Urban–Rural Disparities in the Incidence of Diabetes-Related Complications in Taiwan: A Propensity Score Matching Analysis
Abstract
:1. Introduction
2. Experimental Section
2.1. Data Source
2.2. Study Design and Population
2.3. Variables
2.3.1. Urbanization
2.3.2. Diabetes-Related Complications
2.4. Statistical Analysis
3. Results
3.1. Demographic Characteristics
3.2. Cumulative Survival of All-Cause Mortality and All CV Events
3.3. Urbanization and Diabetes-Related Complications
4. Discussions
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Urbanization | |||||||
---|---|---|---|---|---|---|---|
Rural | Suburban | Urban | p Value | ||||
Cohort | Cohort | Cohort | |||||
(N = 31,310) N.% | (N = 31,310) N.% | (N = 31,310) N.% | |||||
Age | |||||||
<40 | 3040 | (9.7) | 3018 | (9.6) | 3029 | (9.7) | 0.999 |
40–59 | 15,250 | (48.7) | 15,264 | (48.8) | 15,262 | (48.7) | |
≥60 | 13,020 | (41.6) | 13,028 | (41.6) | 13,019 | (41.6) | |
Mean (±SD) | 56.79 | (±12.7) | 56.65 | (±12.9) | 55.81 | (±12.1) | <0.001 |
Gender | |||||||
Female | 14,345 | (45.8) | 14,338 | (45.8) | 13,726 | (43.8) | <0.001 |
Male | 16,965 | (54.2) | 16,972 | (54.2) | 17,584 | (56.2) | |
Insurance range (USD) | |||||||
<500 | 8812 | (28.1) | 8814 | (28.2) | 8802 | (28.1) | 1.000 |
500–999 | 20,722 | (66.2) | 20,722 | (66.2) | 20,724 | (66.2) | |
≥1000 | 1776 | (5.7) | 1774 | (5.7) | 1784 | (5.7) | |
Comorbidities | |||||||
Hypertension | 9757 | (31.2) | 9748 | (31.1) | 9592 | (30.6) | 0.277 |
Hyperlipidemia | 4291 | (13.7) | 4243 | (13.6) | 4454 | (14.2) | 0.038 |
Neuropathy | 1043 | (3.3) | 1034 | (3.3) | 1014 | (3.2) | 0.802 |
Medication | |||||||
Steroid | 16,485 | (52.7) | 15,871 | (50.7) | 15,241 | (48.7) | <0.001 |
NSAIDs | 24,302 | (77.6) | 23,858 | (76.2) | 22,842 | (73.0) | <0.001 |
Statin | 3831 | (12.2) | 3879 | (12.4) | 4467 | (14.3) | <0.001 |
Anti-coagulants | 2786 | (8.9) | 2564 | (8.2) | 2310 | (7.4) | <0.001 |
Diuretics | 13,869 | (44.3) | 13,248 | (42.3) | 11,810 | (37.7) | <0.001 |
Charlson’s index score | |||||||
≤2 | 26,855 | (85.8) | 26,904 | (85.9) | 26,788 | (85.6) | 0.767 |
3 | 2575 | (8.2) | 2548 | (8.1) | 2624 | (8.4) | |
≥4 | 1880 | (6.0) | 1858 | (5.9) | 1898 | (6.1) | |
Mean(±SD) | 1.24 | (±1.4) | 1.21 | (±1.4) | 1.23 | (±1.4) | 0.013 |
No. Cases | Per 1000 PY | Crude HR | (95% CI) | p Value | aHR | (95% CI) | p Value | |
---|---|---|---|---|---|---|---|---|
All CV event (IHD/MI/CHF/Stroke) | ||||||||
Urban | 6659 | 50.309 | Ref. | --- | Ref. | --- | ||
Suburban | 6933 | 52.886 | 1.05 | (1.02–1.09) | 0.005 | 1.04 | (1.00–1.07) | 0.039 |
