背景:急性面神经麻痹,以突然的面部无力为特征,显著影响个人的生活质量。尽管确定了急性面神经麻痹的几个诱发因素,在最近的研究中,尚未全面探讨糖尿病(DM)与急性面神经麻痹之间的具体关系。该研究的目的是使用全国人群样本队列评估DM患者急性面神经麻痹的风险。
方法:使用2002年1月至2019年12月代表大韩民国全部人口的韩国国民健康保险服务样本队列建立DM队列和非DM队列。DM队列包括92,872名患者,他们有用药记录和DM诊断。排除在诊断为DM之前患有面神经麻痹的个体。一个比较队列包括1,012,021名没有DM的个体,在1:4的比例上与社会人口统计学匹配。在两个队列中评估了贝尔麻痹(BP)和RamsayHunt综合征(RHS)的发生率。还评估了急性面神经麻痹的危险因素。
结果:在DM队列中的92,868名患者中,BP和RHS的发生率(IR)为31.42(置信区间[CI],30.24-32.63)和4.58/10,000人年(CI,4.14-5.05),分别。在非DM队列中的371,392名个体中,BP的IR为22.11/10,000人年(CI,21.62-22.59),RHS的IR为2.85/10,000人年(CI,2.68-3.02).BP和RHS的IR比率分别为1.42(CI,1.36-1.48)和1.61(CI,1.43-1.80)。在多变量分析中,DM(危险比[HR]1.428),年龄(HR1.008),高合并症评分(HR1.051)与BP风险增加相关,男性(HR0.803)和居住在大都市(HR0.966)降低了BP的风险。和DM(HR1.615),高共病评分(HR1.078),居住在大都市(HR1.201)与RHS风险增加相关。
结论:本研究提示DM患者发生包括BP和RHS在内的急性面神经麻痹的风险增加。
BACKGROUND: Acute facial palsy, characterized by sudden hemifacial weakness, significantly impacts an individual\'s quality of life. Despite several predisposing factors identified for acute facial palsy, the specific relationship between diabetes mellitus (DM) and acute facial palsy has not been comprehensively explored in recent studies. The aim of the study was to assess the risk of acute facial palsy in patients with DM using a nationwide population sample cohort.
METHODS: DM cohort and non-DM cohort were built using the Korean National Health Insurance Service-Sample Cohort which represents the entire population of the Republic of Korea from January 2002 to December 2019. The DM cohort comprised 92,872 patients with a record of medication and a diagnosis of DM. Individuals who had facial palsy before the diagnosis of DM were excluded. A comparison cohort comprised 1,012,021 individuals without DM matched sociodemographically in a 1:4 ratio. The incidence of Bell\'s palsy (BP) and Ramsay Hunt syndrome (RHS) were evaluated in both cohorts. The risk factors for acute facial palsy were also assessed.
RESULTS: Among the 92,868 patients in the DM cohort, the incidence rate (IR) of BP and RHS were 31.42 (confidence interval [CI], 30.24-32.63) and 4.58 per 10,000 person-years (CI, 4.14-5.05), respectively. Among the 371,392 individuals in the non-DM cohort, the IR of BP was 22.11 per 10,000 person-years (CI, 21.62-22.59) and the IR of RHS was 2.85 per 10,000 person-years (CI, 2.68-3.02). IR ratios for BP and RHS were 1.42 (CI, 1.36-1.48) and 1.61 (CI, 1.43-1.80). In multivariate analysis, DM (hazard ratio [HR] 1.428), age (HR 1.008), and high comorbidity score (HR 1.051) were associated with increased risk of BP, and male (HR 0.803) and living in metropolis (HR 0.966) decreased the risk of BP. And DM (HR 1.615), high comorbidity score (HR 1.078), and living in metropolis (HR 1.201) were associated with increased risk for RHS.
CONCLUSIONS: This study suggests that patients with DM had an increased risk of acute facial palsy including BP and RHS.