Korean Journal of Psychosomatic Medicine (정신신체의학)

Korean Psychosomatic Society (한국정신신체의학회)
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The Association Between Neurodegenerative Diseases and Development of Type 2 Diabetes

신경퇴행성 질환과 제2형 당뇨병 발생의 연관성

  • Sang-Woo, Koo (Department of Psychiatry, Keimyung University School of Medicine) ;
  • Hojun, Lee (Department of Psychiatry, Keimyung University School of Medicine) ;
  • Yang-Tae, Kim (Department of Psychiatry, Keimyung University School of Medicine) ;
  • Hee-Cheol, Kim (Department of Psychiatry, Keimyung University School of Medicine)
  • 구상우 (계명대학교 의과대학 정신건강의학교실) ;
  • 이호준 (계명대학교 의과대학 정신건강의학교실) ;
  • 김양태 (계명대학교 의과대학 정신건강의학교실) ;
  • 김희철 (계명대학교 의과대학 정신건강의학교실)
  • Received : 2022.07.20
  • Accepted : 2022.10.25
  • Published : 2022.12.31
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Abstract

Objectives : A growing body of evidence links type 2 diabetes (T2D) with a neurodegenerative disease (ND) such as Alzheimer's disease and Parkinson's disease. The purpose of this study is to investigate the relationship between NDs and the development of T2D by comparing the incidence of T2D in a group of various NDs (ND group) and control group. Methods : A population-based 10-year follow-up study was conducted using the Korean National Health Information Database for 2002-2015. We used a retrospective cohort study design to investigate the association of ND with T2D occurrence. The study population included ND (n=8,814) and control (n=37,970) groups, all aged 60 years or over. The Kaplan-Meier method was used to estimate the risk of developing T2D as a function of time. Cox proportional hazards regression models were used to evaluate the relationship between ND and T2D. Results : T2D was developed in a significantly higher percentage of patients in the ND group (53.6%) than in the control group (44.7%). The ND group increased the risk of T2D (HR, 1.43; 95% CI, 1.38-1.47). About one-third of patients in both groups were additionally diagnosed with another ND before the occurrence of T2D during a 10-year follow-up period. When compared to those who did not have another ND during the follow-up period, the incidence of T2D in those who were additionally diagnosed with another ND was higher in both the ND and control groups. Conclusions : The ND group had about 1.4 times higher risk of developing T2D than the control group. Our results showed a positive association between ND and T2D.

연구목적 많은 선행 연구들은 제2형 당뇨병과 알츠하이머병이나 파킨슨병과 같은 단일의 신경퇴행성 질환과의 연관성을 보고하고 있다. 본 연구는 다양한 신경퇴행성 질환을 가진 집단(ND군)과 대조군 간에 제2형 당뇨병의 발생률을 조사하여 신경퇴행성 질환과 제2형 당뇨병 발생의 연관성을 조사하고자 한다. 방 법 국민건강보험공단 맞춤형 데이터베이스 자료를 이용하여 60-84세의 노인 인구집단을 ND군과 대조군으로 분류한 뒤 이들을 후향적으로 10년간 추적관찰 하면서 제2형 당뇨병의 발생 빈도와 발생 시까지 생존시간을 평가하였다. 연구 대상자는 ND군 8,814명과 대조군 37,970명이었다. 카플란-마이어 생존 분석과 다변량 콕스 비례 위험 모형을 이용하여 생존 곡선과 위험비를 구하였다. 결 과 ND군에서 제2형 당뇨병의 발생 비율(53.6%)이 대조군(44.7%)에 비해 유의하게 높았다. ND군은 대조군과 비교하여 제2형 당뇨병의 발생 위험성이 1.4배 증가하였다(HR, 1.43; 95% CI, 1.38-1.47). 연구 대상자 중 약 1/3은 10년의 추적 기간 동안에 제2형 당뇨병이 발생하기 전에 다른 신경퇴행성 질환들이 추가로 진단되었다. 두 군 모두에서, 추적 기간 동안에 다른 신경퇴행성 질환이 추가로 진단된 경우에 그렇지 않은 경우보다 제2형 당뇨병의 발생률이 더 높았다. 결 론 ND군은 대조군에 비해 제2형 당뇨병의 발생 위험도가 약 1.4배 높았으며 신경퇴행성 질환과 제2형 당뇨병 발생은 정적인 상관관계를 보였다.

Keywords

Acknowledgement

이 연구는 2020년도 계명대학교 동산의료원 연구비의 지원으로 수행되었음.

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