Unidad de Docencia e Investigación en Medicina Preventiva y Salud Pública, Facultad de Ciencias de la Salud, Avda. de Atenas s/n, 28922 Alcorcón, Madrid, Spain.
Prim Care Diabetes. 2009 Aug;3(3):141-8. doi: 10.1016/j.pcd.2009.06.005. Epub 2009 Jul 25.
To describe the health, treatment and health care resources consumption profile among Spanish adults with diabetes and chronic obstructive pulmonary disease (COPD), and compare it with that of non-diabetic COPD patients.
An observational and descriptive epidemiological study (EPIDEPOC study). The study included patients with stable COPD and aged > or =40 years, evaluated in primary care. Data were collected relating to sociodemographic variables, health profile, quality of life (SF-12), treatment and health care resources consumption. The results corresponding to diabetic and non-diabetic patients were compared.
A total of 10,711 patients (75.6% males) with COPD were evaluated. The prevalence of diabetes was 16.9%. The diabetic patients were significantly older, with a larger percentage of women, and a lesser educational level compared with the non-diabetic patients. In addition, the diabetics were more sedentary, smoked less, and presented a higher percentage of obesity (33.6% versus 19.7%) than the non-diabetic patients. The severity of airways obstruction was greater among the diabetics than in the non-diabetic patients (54.57+/-13.37% versus 57.92+/-13.39%, respectively, p<0.05). As to co-morbidity, the diabetics showed a greater frequency of arterial hypertension, hypercholesterolemia, heart disease, depression and anxiety. Both the physical and the mental component as measured by the SF-12 yielded significantly poorer results among the diabetics. On the other hand, the diabetic subjects showed a higher consumption of drugs for COPD. In addition, they consumed significantly more health care (and thus economical) resources than the non-diabetic patients. The results of the multivariate logistic regression analysis showed that the variables that were independently associated to COPD among diabetic patients were: higher age, higher BMI, concomitant chronic heart disease, use of inhaled corticoids, SF-12 mental component, SF-12 physical component and total cost of COPD.
The presence of diabetes in patients with COPD shows in the bivariate analysis a more severe lung disease, greater co-morbidity, poorer quality of life, and a greater consumption of resources, as well as a less favorable course in the previous year. However, the multivariate logistic regression shows that the variables that are independently associated to COPD among diabetic patients are higher age, higher BMI, concomitant chronic heart disease, use of inhaled corticoids, physical and mental component of quality of life questionnaire and total cost of COPD.
描述西班牙成年糖尿病合并慢性阻塞性肺疾病（COPD）患者的健康状况、治疗方法和医疗资源消耗情况，并与非糖尿病 COPD 患者进行比较。
这是一项观察性和描述性的流行病学研究（EPIDEPOC 研究）。研究纳入了年龄≥40 岁、在初级保健机构接受稳定期 COPD 评估的患者。收集的资料包括社会人口统计学变量、健康状况、生活质量（SF-12）、治疗方法和医疗资源消耗情况。比较了糖尿病和非糖尿病患者的结果。
共评估了 10711 例 COPD 患者（75.6%为男性）。糖尿病的患病率为 16.9%。与非糖尿病患者相比，糖尿病患者年龄更大，女性比例更高，教育程度更低。此外，与非糖尿病患者相比，糖尿病患者活动量更小，吸烟更少，肥胖比例更高（33.6%比 19.7%）。糖尿病患者气道阻塞的严重程度大于非糖尿病患者（分别为 54.57±13.37%和 57.92±13.39%，p<0.05）。合并症方面，糖尿病患者高血压、高胆固醇血症、心脏病、抑郁和焦虑的发生率更高。SF-12 测量的生理和心理成分在糖尿病患者中均显著较差。另一方面，糖尿病患者 COPD 药物治疗的消费更高。此外，与非糖尿病患者相比，他们消耗了更多的医疗保健（因此经济）资源。多变量逻辑回归分析的结果表明，与糖尿病患者 COPD 相关的独立变量为：年龄较大、BMI 较高、合并慢性心脏疾病、使用吸入皮质激素、SF-12 心理成分、SF-12 生理成分和 COPD 总费用。
在 COPD 患者中合并糖尿病会导致肺疾病更严重、合并症更多、生活质量更差、资源消耗更多，且前一年的病情更差。然而，多变量逻辑回归分析表明，与糖尿病患者 COPD 相关的独立变量为年龄较大、BMI 较高、合并慢性心脏疾病、使用吸入皮质激素、生活质量问卷的生理和心理成分以及 COPD 总费用。
