Pilonidal sinus disease in young age is associated with diabetes later in life (年轻时的藏毛窦疾病与以后的糖尿病有关)

Pilonidal sinus or sacrococcygeal cyst is a common surgical problem that typically affects young adults. Diabetes shares common predisposing factors, such obesity and time spent sitting, with pilonidal disease; however, there are no available data concerning the relationship between the two conditions. Based on data derived from a case-control study aiming to investigate the association of type 2 diabetes (T2D) with all types of surgical interventions, the present paper reports, for the first time, on the risk of T2D in individuals who underwent pilonodal sinus surgery (PSS). A random sample of 154 patients (93 men, 61 women) with T2D and 154 sexand age-matched controls were recruited between October 2012 and March 2013. In particular, for every male and female patient with T2D (duration ≥2 years) enrolled in the study, a corresponding control subject of similar age (±2 years) was selected from the non-diabetic individuals visiting the Health Center of Kalivia. Demographic information and medical data were collected by personal interview and from medical records. In addition, height and weight were measured. The mean (±SD) age of the diabetic subjects was 66 ± 8 years (range 40–89 years), with a mean disease duration of 10 ± 7 years (range 2–39 years). The association between disease status and risk factors was assessed by t-test and Pearson’s Chi-squared test. The independent contribution of each factor was analyzed by means of logistic regression analysis. As expected, body mass index (BMI) was higher in diabetic subjects compared with controls (30.9 ± 5.3 vs 28.9 ± 4.1 kg/m, respectively; P = 0.000). The mean number of surgical interventions was significantly higher in diabetic compared with control subjects (1.6 ± 1.2 vs 1.3 ± 1.0, respectively; P = 0.014). In the total sample, 19 individuals (15 men, four women) underwent PSS between 15 and 30 years of age (mean 21 ± 5 years). The prevalence of PSS was significantly higher in diabetic compared with non diabetic subjects (9.7% vs 2.6%, respectively; P = 0.009). The association remained significant after adjustment for confounding factors, namely age, sex and BMI (odds ratio [OR] 4.2; 95% confidence interval [CI] 1.30–13.28; P = 0.016). The prevalence rates with regard to other common surgical interventions are shown in Figure 1. Although the prevalence of cholecystectomy was higher in diabetic than control subjects (14.9% vs 7.8%, respectively; P = 0.048), multivariate analysis did not confirm an association between cholecystectomy and diabetes (OR 2.0; 95% CI 0.93–4.29; P = 0.075). Accordingly, there were no significant differences in the mean age at cholecystectomy between the two groups (51.0 ± 13.2 vs 46.4 ± 12.6 years, respectively; P = 0.37). Interestingly, the prevalence of PSS was significantly higher among the offspring of diabetic fathers compared with the offspring of non-diabetic fathers (14.9% vs 4.6%, respectively; P = 0.007), but not in the offspring of diabetic mothers compared with the offspring of nondiabetic mothers. In addition, there was no significant difference between individuals with diabetic siblings and those with non-diabetic siblings. The odds of having diabetes were ninefold higher in individuals who had a diabetic father and positive history of pilonidal disease than in those who had a non-diabetic father and negative history of pilonidal disease (OR 8.84; 95% CI 1.02–76.7; P = 0.048). Other parameters, including education, smoking, BMI, hypertension, hypercholesterolemia, and coronary and peripheral artery disease, were not related to a history of PSS. The age of diagnosis of diabetes was significantly lower in patients with PSS than in those without PSS (51 ± 10 vs 56 ± 9 years, respectively; P = 0.032), which means that pilonidal disease predisposes for an earlier onset of diabetes. Correspondence Aristofanis Gikas, Themistokleous 17, Maroussi 15122, Greece. Tel: +30 213 1025094 Fax: +3