title: Increased Risk of Herpes Zoster in Diabetic Patients Comorbid with Coronary Artery Disease and Microvascular Disorders: A Population-Based Study in Taiwan.
abstract: We investigated the association between the risk of herpes zoster (HZ) and diabetes-related macrovascular comorbidities and microvascular disorders in diabetic patients. This retrospective study included 25,345 patients with newly identified HZ and age- and gender-matched controls retrieved from the National Health Insurance Research Database in Taiwan during the period of 2005 to 2011. Multivariate logistic regression analyses were used to calculate the odds ratios (OR) and to assess the risk factors for HZ in diabetic patients with associated macrovascular or microvascular disorders. Risk factors for HZ were significantly increased in cases of diabetes mellitus (DM) compared with those in cases of non-DM controls (20.2% vs. 17.0%, OR = 1.24, p<0.001). Results of age- and gender-adjusted analyses demonstrated a significantly higher risk of HZ in DM patients with accompanying coronary artery disease (CAD) (adjusted OR = 1.21, p<0.001) and microvascular disorders (aOR = 1.32, p<0.001) than in DM patients with other comorbidities but no microvascular disorders. Patients who took thiazolidinedione, alpha-glucosidase inhibitors and insulin had a higher HZ risk than those taking metformin or sulphonylureas alone (aOR = 1.11, 1.14 and 1.18, p<0.001, respectively). Patients who took insulin alone or in combination with other antidiabetic agents had a significantly higher risk of HZ (aOR = 1.25, p<0.001) than those who received monotherapy. Diabetic patients comorbid with coronary artery disease and associated microvascular disorders had an increased risk of HZ occurrence.
authors.affiliation: Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chi-Chen
authors.initials: CC
authors.lastname: Ke
authors.affiliation: Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Hui-Chin
authors.initials: HC
authors.lastname: Lai
authors.affiliation: Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Ching-Heng
authors.initials: CH
authors.lastname: Lin
authors.affiliation: Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Hung
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Der-Yuan
authors.initials: DY
authors.lastname: Chen
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Wayne H-H
authors.initials: WH
authors.lastname: Sheu
authors.affiliation: Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan.|Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.|Institute of Pharmacology, National Yang Ming University, Taipei, Taiwan.
authors.forename: Ping-Wing
authors.initials: PW
authors.lastname: Lui
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000150:complications*; D016208:Databases, Factual; D048909:Diabetes Complications / Q000453:epidemiology* / Q000628:therapy; D003920:Diabetes Mellitus / Q000188:drug therapy; D005260:Female; D065089:Glycoside Hydrolase Inhibitors / Q000627:therapeutic use; D006562:Herpes Zoster / Q000150:complications*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007444:Inulin / Q000627:therapeutic use; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008833:Microcirculation; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D013624:Taiwan / Q000453:epidemiology; D045162:Thiazolidinediones / Q000627:therapeutic use; D014652:Vascular Diseases / Q000150:complications*; D055815:Young Adult
chemical_list: D065089:Glycoside Hydrolase Inhibitors; D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; D045162:Thiazolidinediones; D007444:Inulin; D008687:Metformin