{"title":"抗消化性溃疡药物对PUD患者2型糖尿病风险的影响：一项基于人群的回顾性队列研究","authors":"Yi-Jen Fang, Hui-Hsia Hsieh, Cheng-Li Lin, Wan-Yi Lee, Chi-Hua Chen, Fuu-Jen Tsai, Bang-Jau You, Ni Tien, Yun-Ping Lim","doi":"10.1177/20420188251323945","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The etiology of type 2 diabetes mellitus (T2DM) is complex, with environmental factors playing a significant role in its pathophysiology. Nonsteroidal anti-inflammatory drugs usage and <i>Helicobacter pylori</i> infection are the two most frequent causes of peptic ulcer disease (PUD). The link between PUD and T2DM is unclear, and comprehensive analyses of anti-PUD medications' impact on T2DM risk, especially in Asian populations, are lacking. This study aimed to determine the relationship between PUD, anti-PUD medications, and the likelihood of developing T2DM.</p><p><strong>Objectives: </strong>Using a population-based cohort study conducted in Taiwan, we investigated the impact of PUD and anti-PUD medications on the risk of T2DM.</p><p><strong>Design: </strong>This is a retrospective, population-based cohort study using the largest database used in Taiwan.</p><p><strong>Methods: </strong>An 18-year follow-up period study was conducted on a cohort of patients with PUD diagnosed between 2001 and 2018 using the Taiwan National Health Insurance Research Database. The risk of PUD as well as anti-PUD medications use were examined using Cox proportional regression model.</p><p><strong>Results: </strong>Based on multivariable Cox proportional hazards regression analysis, patients with PUD had a higher overall T2DM incidence (22.7 vs 21.3 per 1000 person-years) than patients without PUD. The adjusted hazard ratio was 1.12 (95% confidence interval = 1.10, 1.13). Patients with PUD have a higher risk of T2DM in both genders and age groups. Patients with anti-PUD medications, such as H2 receptor antagonists, proton-pump inhibitors, antibiotics, prostaglandin analogs, anticholinergics, and antacids usage, are associated with a lower risk of developing T2DM than those without. Patients with PUD who underwent surgery were found to have a higher risk of T2DM.</p><p><strong>Conclusion: </strong>Patients with PUD are more likely to develop T2DM. Nevertheless, patients receiving anti-PUD medications have a lower incidence of T2DM.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"16 ","pages":"20420188251323945"},"PeriodicalIF":3.9000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921004/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of anti-peptic ulcer disease medications on type 2 diabetes mellitus risk in patients with PUD: a population-based retrospective cohort study.\",\"authors\":\"Yi-Jen Fang, Hui-Hsia Hsieh, Cheng-Li Lin, Wan-Yi Lee, Chi-Hua Chen, Fuu-Jen Tsai, Bang-Jau You, Ni Tien, Yun-Ping Lim\",\"doi\":\"10.1177/20420188251323945\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The etiology of type 2 diabetes mellitus (T2DM) is complex, with environmental factors playing a significant role in its pathophysiology. Nonsteroidal anti-inflammatory drugs usage and <i>Helicobacter pylori</i> infection are the two most frequent causes of peptic ulcer disease (PUD). The link between PUD and T2DM is unclear, and comprehensive analyses of anti-PUD medications' impact on T2DM risk, especially in Asian populations, are lacking. This study aimed to determine the relationship between PUD, anti-PUD medications, and the likelihood of developing T2DM.</p><p><strong>Objectives: </strong>Using a population-based cohort study conducted in Taiwan, we investigated the impact of PUD and anti-PUD medications on the risk of T2DM.</p><p><strong>Design: </strong>This is a retrospective, population-based cohort study using the largest database used in Taiwan.