Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus
Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus
复制标题
DOI：
10.1185/03007995.2016.1168291
复制
发表时间：
2016-01-01
影响因子：
2.3
通讯作者：
Rajpathak, Swapnil
中科院分区：
文献类型：
--
作者：
Iglay, Kristy;Hannachi, Hakima;Rajpathak, Swapnil
目的：2型糖尿病（T2 DM）患者常伴有多种合并症，这些合并症可能影响降糖治疗的选择。本研究旨在量化常见合并症的患病率和共患病率。研究设计和方法：使用昆泰电子病历数据库进行回顾性研究。纳入了2014年7月至2015年6月（索引期）有≥ 1次就诊且有≥ 1年病史的T2 DM成人患者。索引日期定义为1年索引期内最近的就诊日期。主要结果测量：使用索引日期之前（包括索引日期）的所有可用数据评估共病情况。通过描述性分析总结患者特征、实验室指标和合并症，包括总体和年龄亚组（< 65岁、65-74岁、75岁以上）和性别。结果：在1，389，016名合格患者中，53%为女性，中位年龄为65岁。除T2 DM外，97.5%的患者至少有一种共病，88.5%的患者至少有两种共病。老年组的合并症负担趋于增加，男性高于女性。T2 DM患者中最常见的疾病包括高血压（HTN）（82.1%）、超重/肥胖（78.2%）、高脂血症（77.2%）、慢性肾脏疾病（CKD）（24.1%）和心血管疾病（CVD）（21.6%）。HTN和高脂血症的合并表现出最高的共同患病率（67.5%），其次是超重/肥胖和HTN（66.0%）、超重/肥胖和高脂血症（62.5%），HTN和CKD高脂血症合并慢性肾脏病（22.4%）、高脂血症合并心血管病（21.1%）、高血压合并心血管病（20.2%）、高脂血症合并心血管病（20.1%）、超重/肥胖合并慢性肾脏病（19.1%）、超重/肥胖合并心血管病（17.0%）。局限性：局限性包括由于使用诊断代码、药物代码或实验室措施识别医学状况而导致的错误分类/低报的可能性。结论：绝大多数T2 DM患者存在多种合并症。为了确保患者管理的综合方法，应在临床决策的背景下考虑多药耐药的存在。
Objective: Patients with type 2 diabetes (T2DM) often have multiple comorbidities which may impact the selection of antihyperglycemic therapies. The purpose of this study was to quantify the prevalence and co-prevalence of common comorbidities. Research design and methods: A retrospective study was conducted using the Quintiles Electronic Medical Record database. Adult patients with T2DM who had >= 1 encounter from July 2014 to June 2015 (index period) with >= 1 year medical history available were included. The index date was defined as the most recent encounter date during the 1 year index period. Main outcome measures: Comorbid conditions were assessed using all data available prior to and including the index date. Patient characteristics, laboratory measures, and comorbidities were summarized via descriptive analyses, overall and by subgroups of age (< 65, 65-74, 75+ years) and gender. Results: Of the 1,389,016 eligible patients, 53% were female and the median age was 65 years. 97.5% of patients had at least one comorbid condition in addition to T2DM and 88.5% had at least two. The comorbidity burden tended to increase in older age groups and was higher in men than women. The most common conditions in patients with T2DM included hypertension (HTN) in 82.1%; overweight/obesity in 78.2%; hyperlipidemia in 77.2%; chronic kidney disease (CKD) in 24.1%; and cardiovascular disease (CVD) in 21.6%. The highest co-prevalence was demonstrated for the combination of HTN and hyperlipidemia (67.5%), followed by overweight/obesity and HTN (66.0%), overweight/obesity and hyperlipidemia (62.5%), HTN and CKD (22.4%), hyperlipidemia and CKD (21.1%), HTN and CVD (20.2%), hyperlipidemia and CVD (20.1%), overweight/obesity and CKD (19.1%) and overweight/obesity and CVD (17.0%). Limitations: Limitations include the potential for misclassification/underreporting due to the use of diagnostic codes, drug codes, or laboratory measures for identification of medical conditions. Conclusions: The vast majority of patients with T2DM have multiple comorbidities. To ensure a comprehensive approach to patient management, the presence of multimorbidity should be considered in the context of clinical decision making.