title: Diabetes mellitus is associated with acquisition and increased mortality in HIV-uninfected patients with cryptococcosis: A population-based study.
abstract: OBJECTIVE
  To disclose the association between diabetes mellitus (DM) and cryptococcosis in HIV-uninfected patients.
  
  
  METHODS
  Case patients' diagnoses with cryptococcosis and cryptococcal meningitis were based on data from the Taiwan National Health Insurance Research Database from 2000 to 2010, and diagnoses were defined using the International Classification of Disease, Ninth Revision, Clinical Modification. A case-control study comprising inpatient and outpatient populations was conducted using 4 controls for each patient (4587 case patients and 18,348 controls) matched for age, sex, monthly income, and urbanization level.
  
  
  RESULTS
  Human immunodeficiency virus (HIV)-uninfected patients with cryptococcosis were more likely to have diabetes than matched control patients (adjusted odds ratio [OR], 1.45; 95% confidence interval [95% CI], 1.36-1.64; p < 0.001). A diagnosis of DM was also associated with 1-year and overall mortality from cryptococcosis (hazard ratio [HR], 1.39; 95% CI, 1.17-1.65; p < 0.001, HR, 1.47; 95% CI, 1.29-1.67; p < 0.001; respectively) and cryptococcal meningitis (p = 0.018).
  
  
  CONCLUSIONS
  Diabetes was associated with the occurrence of cryptococcosis and cryptococcal meningitis in HIV-uninfected patients. DM was also associated with 1-year and overall mortality for these patients.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan, ROC.
authors.forename: Kuo-Hsi
authors.initials: KH
authors.lastname: Lin
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan, ROC.
authors.forename: Chih-Ming
authors.initials: CM
authors.lastname: Chen
authors.affiliation: Institutes of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Te-Li
authors.initials: TL
authors.lastname: Chen
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan, ROC.
authors.forename: Shu-Chen
authors.initials: SC
authors.lastname: Kuo
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan, ROC.
authors.forename: Chih-Chauan
authors.initials: CC
authors.lastname: Kao
authors.affiliation: Department of Medical Research, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan, ROC.
authors.forename: Ya-Chung
authors.initials: YC
authors.lastname: Jeng
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, ROC. Electronic address: D7905@mail.cmuh.org.tw.
authors.forename: Mao-Wang
authors.initials: MW
authors.lastname: Ho
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003453:Cryptococcosis / Q000453:epidemiology* / Q000401:mortality*; D048909:Diabetes Complications / Q000453:epidemiology* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology
keywords: Cryptococcal meningitis; Cryptococcosis; Diabetes mellitus