A population-based cohort study suggests an increased risk of multiple sclerosis incidence in patients with type 2 diabetes mellitus

J Epidemiol. 2017 May;27(5):235-241. doi: 10.1016/j.je.2016.06.006. Epub 2017 Jan 27.

Abstract

Background: To prospectively investigate the incidence and relative risks of multiple sclerosis (MS) in patients with type 2 diabetes (T2DM).

Materials and methods: Patients with T2DM (n = 614,623) and age- and sex-matched controls (n = 614,021) were followed from 2000 to 2008 to identify cases of newly diagnosed MS (ICD-9-CM: 340). The person-year approach with Poisson assumption was used to evaluate the incidence density. We estimated the covariate-adjusted hazard ratio (HR) of MS incidence in relation to T2DM diabetes using a multiple Cox proportional hazard regression model.

Results: Over 9 years of follow-up, 175 T2DM patients were newly diagnosed with MS, and 114 matched controls had the same first-ever diagnosis, representing a covariate-adjusted HR of 1.44 (95% confidence interval [CI], 1.08-1.94). The sex-specific adjusted HR for both men and women with T2DM was also elevated at 1.34 (95% CI, 0.81-2.23) and 1.51 (95% CI, 1.05-2.19), respectively. Women aged ≤50 years had the greatest risk of MS (HR 2.16; 95% CI, 1.02-4.59).

Conclusion: This study demonstrated a moderate but significant association of T2DM with MS incidence, and the association was not confounded by socio-demographic characteristics or certain MS-related co-morbidities.

Keywords: Cohort studies; Cox proportional hazard model; Diabetes mellitus; Multiple sclerosis.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Case-Control Studies
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • International Classification of Diseases
  • Male
  • Middle Aged
  • Multiple Sclerosis / diagnosis
  • Multiple Sclerosis / epidemiology*
  • Multiple Sclerosis / etiology
  • Population Surveillance
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Sex Distribution
  • Taiwan / epidemiology