Clinical Epidemiology (Mar 2023)
Associations of Traumatic Injury with Abnormal Glucose Metabolism: A Population-Based Prospective Cohort Study
Abstract
Tao Liu,1,* Xin Liu,1,* Yue Li,1 Aitian Wang,2 Shuohua Chen,3 Shouling Wu,3 Shike Hou,1 Haojun Fan,1 Chunxia Cao1 1Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, People’s Republic of China; 2Department of Intensive Medicine, Kailuan General Hospital, Tangshan, People’s Republic of China; 3Department of Cardiology, Kailuan General Hospital, Tangshan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chunxia Cao; Haojun Fan, Institute of Disaster and Emergency Medicine, Tianjin University, No. 92 Weijin Road, Nankai District, Tianjin, 300072, People’s Republic of China, Tel +86 02227893596, Fax +86 02227893596-307, Email [email protected]; [email protected]: Empirical data on the association between traumatic injury and abnormal glucose metabolism risk is limited. This study aimed to investigate the association between traumatic injury and abnormal glucose metabolism.Patients and Methods: This study included 153,162 participants in the Kailuan Study from 2006 to 2013. Participants with abnormal glucose metabolism at baseline were excluded. All participants were monitored every two years until December 31, 2019. During follow-up, 1915 subjects with a first traumatic injury (defined as a physical injury caused by an external force) were identified. For each subject with traumatic injury, one control subject was randomly selected and matched for age (± 3 years) and sex. A total of 3830 subjects were included in the final analysis. Cox proportional hazards models were used to examine the association between traumatic injury and the subsequent risk of abnormal glucose metabolism.Results: During a median follow-up of 6.91 (3.57– 9.41) years, 990 abnormal glucose metabolism events occurred. After adjustment for demographics, lifestyle behaviors, and traditional risk factors, those who had traumatic injury compared to controls were 32% more likely to develop any abnormal glucose metabolism (hazard ratio [HR] 1.32; 95% confidence interval [CI]1.16– 1.49), including impaired fasting glucose (IFG) (HR 1.29; 95% CI 1.12– 1.48) and diabetes (HR 1.37; 95% CI 1.10– 1.70). The risks for abnormal glucose metabolism, IFG, and diabetes in subjects with moderate-severe injury were higher than in subjects with mild injury for the 1-year follow-up period, while the association was not significantly different by injury severity for the whole follow-up period.Conclusion: Traumatic injury was associated with an increased risk of abnormal glucose metabolism. However, the risks of outcome events decreased as the follow-up period extended. Improved short- and long-term prevention and management strategies for controlling glucose are needed for individuals with traumatic injury.Keywords: traumatic injury, glucose metabolism, diabetes, impaired fasting glucose, cohort study
