Inflammatory Bowel Diseases Increase Risk of Type 2 Diabetes in a Nationwide Cohort Study

Tine Jess; Britt W Jensen; Mikael Andersson; Marie Villumsen; Kristine H Allin

doi:10.1016/j.cgh.2019.07.052

Inflammatory Bowel Diseases Increase Risk of Type 2 Diabetes in a Nationwide Cohort Study

Tine Jess, Britt W Jensen, Mikael Andersson, Marie Villumsen, Kristine H Allin

www.ccrp.dk

95 Citations (Scopus)

Abstract

BACKGROUND & AIMS: The intestine regulates glucose homeostasis, but it is not clear whether chronic intestinal inflammation affects risk for type 2 diabetes. We investigated the long-term risk of type 2 diabetes in patients with inflammatory bowel diseases (IBD) in a nationwide cohort study in Denmark.

METHODS: In a nationwide population-based cohort of 6,028,844 persons in Denmark, we compared data from individuals with a diagnosis of IBD (Crohn's disease [CD] or ulcerative colitis UC]) with data from individuals from the general population from 1977 through 2014. Persons with type 2 diabetes were identified in the National Patient Register. Risk is presented as standardized incidence ratios (SIR) with 95% CIs.

RESULTS: During 736,072 person-years of follow-up, 3436 patients with IBD developed type 2 diabetes vs 2224 expected (SIR, 1.54; 95% CI, 1.49-1.60). The risk was significantly increased in patients with UC (SIR, 1.54; 95% CI, 1.48-1.60), in patients with CD (SIR, 1.57; 95% CI, 1.47-1.67), in women (SIR, 1.51; 95% CI, 1.44-1.59), and in men (SIR, 1.57; 95% CI, 1.50-1.65). The risk was highest the first year after a diagnosis of IBD (SIR, 4.48; 95% CI, 4.16-4.83), but remained increased for 20 or more years following the diagnosis (SIR, 1.26; 95% CI, 1.16-1.38). The increased risk could not be accounted for by frequency of health care contacts or corticosteroid exposure. Patients who received a diagnosis of IBD from 2003 through 2014 (SIR, 1.79; 95% CI, 1.67-1.91) had a significantly higher risk of type 2 diabetes than patients who received a diagnosis of IBD from 1977 through 1988 (SIR, 1.47; 95% CI, 1.39-1.56) or 1989 through 2002 (SIR, 1.48; 95% CI, 1.41-1.56) (P < .001).

CONCLUSIONS: In a population-based cohort study, we found an increased risk of type 2 diabetes in patients with UC or CD, with highest risk estimates from 2003 through 2014, compared with earlier years. Studies are needed to determine the effects of IBD treatment on risk of type 2 diabetes.

Original language	English
Journal	Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
Volume	18
Issue number	4
Pages (from-to)	881-888.e1
ISSN	1542-3565
DOIs	https://doi.org/10.1016/j.cgh.2019.07.052
Publication status	Published - Apr 2020

Keywords

Inflammation
Gastrointestinal Microbiome
Metabolic Disorder
Glucose Homeostasis
Corticosteroids

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10.1016/j.cgh.2019.07.052

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Inflammatory Bowel Diseases Increase Risk of Type 2 Diabetes in a Nationwide Cohort Study. / Jess, Tine; Jensen, Britt W; Andersson, Mikael et al.
In: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, Vol. 18, No. 4, 04.2020, p. 881-888.e1.

