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墨西哥人群特发性肺纤维化的危险因素。一项病例对照研究。

Risk factors for idiopathic pulmonary fibrosis in a Mexican population. A case-control study.

机构信息

Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, México DF, México.

出版信息

Respir Med. 2010 Feb;104(2):305-9. doi: 10.1016/j.rmed.2009.08.013. Epub 2009 Sep 25.

Abstract

The etiology of idiopathic pulmonary fibrosis (IPF) remains poorly understood, but some studies have suggested that cigarette smoking or other occupational or environmental exposures, diabetes mellitus, or gastroesophageal reflux may play a role. In this study we evaluated the clinical records of a group of 97 consecutive patients with IPF, and 560 patients suffering 5 different respiratory disorders that were examined as controls: asthma (n=111), chronic obstructive pulmonary disease (n=132), squamous cell lung carcinoma (n=118), lung adenocarcinoma (n=101) and patients with otorhinolaryngology problems but without lung disease (n=98). In bivariate analyses male sex, diabetes mellitus and being former cigarette smoker were associated with IPF. After adjusting by these variables, multivariate analysis revealed that type 2 diabetes mellitus [11.3% in IPF patients vs 2.9% in controls, OR=4.3 (95% CI: 1.9-9.8), p<0.0001] was an independent risk factor associated to IPF. Our results provide additional evidence of a putative relationship between DM2 and idiopathic pulmonary fibrosis. Experimental research is necessary for thorough assessment of the pathogenic mechanisms involved in this association.

摘要

特发性肺纤维化(IPF)的病因仍不清楚,但一些研究表明,吸烟或其他职业或环境暴露、糖尿病或胃食管反流可能起作用。在这项研究中,我们评估了一组 97 例连续 IPF 患者的临床记录,以及 560 例患有 5 种不同呼吸系统疾病的患者作为对照:哮喘(n=111)、慢性阻塞性肺疾病(n=132)、鳞状细胞肺癌(n=118)、肺腺癌(n=101)和耳鼻喉科问题但无肺部疾病的患者(n=98)。在单变量分析中,男性、糖尿病和曾经吸烟与 IPF 相关。在调整这些变量后,多变量分析显示 2 型糖尿病[IPF 患者中为 11.3%,对照组中为 2.9%,OR=4.3(95%CI:1.9-9.8),p<0.0001]是与 IPF 相关的独立危险因素。我们的结果提供了 DM2 与特发性肺纤维化之间可能存在关联的额外证据。需要进行实验研究以全面评估该关联中涉及的发病机制。

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