Impact of Cytomegalovirus Disease on New-Onset Type 2 Diabetes Mellitus: Population-Based Matched Case-Control Cohort Study

Sang Hoon Han; Kyung Do Han; Kyoung Hwa Lee; Seul Gi Yoo; Yeonju La; Da Eun Kwon

대한당뇨병학회 Diabetes and Metabolism Journal (DMJ) Impact of Cytomegalovirus Disease on New-Onset Type 2 Diabetes Mellitus: Population-Based Matched Case-Control Cohort Study

Accredited SCIE SCOPUS

( Seul Gi Yoo ) , ( Kyung Do Han ) , ( Kyoung Hwa Lee ) , ( Yeonju La ) , ( Da Eun Kwon ) , ( Sang Hoon Han )

대한당뇨병학회 2019.12

Diabetes and Metabolism Journal (DMJ) vol. 43 iss. 6 815-829(15pages)

UCI I410-ECN-0102-2021-500-000604176

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Abstract

Background: A latent cytomegalovirus (CMV) cause chronic inflammation through undesirable inflation of cell-mediated immune response. CMV immunoglobulin G has been associated with cardiovascular disease and type 1 diabetes mellitus. We evaluated impact of CMV diseases on new-onset type 2 diabetes mellitus (T2DM). Methods: From the Korean Health Insurance Review and Assessment Service claim database of entire population with 50 million, we retrieved 576 adult case group with CMV diseases diagnosed with International Statistical Classification of Diseases and Related-Health Problems 10th Revision (ICD-10) B25 code between 2010 and 2014 after exclusion of patients with T2DM to 2006. The 2,880 control patients without T2DM from 2006 to cohort entry point were selected between 2010 and 2014 by age, sex matching with case group. The subjects without new-onset T2DM were followed until 2015. T2DM, hypertension (HTN), dyslipidemia (DYS), and end-stage renal disease (ESRD) were coded as ICD-10. Results: The frequency of new-onset T2DM in case group was significantly higher than that in control (5.6% vs. 2.2%, P<0.001). The group with T2DM (n=95) had higher incidence of CMV diseases than the group without T2DM (n=3,361) (33.7% vs. 16.2%, P<0.001). In multivariate regression model adjusted by age, sex, lower income, HTN, and DYS, the incidence rate (IR) of T2DM in case group was significantly higher than that in the control group (IR per 1,000, 19.0 vs. 7.3; odds ratio, 2.1; 95% confidence interval, 1.3 to 3.2). The co-existence of HTN, DYS, and ESRD with CMV diseases did not influence the IR of T2DM. Conclusion: CMV diseases increase the patients’ risk of developing T2DM.

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Table of Contents

INTRODUCTION
METHODS
RESULTS
DISCUSSION
SUPPLEMENTARY MATERIALS
CONFLICTS OF INTEREST
AUTHOR CONTRIBUTIONS
ORCID
ACKNOWLEDGMENTS
REFERENCES
Supplementary Table 1. Comparison of clinical characteristics between adult individuals with and without new-onset T2DM after cohort entry in the matched cohort of total 3,456
Supplementary Table 2. Multivariate logistic regression models to examine the effect of refractory cytomegalovirus disease on new-onset T2DM in various subgroups
Supplementary Table 3. Comparison of incidence rate of new onset T2DM between adult individuals with and without cytomegalovirus disease in the matched cohort of 1:3 ratio with age, sex, cohort entry year, lower income status, hypertension, and dyslipidemia
Supplementary Table 4. Distribution for incidence of cytomegalovirus disease or infection according to ICD-10 codes in the entire-population database
Supplementary Table 5. Frequencies of solid organ transplantation recipients with CMV disease or infection according to ICD-10 codes between 2010 and 2015 in the total database

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