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Diabetes is an independent risk factor for peptic ulcer bleeding: A nationwide population‐based cohort study
Author(s) -
Peng YenLing,
Leu HsinBang,
Luo JiingChyuan,
Huang ChinChou,
Hou MingChih,
Lin HanChieh,
Lee FaYauh
Publication year - 2013
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12190
Subject(s) - medicine , hazard ratio , diabetes mellitus , cumulative incidence , risk factor , gastroenterology , population , type 2 diabetes , cohort , cohort study , proportional hazards model , kidney disease , confidence interval , endocrinology , environmental health
Background and Aims Diabetic patients reportedly have a higher incidence of peptic ulcer disease. The aim of this study was to investigate if type II diabetic patients have higher risk of developing peptic ulcer bleeding ( PUB ) and to identify possible risk factors of PUB in diabetic patients. Methods Using the N ational H ealth I nsurance R esearch D atabase of T aiwan, records of 5699 type II diabetic patients and 11 226 age‐ and sex‐matched non‐diabetic patients in a 1:2 ratio were extracted for comparison from a cohort dataset of 1 000 000 randomly sampled subjects. Log‐rank test was used to analyze differences in cumulative hazard of PUB between the two groups. C ox proportional hazard regressions were used to evaluate independent risk factors for PUB in all patients and identified risk factors of PUB in type II diabetic patients. Results In a 7‐year follow‐up period, type II diabetic patients had significantly higher cumulative hazard of PUB than the controls ( P < 0.001, log‐rank test). By C ox proportional hazard regression analysis, diabetes was independently associated with increased risk of PUB (hazard ratio 1.44, 95% confidence interval 1.11–1.86; P < 0.001) after adjusting for age, sex, comorbidities (e.g. hypertension, coronary heart disease, heart failure, chronic renal disease, cirrhosis, and peptic ulcer disease), and ulcerogenic medication. Age, chronic renal disease, history of peptic ulcer disease, and use of non‐steroidal anti‐inflammatory drugs were risk factors for PUB in diabetic patients. Conclusions Type II diabetic patients have significantly higher risk of PUB even after adjustments for possible confounding factors like age, sex, underlying comorbidities, and ulcerogenic medication.