Research output: Contribution to journal › Journal article › Research › peer-review

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title = "Inflammatory Bowel Diseases Increase Risk of Type 2 Diabetes in a Nationwide Cohort Study",

abstract = "BACKGROUND \& AIMS: The intestine regulates glucose homeostasis, but it is not clear whether chronic intestinal inflammation affects risk for type 2 diabetes. We investigated the long-term risk of type 2 diabetes in patients with inflammatory bowel diseases (IBD) in a nationwide cohort study in Denmark.METHODS: In a nationwide population-based cohort of 6,028,844 persons in Denmark, we compared data from individuals with a diagnosis of IBD (Crohn's disease [CD] or ulcerative colitis UC]) with data from individuals from the general population from 1977 through 2014. Persons with type 2 diabetes were identified in the National Patient Register. Risk is presented as standardized incidence ratios (SIR) with 95\% CIs.RESULTS: During 736,072 person-years of follow-up, 3436 patients with IBD developed type 2 diabetes vs 2224 expected (SIR, 1.54; 95\% CI, 1.49-1.60). The risk was significantly increased in patients with UC (SIR, 1.54; 95\% CI, 1.48-1.60), in patients with CD (SIR, 1.57; 95\% CI, 1.47-1.67), in women (SIR, 1.51; 95\% CI, 1.44-1.59), and in men (SIR, 1.57; 95\% CI, 1.50-1.65). The risk was highest the first year after a diagnosis of IBD (SIR, 4.48; 95\% CI, 4.16-4.83), but remained increased for 20 or more years following the diagnosis (SIR, 1.26; 95\% CI, 1.16-1.38). The increased risk could not be accounted for by frequency of health care contacts or corticosteroid exposure. Patients who received a diagnosis of IBD from 2003 through 2014 (SIR, 1.79; 95\% CI, 1.67-1.91) had a significantly higher risk of type 2 diabetes than patients who received a diagnosis of IBD from 1977 through 1988 (SIR, 1.47; 95\% CI, 1.39-1.56) or 1989 through 2002 (SIR, 1.48; 95\% CI, 1.41-1.56) (P < .001).CONCLUSIONS: In a population-based cohort study, we found an increased risk of type 2 diabetes in patients with UC or CD, with highest risk estimates from 2003 through 2014, compared with earlier years. Studies are needed to determine the effects of IBD treatment on risk of type 2 diabetes.",

keywords = "Inflammation, Gastrointestinal Microbiome, Metabolic Disorder, Glucose Homeostasis, Corticosteroids",

author = "Tine Jess and Jensen, \{Britt W\} and Mikael Andersson and Marie Villumsen and Allin, \{Kristine H\}",

year = "2020",

month = apr,

doi = "10.1016/j.cgh.2019.07.052",

language = "English",

volume = "18",

pages = "881--888.e1",

journal = "Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association",

issn = "1542-3565",

publisher = "W.B. Saunders",

number = "4",

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TY - JOUR

T1 - Inflammatory Bowel Diseases Increase Risk of Type 2 Diabetes in a Nationwide Cohort Study

