~ 1.14)。ESKD的风险在年轻人、无潜在慢性肾脏疾病、独居时间较长和家庭收入较低的人群中特别高。坚持良好的生活方式(不吸烟、不饮酒、定期锻炼)与ESKD风险显著降低相关,在IDLA组中效果更明显。结论:独居与T2DM患者ESKD风险升高相关。针对糖尿病患者量身定制的医疗干预措施和社会支持对于预防糖尿病并发症至关重要。
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来源期刊
Diabetes & Metabolism Journal
Diabetes & Metabolism Journal Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
10.40
自引率
6.80%
发文量
92
审稿时长
52 weeks
期刊介绍: The aims of the Diabetes & Metabolism Journal are to contribute to the cure of and education about diabetes mellitus, and the advancement of diabetology through the sharing of scientific information on the latest developments in diabetology among members of the Korean Diabetes Association and other international societies. The Journal publishes articles on basic and clinical studies, focusing on areas such as metabolism, epidemiology, pathogenesis, complications, and treatments relevant to diabetes mellitus. It also publishes articles covering obesity and cardiovascular disease. Articles on translational research and timely issues including ubiquitous care or new technology in the management of diabetes and metabolic disorders are welcome. In addition, genome research, meta-analysis, and randomized controlled studies are welcome for publication. The editorial board invites articles from international research or clinical study groups. Publication is determined by the editors and peer reviewers, who are experts in their specific fields of diabetology.
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