TY - JOUR
T1 - Temporally ordered associations between type 2 diabetes and brain disorders - a Danish register-based cohort study
AU - Wimberley, Theresa
AU - Horsdal, Henriette T
AU - Brikell, Isabell
AU - Laursen, Thomas M
AU - Astrup, Aske
AU - Fanelli, Giuseppe
AU - Bralten, Janita
AU - Poelmans, Geert
AU - Gils, Veerle Van
AU - Jansen, Willemijn J
AU - Vos, Stephanie J B
AU - Bertaina-Anglade, Valérie
AU - Camacho-Barcia, Lucia
AU - Mora-Maltas, Bernat
AU - Fernandez-Aranda, Fernando
AU - Bonet, Mònica B
AU - Salas-Salvadó, Jordi
AU - Franke, Barbara
AU - Dalsgaard, Søren
N1 - © 2022. The Author(s).
PY - 2022/8/26
Y1 - 2022/8/26
N2 - BACKGROUND: Type 2 diabetes mellitus (T2DM) is linked with several neurodegenerative and psychiatric disorders, either as a comorbid condition or as a risk factor. We aimed to expand the evidence by examining associations with a broad range of brain disorders (psychiatric and neurological disorders, excluding late-onset neurodegenerative disorders), while also accounting for the temporal order of T2DM and these brain disorders.METHODS: In a population-based cohort-study of 1,883,198 Danish citizens, born 1955-1984 and followed until end of 2016, we estimated associations between T2DM and 16 brain disorders first diagnosed between childhood and mid-adulthood. We calculated odds ratios (OR) and hazard ratios (HR) with 95% confidence intervals (CI) in temporally ordered analyses (brain disorder diagnosis after T2DM and vice versa), adjusted for sex, age, follow-up, birth year, and parental factors.RESULTS: A total of 67,660 (3.6%) of the study population were identified as T2DM cases after age 30 and by a mean age of 45 years (SD of 8 years). T2DM was associated with most psychiatric disorders. Strongest associations were seen with other (i.e. non-anorectic) eating disorders (OR [95% CI]: 2.64 [2.36-2.94]) and schizophrenia spectrum disorder (2.73 [2.63-2.84]). Among neurological disorders especially inflammatory brain diseases (1.73 [1.57-1.91]) and epilepsy (1.67 [1.60-1.75]) were associated with T2DM. Most associations remained in both directions in the temporally ordered analyses. For most psychiatric disorders, associations were strongest in females.CONCLUSIONS: T2DM was associated with several psychiatric and neurological disorders, and most associations were consistently found for both temporal order of disorders. This suggests a shared etiology of T2DM and those brain disorders. This study can form the starting point for studies directed at further elucidating potential causal links between disorders and shared biological mechanisms.
AB - BACKGROUND: Type 2 diabetes mellitus (T2DM) is linked with several neurodegenerative and psychiatric disorders, either as a comorbid condition or as a risk factor. We aimed to expand the evidence by examining associations with a broad range of brain disorders (psychiatric and neurological disorders, excluding late-onset neurodegenerative disorders), while also accounting for the temporal order of T2DM and these brain disorders.METHODS: In a population-based cohort-study of 1,883,198 Danish citizens, born 1955-1984 and followed until end of 2016, we estimated associations between T2DM and 16 brain disorders first diagnosed between childhood and mid-adulthood. We calculated odds ratios (OR) and hazard ratios (HR) with 95% confidence intervals (CI) in temporally ordered analyses (brain disorder diagnosis after T2DM and vice versa), adjusted for sex, age, follow-up, birth year, and parental factors.RESULTS: A total of 67,660 (3.6%) of the study population were identified as T2DM cases after age 30 and by a mean age of 45 years (SD of 8 years). T2DM was associated with most psychiatric disorders. Strongest associations were seen with other (i.e. non-anorectic) eating disorders (OR [95% CI]: 2.64 [2.36-2.94]) and schizophrenia spectrum disorder (2.73 [2.63-2.84]). Among neurological disorders especially inflammatory brain diseases (1.73 [1.57-1.91]) and epilepsy (1.67 [1.60-1.75]) were associated with T2DM. Most associations remained in both directions in the temporally ordered analyses. For most psychiatric disorders, associations were strongest in females.CONCLUSIONS: T2DM was associated with several psychiatric and neurological disorders, and most associations were consistently found for both temporal order of disorders. This suggests a shared etiology of T2DM and those brain disorders. This study can form the starting point for studies directed at further elucidating potential causal links between disorders and shared biological mechanisms.
KW - Adult
KW - Child
KW - Cohort Studies
KW - Denmark
KW - Diabetes Mellitus, Type 2
KW - Epilepsy
KW - Female
KW - Humans
KW - Middle Aged
KW - Proportional Hazards Models
KW - Risk Factors
U2 - 10.1186/s12888-022-04163-z
DO - 10.1186/s12888-022-04163-z
M3 - Article
C2 - 36028833
SN - 1471-244X
VL - 22
JO - BMC Psychiatry
JF - BMC Psychiatry
IS - 1
M1 - 573
ER -