Background Altered immune function after appendicectomy has been associated with autoimmune disease, even though the mechanisms are not clearly elucidated. This study aimed to investigate whether the frequency of new-onset type II diabetes was increased after appendicectomy in a case-control study. Methods This was a retrospective cohort study from the Taiwan Longitudinal Health Insurance Database 2000. The relative risk was compared with that in the general population using population-based data. Each patient was tracked for a 3-year interval to identify those who developed type II diabetes. Cox proportional hazard regression analysis was used to assess the risk of type II diabetes during follow-up. Results A total of 31-512 patients were included in the study, of whom 5252 had an appendicectomy (study cohort) and 26-260 were matched for comparison. Some 714 patients (2·3-per cent) developed type II diabetes during the 3-year follow-up, 161 in the study cohort (3·1-per cent) and 553 in the comparison cohort (2·1-per cent). The adjusted hazard ratio (HR) for type II diabetes in the study cohort was 1·45 (95-per cent c.i. 1·22 to 1·74). This increased risk was most pronounced in men (adjusted HR 1·47, 1·16 to 1·88) and in those with a perforated appendix (adjusted HR 2·28, 1·71 to 3·03), and applied only to patients younger than 65-years of age. Conclusion An increased risk of new-onset type II diabetes within 3-years after appendicectomy was found in patients aged less than 65-years. The risk was highest in men and in those with complicated appendicitis. Appendicectomy increases risk of diabetes.
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