Associations of Traumatic Injury with Abnormal Glucose Metabolism: A Population-Based Prospective Cohort Study

Abstract

Purpose

Empirical data on the association between traumatic injury and abnormal glucose metabolism risk is limited. This study aimed to investigate the association between traumatic injury and abnormal glucose metabolism.

Patients and Methods

This study included 153,162 participants in the Kailuan Study from 2006 to 2013. Participants with abnormal glucose metabolism at baseline were excluded. All participants were monitored every two years until December 31, 2019. During follow-up, 1915 subjects with a first traumatic injury (defined as a physical injury caused by an external force) were identified. For each subject with traumatic injury, one control subject was randomly selected and matched for age (± 3 years) and sex. A total of 3830 subjects were included in the final analysis. Cox proportional hazards models were used to examine the association between traumatic injury and the subsequent risk of abnormal glucose metabolism.

Results

During a median follow-up of 6.91 (3.57–9.41) years, 990 abnormal glucose metabolism events occurred. After adjustment for demographics, lifestyle behaviors, and traditional risk factors, those who had traumatic injury compared to controls were 32% more likely to develop any abnormal glucose metabolism (hazard ratio [HR] 1.32; 95% confidence interval [CI]1.16–1.49), including impaired fasting glucose (IFG) (HR 1.29; 95% CI 1.12–1.48) and diabetes (HR 1.37; 95% CI 1.10–1.70). The risks for abnormal glucose metabolism, IFG, and diabetes in subjects with moderate-severe injury were higher than in subjects with mild injury for the 1-year follow-up period, while the association was not significantly different by injury severity for the whole follow-up period.

Conclusion

Traumatic injury was associated with an increased risk of abnormal glucose metabolism. However, the risks of outcome events decreased as the follow-up period extended. Improved short- and long-term prevention and management strategies for controlling glucose are needed for individuals with traumatic injury.

Keywords:

• traumatic injury
• glucose metabolism
• diabetes
• impaired fasting glucose
• cohort study

Ethics Approval and Informed Consent

This study was approved by the ethics committees of Kailuan General Hospital. Written informed consent form was obtained from all participants.

Consent for Publication

All authors have consented to publication of this research.

Acknowledgments

The authors thank all the survey teams of the Kailuan Study Group for their contribution and the study participants who contributed their information. This work was supported by National Key R&D Program of China (2021YFC2600504).

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by National Key R&D Program of China (2021YFC2600504).