In-Hospital Outcomes of Inflammatory Bowel Diseases in Patients With Diabetes Mellitus: A Propensity Score Matching Analysis

Background Severe coronavirus disease 2019 (COVID‐19) is characterized by a proinflammatory state with high mortality. Statins have anti‐inflammatory effects and may attenuate the severity of COVID‐19. Methods and Results An observational study of all consecutive adult patients with COVID‐19 admitted to a single center located in Bronx, New York, was conducted from March 1, 2020, to May 2, 2020. Patients were grouped as those who did and those who did not receive a statin, and in‐hospital mortality was compared by competing events regression. In addition, propensity score matching and inverse probability treatment weighting were used in survival models to examine the association between statin use and death during hospitalization. A total of 4252 patients were admitted with COVID‐19. Diabetes mellitus modified the association between statin use and in‐hospital mortality. Patients with diabetes mellitus on a statin (n=983) were older (69±11 versus 67±14 years; P <0.01), had lower inflammatory markers (C‐reactive protein, 10.2; interquartile range, 4.5–18.4 versus 12.9; interquartile range, 5.9–21.4 mg/dL; P <0.01) and reduced cumulative in‐hospital mortality (24% versus 39%; P <0.01) than those not on a statin (n=1283). No difference in hospital mortality was noted in patients without diabetes mellitus on or off statin (20% versus 21%; P =0.82). Propensity score matching (hazard ratio, 0.88; 95% CI, 0.83–0.94; P <0.01) and inverse probability treatment weighting (HR, 0.88; 95% CI, 0.84–0.92; P <0.01) showed a 12% lower risk of death during hospitalization for statin users than for nonusers. Conclusions Statin use was associated with reduced in‐hospital mortality from COVID‐19 in patients with diabetes mellitus. These findings, if validated, may further reemphasize administration of statins to patients with diabetes mellitus during the COVID‐19 era.

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Epidemiologic Association between Inflammatory Bowel Diseases and Type 1 Diabetes Mellitus: a Meta-Analysis

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-798 ◽

2020 ◽

Vol 29 (3) ◽

pp. 407-413

Author(s):

Shuang Lu ◽

Jian Gong ◽

Yuyong Tan ◽

Deliang Liu

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Inflammatory Bowel Diseases ◽

Subgroup Analysis ◽

Meta Analysis ◽

Complete Analysis ◽

Bowel Diseases ◽

Inflammatory Bowel

Background and Aims: Patients with inflammatory bowel diseases (IBD) are at high risk of developing several autoimmune diseases. However, the epidemiological connection between IBD and type 1 diabetes mellitus (T1DM) remains controversial. This meta-analysis aimed to determine the association between the two diseases. Methods: A literature search was performed using Medline, Embase, and Central databases from inception to December 31, 2019. Studies evaluating the prevalence of T1DM in patients with IBD and controls were included. Statistical analysis was performed with a random effects model using the generic inverse variance method. Results: After the literature research, five cross-sectional studies and one case-control study met the inclusion criteria. A total of 45,103 participants with Crohn’s disease (CD) and 76,046 with ulcerative colitis (UC) were included. The pooled odds ratios (ORs) of T1DM were 1.16 (confidence interval [95% CI]: 0.87–1.55) in patients with CD and 1.20 (95% CI: 0.90–1.59) in patients with UC compared with the control groups. Significant heterogeneity was observed (CD: I 2 =70% and UC: I 2 =80%) in the complete analysis. Subgroup analysis stratified by study region was performed. Recalculated results indicated a positive association between CD and TD1M in Northern Europe with an OR of 1.65 (95% CI: 1.43–1.90; I 2 =0%). Patients with UC in Israel were at a higher risk of developing T1DM with an OR of 1.70 (95% CI: 1.38–2.09; I 2 =0%). Conclusion: The complete meta-analysis suggests no association between IBD and T1DM. However, the subgroup analysis indicated that patients with CD or UC from specific regions may be at a higher risk of developing T1DM than those without IBD.

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Diabetes mellitus is associated with worse baseline and less post-treatment recovery of arterial stiffness in patients with primary aldosteronism

Therapeutic Advances in Chronic Disease ◽

10.1177/20406223211066727 ◽

2022 ◽

Vol 13 ◽

pp. 204062232110667

Author(s):

Cheng-Hsuan Tsai ◽

Xue-Ming Wu ◽

Che-Wei Liao ◽

Zheng-Wei Chen ◽

Chien-Ting Pan ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Propensity Score ◽

Arterial Stiffness ◽

Diastolic Blood Pressure ◽

Propensity Score Matching ◽

Primary Aldosteronism ◽

Specific Treatment ◽

Post Treatment ◽

Patients With Diabetes

Background: Aldosterone excess in primary aldosteronism (PA) has been linked to insulin resistance, and diabetes mellitus has been associated with increased arterial stiffness and worse cardiovascular outcomes. However, the impact of diabetes on baseline and post-treatment arterial stiffness in patients with PA is unknown. Methods: This study prospectively enrolled 1071 PA patients, of whom 177 had diabetes and 894 did not. Clinical, biochemical, and brachial-ankle pulse wave velocity (baPWV) data were analyzed at baseline and 1 year after PA-specific treatment. After propensity score matching of age, sex, body mass index, systolic and diastolic blood pressure, hypertension duration, and number of antihypertensive medications, 144 patients with diabetes and 320 without diabetes were included for further analysis. Results: After propensity score matching, the baseline characteristics were balanced between the diabetes and nondiabetes groups except for fasting glucose, HbA1c, and lipid profiles. The patients with diabetes had significantly worse baseline baPWV compared with those without diabetes. After multivariable linear regression, the presence of diabetes mellitus remained a significant predictor of worse baseline mean baPWV (β: 46.3, 95% confidence interval: 2.9–89.7, p = 0.037). After 1 year of PA-specific treatment, only the nondiabetes group had significant recovery of mean baPWV (1661.8 ± 332.3 to 1565.0 ± 329.2 cm/s, p < 0.001; Δ = −96.8 ± 254.6 cm/s). In contrast, the diabetes group had less improvement (1771.2 ± 353.8 cm/s to 1742.0 ± 377.2 cm/s, p = 0.259; Δ = −29.2 ± 263.2 cm/s) even though the systolic and diastolic blood pressure significantly improved in both groups. Conclusion: The presence of diabetes mellitus in PA patients was associated with worse baseline and less post-treatment recovery of arterial stiffness.

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