High prevalence of diabetes mellitus among patients with Fabry disease in Taiwan: a cross-sectional study

Shih-Han Hung; Sudha Xirasagar; Yen-Fu Cheng; Herng-Ching Lin; Chin-Shyan Chen

doi:10.1136/bmjopen-2025-099735

High prevalence of diabetes mellitus among patients with Fabry disease in Taiwan: a cross-sectional study

BMJ Open. 2025 May 31;15(5):e099735. doi: 10.1136/bmjopen-2025-099735.

Authors

Shih-Han Hung^{1

2

3}, Sudha Xirasagar⁴, Yen-Fu Cheng^#^{5

6

7

8

9}, Herng-Ching Lin^#^{10

11}, Chin-Shyan Chen^#^{12

13}

Affiliations

¹ Department of Otolaryngology, Taipei Medical University, Taipei, Taiwan.
² Department of Otolaryngology, Wan Fang Hospital, Taipei, Taiwan.
³ International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁴ Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
⁵ Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.
⁶ Department of Otorhinolaryngology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁷ Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
⁸ Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁹ Research Center of Data Science on Healthcare Industry, College of Management, Taipei Medical University, Taipei, Taiwan.
¹⁰ School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan.
¹¹ Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
¹² Research Center of Data Science on Healthcare Industry, College of Management, Taipei Medical University, Taipei, Taiwan stan@mail.ntpu.edu.tw.
¹³ Department of Economics, National Taipei University, New Taipei City, Taiwan.

^# Contributed equally.

Abstract

Objectives: This study aimed to investigate the prevalence of diabetes mellitus in patients with Fabry disease using a nationwide population-based dataset. We hypothesised that patients with Fabry disease would have a higher prevalence of diabetes mellitus compared with the general population.

Design: A cross-sectional study.

Setting: Taiwan.

Participants: We identified a study sample from Taiwan's LHID2010 Database. There were 9408 sampled patients in this study, 2352 study patients with Fabry disease and 7056 propensity-score-matched comparison patients.

Primary outcome measures: Multiple logistic regression analyses were conducted to explore the association between diabetes mellitus and Fabry disease after taking the variables of age, sex, geographic location, monthly income category, urbanisation level of the patient's residence, hyperlipidaemia and hypertension into consideration.

Results: The results revealed significantly higher prevalence of diabetes mellitus among patients with Fabry disease than among comparison patients (35.8% vs 29.6%, p<0.001). The difference was observed, irrespective of gender, males 37.0% vs 30.6%, (p<0.001) and female patients, 34.8% vs 28.7% (p<0.001). The adjusted OR of diabetes mellitus for patients with Fabry disease was 1.424 (95% CI=1.276~1.591) when compared with comparison patients. Classified by sex, the adjusted ORs for diabetes were 1.428 (95% CI=1.213~1.682) for males and 1.424 (95% CI=1.226~1.655) for females. Additionally, among patients aged <65 years, the adjusted OR was 1.489 (95% CI=1.277~1.737), and among patients aged 65 or older, the adjusted OR was 1.361 (95% CI=1.161~1.596).

Conclusions: Our findings suggest the importance of screening for diabetes mellitus in patients with Fabry disease. Physicians should be conscious of this association and be prepared to manage both conditions concurrently.

Keywords: DIABETES & ENDOCRINOLOGY; Diabetes Mellitus, Type 2; Epidemiology.

MeSH terms

Adult
Aged
Cross-Sectional Studies
Diabetes Mellitus* / epidemiology
Fabry Disease* / complications
Fabry Disease* / epidemiology
Female
Humans
Logistic Models
Male
Middle Aged
Prevalence
Propensity Score
Risk Factors
Taiwan / epidemiology
Young Adult