| Summary: | 碩士 === 國立彰化師範大學 === 統計資訊研究所 === 100 === Motive and Purpose
Diabetes mellitus (DM) is the fifth among the top ten leading causes of death in Taiwan and complications are the major cause of death. There are a few reports addressed on the risk of DM in the patients of rheumatoid arthritis (RA). Here, we further investigated if the co-morbidities of RA, including hypertension and disorder of lipid metabolism (DLM), are risk factors for diabetes in Taiwan. And we want to know whether there were spatial autocorrelation of T2D incidence rate in Taiwan.
Material and Methods
We used a databank containing one million Taiwanese, who were randomly selected by the National Health Institute from the 23 million Taiwanese citizens covered by the National Health Insurance in 2005. In the study of T2D, all persons aged more than 20 in 2001-2009. We used spatial analysis to examine whether there were spatial autocorrelation of T2D incidence rate, and the spatial correlation of T2D and area deprivation. In the study of T2D and RA, all persons aged more than 20 without the RA or T2D diagnosis at the end of 1997 were included as the subjects of the prospective study. They were divided into two cohorts, one with the diagnosis of RA, the other without. The outcome of interest was a diagnosis of T2D. Kaplan-Meier plot, log-rank test, and Cox regression were conducted to study the effects of age, gender and the co-morbidities on T2D risk.
Results
There were significant spatial autocorrelation of T2D incidence rate (Moran's I=0.36) and spatial correlation with area deprivation in Taiwan (coefficient=0.63). The rate ratios of age-standardized incidence rates for T2D among RA to non-RA are 1.68 and 1.46 for men and women, respectively. The hazard ratio of RA patients with hypertension and DLM compare with the person not RA patients with hypertension and DLM is 2.25(95%CI=2.05-2.48).
Conclusions
In Taiwan, high T2D incidence rate concentrated in Yunlin and Chiayi county. RA appears to be associated with an increased risk for T2D, certain co-morbidities further increase the risk.
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