[慢性阻塞性肺疾病与Ⅰ型和Ⅱ型糖尿病之间的关联]

Kobylianskiĭ V I, Babadzhanova G Iu, Suntsov Iu I

Ter Arkh. 2010;82(3):13-8.

AIM

To study an association between multifactorial obstructive pulmonary disease (COPD) and asthma and types 1 and 2 diabetes (T1D and T2D).

SUBJECTS AND METHODS

A multicenter study was conducted in two formed cohorts of patients with bronchopulmonary pathology (n = 616) and diabetes (n = 700). Random sampling, retrospective data collection, by applying a blind approach, as well as questioning and, if need be, diagnosis verification and an additional study were accomplished. Statistical methods were employed to make a cross assessment of the prevalence of the diseases in each cohort as compared to a control group in which population-based values were used.

RESULTS

In the cohort of patients with bronchopulmonary pathology, the prevalence of T2D was considerable in patients with COPD, it was 9.49%, which was greater than the control values (3.0; p < 0.01), more than 25 times higher (p < 0.05) than that in asthmatic patients in whom the prevalence was 3.64% and it did not differ from the control group. In COPD concurrent with T2D, the prevalence of diabetes was as high as 16.15% (p < 0.001). At the same time, the prevalence of bronchopulmonary pathology in the T2D cohort being 2.3% for COPD and 1.0% for asthma was lower than the population-based value (p < 0.05), 2.6% and 6.1%, respectively. It was contrastingly found that T1D was absent in the asthmatic patients and the prevalence of asthma (0.33%) was low in patients with asthma (p < 0.05). In parallel, an association between COPD and T1D could not be traced, by taking into account an age difference and other specific features of a pathological process in these patient groups.

CONCLUSION

Unlike asthma, COPD, in combination with asthma in particular, is an essential risk factor for T2D. Asthma and T1D mutually exclude each other.

目的

研究多因素阻塞性肺疾病（慢性阻塞性肺疾病，COPD）与哮喘以及1型和2型糖尿病（T1D和T2D）之间的关联。

对象与方法

在两个已形成的支气管肺疾病患者队列（n = 616）和糖尿病患者队列（n = 700）中进行了一项多中心研究。采用随机抽样、回顾性数据收集，运用盲法，以及询问，并在必要时进行诊断验证和额外研究。采用统计方法对每个队列中疾病的患病率与使用基于人群值的对照组进行交叉评估。

结果

在支气管肺疾病患者队列中，COPD患者的T2D患病率相当高，为9.49%，高于对照组值（3.0；p < 0.01），比哮喘患者患病率（3.64%）高25倍以上（p < 0.05），且与对照组无差异。在合并T2D的COPD患者中，糖尿病患病率高达16.15%（p < 0.001）。同时，在T2D队列中，COPD的支气管肺疾病患病率为2.3%，哮喘为1.0%，低于基于人群的值（p < 0.05），分别为2.6%和6.1%。对比发现，哮喘患者中不存在T1D，哮喘患者中哮喘患病率较低（0.33%）（p < 0.05）。同时，考虑到这些患者群体的年龄差异和病理过程的其他特定特征，未发现COPD与T1D之间存在关联。