Risk assessment for gastrointestinal diseases via clinical dimension and genome-wide polygenic risk scores of type 2 diabetes: a population-based cohort study

Objective

We aimed to evaluate whether individuals with type 2 diabetes mellitus (T2DM) were at higher risk of developing a wide range of gastrointestinal diseases based on a population-based cohort study.

Research Design and Methods

This study included 374,125 participants free of gastrointestinal disorders at baseline; of them, 19,719 (5.27%) with T2DM, followed up by linking to multiple medical records to record the gastrointestinal disease diagnoses. Multivariable Cox models were used to estimate the hazard ratios (HRs) and confidence intervals (CIs). Logistic models were used to examine the associations between polygenic risk scores (PRS) and clinical gastrointestinal phenotypes.

Results

During a median follow-up of 12.0 years, we observed the new onset of 15 gastrointestinal diseases. Compared to non-diabetes, participants with T2DM had increased risk of gastritis and duodenitis (HR 1.58, 95%CI 1.51-1.65), peptic ulcer (HR 1.56, 95%CI 1.43-1.71), diverticular disease (HR 1.19, 95%CI 1.14-1.24), pancreatitis (HR 1.45, 95%CI 1.24-1.71), non-alcoholic fatty liver disease (HR 2.46, 95%CI 2.25-2.69), liver cirrhosis (HR 2.92, 95%CI 2.58-3.30), biliary disease (HR 1.18, 95%CI 1.10-1.26), gastrointestinal tract cancers (HR 1.28, 95%CI 1.17-1.40), hepatobiliary and pancreatic cancer (HR 2.32, 95%CI 2.01-2.67). Positive associations were also observed of PRS of T2DM with gastritis and duodenitis, and non-alcoholic fatty liver disease.

Conclusions

In this large cohort study, we found that T2DM was associated with increased risks of a wide range of gastrointestinal outcomes. We suggested the importance of early detection and prevention of gastrointestinal disorders among patients with T2DM.