부산대학교 도서관

Objective: Rheumatoid arthritis (RA) may increase the risk for diabetes due to chronic inflammation; however, this topic remains controversial. This study aimed to clarify this issue and its effect on age and serial follow-up periods. Methods: This nationwide population-based cohort study was conducted by identifying patients with and without RA matched at a 1:10 ratio by age, sex, and index date between 2000 and 2013 from the Taiwan National Health Insurance Research Database. Cox proportional hazard regression analysis was used to compare the risk for diabetes between the two cohorts by following up until 2014. Results: In total, 4769 patients with RA and 47,690 patients without RA were identified into this study. The mean age (±SD) and female ratio were 51.7 (±14.2) years and 74.6% in both cohorts. Overall, risk for diabetes was significantly higher in the patients with RA than in those without RA (crude hazard ratio: 1.15; 95% confidence interval [CI]: 1.01-1.30). However, the significance disappeared after adjusting for underlying comorbidities, NSAID drug use, and monthly income (adjusted hazard ratio [AHR]: 1.02; 95% CI: 0.90-1.15). Stratified analyses showed that the patients with RA in the age subgroup of ≥85 years (AHR: 13.06; 95% CI: 2.47-69.14) and follow-up within 1 year (AHR: 1.80; 95% CI: 1.18-2.75) were at higher risk for diabetes than the patients without RA. Conclusion: In the age subgroup of ≥85 years and follow-up within 1 year, the patients with RA had a higher risk for diabetes than those without RA. However, this difference did not exist in the overall analysis. Further studies recruiting disease-modifying antirheumatic drugs and glucocorticoids are needed to clarify this issue.