We have recently reported in GUT that regular proton pump inhibitor (PPI) use was associated with a 24% increased risk of type 2 diabetes mellitus (T2DM).1 This was the first study demonstrating an association between PPIs and diabetes. However, all included participants were healthcare professionals and the findings have not been verified in general populations. Additionally, investigation of subgroups at high absolute risk of diabetes among PPI users is still lacking. Because the absolute effects of interventions tend to increase with baseline risk, individualised treatment based on the patients’ underlying risk may confer benefits and reduce harms. Such risk stratification strategy had been applied to select patients for antihypertensive and statin therapy.2 3 In the present study, we conducted a prospective analysis of the UK-Biobank to (1)confirm the association between PPI use and T2DM in general population and (2) to investigate which population groups may have high net risk. We included participants free of diabetes from the UK Biobank.4 Regular use of PPIs was defined as taking PPIs in most days of week for the last 4 weeks. T2DM cases were identified from different data sources (primary care, hospital admissions, self-report and death register). We evaluated hazard ratios (HRs) adjusting for potential confounders. We calculated the risk difference (RD) based …

中文翻译：

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质子泵抑制剂相关 2 型糖尿病的风险分层：基于人群的队列研究

我们最近在 GUT 报告说，定期使用质子泵抑制剂 (PPI) 与 24% 的 2 型糖尿病 (T2DM) 风险增加相关。1 这是第一项证明 PPI 与糖尿病之间存在关联的研究。然而，所有纳入的参与者都是医疗保健专业人员，并且这些发现尚未在一般人群中得到验证。此外，仍然缺乏对 PPI 使用者中糖尿病绝对风险高的亚组的调查。由于干预措施的绝对效果往往会随着基线风险的增加而增加，因此基于患者潜在风险的个体化治疗可能会带来益处并减少危害。这种风险分层策略已应用于选择接受抗高血压和他汀类药物治疗的患者。 2 3 在本研究中，我们对 UK-Biobank 进行了前瞻性分析，以 (1) 确认 PPI 使用与普通人群中 T2DM 之间的关联，以及 (2) 调查哪些人群可能具有高净风险。我们纳入了来自英国生物银行的无糖尿病参与者。4 定期使用 PPI 被定义为在过去 4 周内一周中的大部分时间服用 PPI。T2DM 病例是从不同的数据来源（初级保健、住院、自我报告和死亡登记）中确定的。我们评估了针对潜在混杂因素进行调整的风险比 (HR)。我们计算了风险差异（RD）基于…… 4 定期使用 PPI 被定义为在过去 4 周内一周中的大部分时间服用 PPI。T2DM 病例是从不同的数据来源（初级保健、住院、自我报告和死亡登记）中确定的。我们评估了针对潜在混杂因素进行调整的风险比 (HR)。我们计算了风险差异（RD）基于…… 4 定期使用 PPI 被定义为在过去 4 周内一周中的大部分时间服用 PPI。T2DM 病例是从不同的数据来源（初级保健、住院、自我报告和死亡登记）中确定的。我们评估了针对潜在混杂因素进行调整的风险比 (HR)。我们计算了风险差异（RD）基于……