AU - Jess, Tine

AU - Jensen, Britt W

AU - Andersson, Mikael

AU - Villumsen, Marie

AU - Allin, Kristine H

PY - 2020/4

Y1 - 2020/4

N2 - BACKGROUND & AIMS: The intestine regulates glucose homeostasis, but it is not clear whether chronic intestinal inflammation affects risk for type 2 diabetes. We investigated the long-term risk of type 2 diabetes in patients with inflammatory bowel diseases (IBD) in a nationwide cohort study in Denmark.METHODS: In a nationwide population-based cohort of 6,028,844 persons in Denmark, we compared data from individuals with a diagnosis of IBD (Crohn's disease [CD] or ulcerative colitis UC]) with data from individuals from the general population from 1977 through 2014. Persons with type 2 diabetes were identified in the National Patient Register. Risk is presented as standardized incidence ratios (SIR) with 95% CIs.RESULTS: During 736,072 person-years of follow-up, 3436 patients with IBD developed type 2 diabetes vs 2224 expected (SIR, 1.54; 95% CI, 1.49-1.60). The risk was significantly increased in patients with UC (SIR, 1.54; 95% CI, 1.48-1.60), in patients with CD (SIR, 1.57; 95% CI, 1.47-1.67), in women (SIR, 1.51; 95% CI, 1.44-1.59), and in men (SIR, 1.57; 95% CI, 1.50-1.65). The risk was highest the first year after a diagnosis of IBD (SIR, 4.48; 95% CI, 4.16-4.83), but remained increased for 20 or more years following the diagnosis (SIR, 1.26; 95% CI, 1.16-1.38). The increased risk could not be accounted for by frequency of health care contacts or corticosteroid exposure. Patients who received a diagnosis of IBD from 2003 through 2014 (SIR, 1.79; 95% CI, 1.67-1.91) had a significantly higher risk of type 2 diabetes than patients who received a diagnosis of IBD from 1977 through 1988 (SIR, 1.47; 95% CI, 1.39-1.56) or 1989 through 2002 (SIR, 1.48; 95% CI, 1.41-1.56) (P < .001).CONCLUSIONS: In a population-based cohort study, we found an increased risk of type 2 diabetes in patients with UC or CD, with highest risk estimates from 2003 through 2014, compared with earlier years. Studies are needed to determine the effects of IBD treatment on risk of type 2 diabetes.

AB - BACKGROUND & AIMS: The intestine regulates glucose homeostasis, but it is not clear whether chronic intestinal inflammation affects risk for type 2 diabetes. We investigated the long-term risk of type 2 diabetes in patients with inflammatory bowel diseases (IBD) in a nationwide cohort study in Denmark.METHODS: In a nationwide population-based cohort of 6,028,844 persons in Denmark, we compared data from individuals with a diagnosis of IBD (Crohn's disease [CD] or ulcerative colitis UC]) with data from individuals from the general population from 1977 through 2014. Persons with type 2 diabetes were identified in the National Patient Register. Risk is presented as standardized incidence ratios (SIR) with 95% CIs.RESULTS: During 736,072 person-years of follow-up, 3436 patients with IBD developed type 2 diabetes vs 2224 expected (SIR, 1.54; 95% CI, 1.49-1.60). The risk was significantly increased in patients with UC (SIR, 1.54; 95% CI, 1.48-1.60), in patients with CD (SIR, 1.57; 95% CI, 1.47-1.67), in women (SIR, 1.51; 95% CI, 1.44-1.59), and in men (SIR, 1.57; 95% CI, 1.50-1.65). The risk was highest the first year after a diagnosis of IBD (SIR, 4.48; 95% CI, 4.16-4.83), but remained increased for 20 or more years following the diagnosis (SIR, 1.26; 95% CI, 1.16-1.38). The increased risk could not be accounted for by frequency of health care contacts or corticosteroid exposure. Patients who received a diagnosis of IBD from 2003 through 2014 (SIR, 1.79; 95% CI, 1.67-1.91) had a significantly higher risk of type 2 diabetes than patients who received a diagnosis of IBD from 1977 through 1988 (SIR, 1.47; 95% CI, 1.39-1.56) or 1989 through 2002 (SIR, 1.48; 95% CI, 1.41-1.56) (P < .001).CONCLUSIONS: In a population-based cohort study, we found an increased risk of type 2 diabetes in patients with UC or CD, with highest risk estimates from 2003 through 2014, compared with earlier years. Studies are needed to determine the effects of IBD treatment on risk of type 2 diabetes.

KW - Inflammation

KW - Gastrointestinal Microbiome

KW - Metabolic Disorder

KW - Glucose Homeostasis

KW - Corticosteroids

UR - https://www.scopus.com/pages/publications/85081700864

U2 - 10.1016/j.cgh.2019.07.052

DO - 10.1016/j.cgh.2019.07.052

M3 - Journal article

C2 - 31394285

SN - 1542-3565

VL - 18

SP - 881-888.e1

JO - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

IS - 4

ER -

Inflammatory Bowel Diseases Increase Risk of Type 2 Diabetes in a Nationwide Cohort Study

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