</p><p><strong>Methods: </strong>An 18-year follow-up period study was conducted on a cohort of patients with PUD diagnosed between 2001 and 2018 using the Taiwan National Health Insurance Research Database. The risk of PUD as well as anti-PUD medications use were examined using Cox proportional regression model.</p><p><strong>Results: </strong>Based on multivariable Cox proportional hazards regression analysis, patients with PUD had a higher overall T2DM incidence (22.7 vs 21.3 per 1000 person-years) than patients without PUD. The adjusted hazard ratio was 1.12 (95% confidence interval = 1.10, 1.13). Patients with PUD have a higher risk of T2DM in both genders and age groups. Patients with anti-PUD medications, such as H2 receptor antagonists, proton-pump inhibitors, antibiotics, prostaglandin analogs, anticholinergics, and antacids usage, are associated with a lower risk of developing T2DM than those without. Patients with PUD who underwent surgery were found to have a higher risk of T2DM.</p><p><strong>Conclusion: </strong>Patients with PUD are more likely to develop T2DM. 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引用次数: 0
摘要
背景：2型糖尿病（T2DM）病因复杂，环境因素在其病理生理中起重要作用。非甾体抗炎药的使用和幽门螺杆菌感染是消化性溃疡疾病（PUD）的两个最常见的原因。PUD和T2DM之间的联系尚不清楚，抗PUD药物对T2DM风险影响的综合分析，特别是在亚洲人群中，还缺乏。本研究旨在确定PUD、抗PUD药物与发展为T2DM的可能性之间的关系。目的：通过在台湾进行的一项基于人群的队列研究，我们调查了PUD和抗PUD药物对T2DM风险的影响。设计：这是一项回顾性、基于人群的队列研究，使用了台湾最大的数据库。采用Cox比例回归模型对PUD风险及抗PUD药物使用情况进行检验。结果：基于多变量Cox比例风险回归分析，PUD患者的T2DM总发病率高于无PUD患者（22.7 vs 21.3 / 1000人-年）。校正后的风险比为1.12（95%可信区间= 1.10,1.13）。无论性别还是年龄组，PUD患者发生2型糖尿病的风险都较高。服用抗pud药物（如H2受体拮抗剂、质子泵抑制剂、抗生素、前列腺素类似物、抗胆碱能药和抗酸药）的患者发生T2DM的风险低于未服用的患者。接受手术的PUD患者患2型糖尿病的风险更高。结论：PUD患者更易发展为2型糖尿病。然而，接受抗pud药物治疗的患者T2DM发病率较低。
Impact of anti-peptic ulcer disease medications on type 2 diabetes mellitus risk in patients with PUD: a population-based retrospective cohort study.
Background: The etiology of type 2 diabetes mellitus (T2DM) is complex, with environmental factors playing a significant role in its pathophysiology. Nonsteroidal anti-inflammatory drugs usage and Helicobacter pylori infection are the two most frequent causes of peptic ulcer disease (PUD). The link between PUD and T2DM is unclear, and comprehensive analyses of anti-PUD medications' impact on T2DM risk, especially in Asian populations, are lacking. This study aimed to determine the relationship between PUD, anti-PUD medications, and the likelihood of developing T2DM.
Objectives: Using a population-based cohort study conducted in Taiwan, we investigated the impact of PUD and anti-PUD medications on the risk of T2DM.
Design: This is a retrospective, population-based cohort study using the largest database used in Taiwan.
Methods: An 18-year follow-up period study was conducted on a cohort of patients with PUD diagnosed between 2001 and 2018 using the Taiwan National Health Insurance Research Database. The risk of PUD as well as anti-PUD medications use were examined using Cox proportional regression model.
Results: Based on multivariable Cox proportional hazards regression analysis, patients with PUD had a higher overall T2DM incidence (22.7 vs 21.3 per 1000 person-years) than patients without PUD. The adjusted hazard ratio was 1.12 (95% confidence interval = 1.10, 1.13). Patients with PUD have a higher risk of T2DM in both genders and age groups. Patients with anti-PUD medications, such as H2 receptor antagonists, proton-pump inhibitors, antibiotics, prostaglandin analogs, anticholinergics, and antacids usage, are associated with a lower risk of developing T2DM than those without. Patients with PUD who underwent surgery were found to have a higher risk of T2DM.
Conclusion: Patients with PUD are more likely to develop T2DM. Nevertheless, patients receiving anti-PUD medications have a lower incidence of T2DM.
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