Type 1 diabetes mellitus and risk of incident epilepsy: a population-based, open-cohort study.
Type 1 diabetes mellitus and risk of incident epilepsy: a population-based, open-cohort study.
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DOI：
10.1007/s00125-016-4142-x
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发表时间：
2017-03
期刊：
影响因子：
8.2
通讯作者：
Nirantharakumar K
中科院分区：
文献类型：
--
作者：
Dafoulas GE;Toulis KA;Mccorry D;Kumarendran B;Thomas GN;Willis BH;Gokhale K;Gkoutos G;Narendran P;Nirantharakumar K
本研究的目的是探讨英国参与者中癫痫发作与1型糖尿病之间的关系。使用健康改善网络数据库，我们进行了一项回顾性开放队列研究。从1990年1月1日至2015年9月15日，确定并随访了年龄≤40岁的新诊断为1型糖尿病的患者。这些患者在诊断时被确定为未患癫痫，根据年龄、性别和参与的一般实践，与最多4名无1型糖尿病的患者随机匹配。随后使用汤森剥夺指数、脑瘫、头部损伤和学习障碍作为模型协变量进行考克斯回归分析。研究人群共包括24，610名个体（4922名1型糖尿病患者和19，688名对照）。这些人平均随访5.4年（约132，000人-年随访）。与对照组相比，1型糖尿病患者在观察期间被诊断为癫痫的可能性显著更高（粗HR [95% CI]：3.02 [1.95，4.69]）。据估计，患者和对照组的发病率分别为132和44/100，000人年。校正模型协变量后，该结果持续存在（校正的HR [95% CI]：3.01 [1.93，4.68]），并且在敏感性分析中也具有稳健性，排除成人发作的1型糖尿病。1型糖尿病患者发生癫痫的风险是无1型糖尿病患者的3倍。在研究1型糖尿病患者的糖尿病相关疾病时，应考虑到这一点。
The aim of this research was to explore the relationship between incident epilepsy and type 1 diabetes in British participants. Using The Health Improvement Network database, we conducted a retrospective, open-cohort study. Patients who were newly diagnosed with type 1 diabetes mellitus at the age of ≤40 years were identified and followed-up from 1 January 1990 to 15 September 2015. These patients, identified as not suffering from epilepsy at the time of diagnosis, were randomly matched with up to four individuals without type 1 diabetes mellitus, based on age, sex and participating general practice. A Cox regression analysis was subsequently performed using Townsend deprivation index, cerebral palsy, head injury and learning disabilities as model covariates. The study population consisted of a total of 24,610 individuals (4922 with type 1 diabetes and 19,688 controls). These individuals were followed up for a mean of 5.4 years (approximately 132,000 person-years of follow up). Patients with type 1 diabetes were significantly more likely to be diagnosed with epilepsy during the observation period compared with controls (crude HR [95% CI]: 3.02 [1.95, 4.69]). The incidence rate was estimated to be 132 and 44 per 100,000 person-years in patients and controls, respectively. This finding persisted after adjusting for model covariates (adjusted HR [95% CI]: 3.01 [1.93, 4.68]) and was also robust to sensitivity analysis, excluding adult-onset type 1 diabetes mellitus. Patients with type 1 diabetes are at approximately three-times greater risk of developing epilepsy compared with matched controls without type 1 diabetes. This should be considered when investigating seizure-related disorders in patients with type 1 diabetes mellitus.
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影响因子：
8.2
作者：
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通讯作者：
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