Rural | 7624 | 59.548 | 1.18 | (1.14–1.22) | <0.001 | 1.15 | (1.12–1.19) | <0.001 |
IHD | ||||||||
Urban | 4818 | 35.228 | Ref. | --- | Ref. | --- | ||
Suburban | 4818 | 35.380 | 1.00 | (0.96–1.04) | 0.864 | 0.99 | (0.95–1.03) | 0.584 |
Rural | 5294 | 39.656 | 1.12 | (1.08–1.17) | <0.001 | 1.09 | (1.05–1.14) | <0.001 |
MI | ||||||||
Urban | 405 | 2.706 | Ref. | --- | Ref. | --- | ||
Suburban | 355 | 2.382 | 0.88 | (0.76–1.02) | 0.080 | 0.88 | (0.77–1.02) | 0.088 |
Rural | 347 | 2.351 | 0.87 | (0.75–1.00) | 0.055 | 0.87 | (0.75–1.00) | 0.057 |
CHF | ||||||||
Urban | 1116 | 7.538 | Ref. | --- | Ref. | --- | ||
Suburban | 1252 | 8.518 | 1.13 | (1.04–1.22) | 0.003 | 1.09 | (1.01–1.18) | 0.035 |
Rural | 1481 | 10.204 | 1.35 | (1.25–1.46) | <0.001 | 1.29 | (1.19–1.39) | <0.001 |
Stroke | ||||||||
Urban | 1882 | 12.863 | Ref. | --- | Ref. | --- | ||
Suburban | 2098 | 14.483 | 1.13 | (1.06–1.20) | <0.001 | 1.12 | (1.05–1.19) | <0.001 |
Rural | 2296 | 16.032 | 1.25 | (1.17–1.32) | <0.001 | 1.24 | (1.17–1.32) | <0.001 |
Blindness | ||||||||
Urban | 17 | 0.113 | Ref. | --- | Ref. | --- | ||
Suburban | 24 | 0.160 | 1.42 | (0.76–2.64) | 0.270 | 1.45 | (0.78–2.70) | 0.244 |
Rural | 35 | 0.236 | 2.09 | (1.17–3.72) | 0.013 | 2.14 | (1.20–3.83) | 0.010 |
Ulcer | ||||||||
Urban | 88 | 0.586 | Ref. | --- | Ref. | --- | ||
Suburban | 75 | 0.502 | 0.86 | (0.63–1.17) | 0.325 | 0.85 | (0.62–1.16) | 0.301 |
Rural | 123 | 0.831 | 1.42 | (1.08–1.87) | 0.012 | 1.40 | (1.06–1.84) | 0.016 |
ESRD | ||||||||
Urban | 1107 | 7.467 | Ref. | --- | Ref. | --- | ||
Suburban | 1186 | 8.054 | 1.08 | (0.99–1.17) | 0.069 | 1.08 | (1.00–1.17) | 0.061 |
Rural | 1255 | 8.606 | 1.15 | (1.06–1.25) | 0.001 | 1.15 | (1.06–1.25) | 0.001 |
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Tai, S.-Y.; He, J.-S.; Kuo, C.-T.; Kawachi, I. Urban–Rural Disparities in the Incidence of Diabetes-Related Complications in Taiwan: A Propensity Score Matching Analysis. J. Clin. Med. 2020, 9, 3012. https://doi.org/10.3390/jcm9093012
Tai S-Y, He J-S, Kuo C-T, Kawachi I. Urban–Rural Disparities in the Incidence of Diabetes-Related Complications in Taiwan: A Propensity Score Matching Analysis. Journal of Clinical Medicine. 2020; 9(9):3012. https://doi.org/10.3390/jcm9093012
Chicago/Turabian StyleTai, Shu-Yu, Jiun-Shiuan He, Chun-Tung Kuo, and Ichiro Kawachi. 2020. "Urban–Rural Disparities in the Incidence of Diabetes-Related Complications in Taiwan: A Propensity Score Matching Analysis" Journal of Clinical Medicine 9, no. 9: 3012. https://doi.org/10.3390/jcm9093012