Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
Eur J Clin Invest. 2013 Nov;43(11):1113-9. doi: 10.1111/eci.12147. Epub 2013 Sep 12.
Type 2 diabetes mellitus (DM) is a common medical disorder and a leading cause of morbidity and mortality worldwide. We investigated whether chronic obstructive pulmonary disease (COPD) was the risk factor for type 2 diabetes in an Asian population.
From Taiwan's National Health Insurance Research Database, we collected data from 16,088 patients, including 8044 COPD patients and 8044 age- and gender- matched control subjects. Cox proportional hazard regression was performed to evaluate independent risk factors for type 2 diabetes in all patients and identify risk factors in patients with COPD.
During the 5.5-year follow-up, patients with COPD were found to have a significantly higher rate of incident type 2 diabetes than the control group (P < 0.001). COPD was significantly associated with type 2 diabetes hazard ratio (HR : 1.41, 1.23-1.63, P < 0.001) after adjusting sex, age, residential area, insurance premium, steroid use, hypertriglycemia, hypertension, coronary artery disease (CAD) and cerebrovascular disease. Cox regression analysis showed that hypertension (HR : 1.55, 1.33-1.80, P < 0.001) and hypertriglycemia (HR : 1.48, 1.15-1.90, P = 0.002) were important risk factors for type 2 diabetes in patients with COPD.
Patients with COPD have a higher risk of type 2 diabetes compared with control subjects after adjusting for confounding factors such as sex, age, residential area, insurance premium, steroid use, hypertriglycemia, hypertension, CAD and cerebrovascular disease. Continuous surveillance of signals of dysglycemia may be incorporated into care programmes for patients with COPD.
2 型糖尿病（DM）是一种常见的医学疾病，也是全球发病率和死亡率的主要原因。我们研究了慢性阻塞性肺疾病（COPD）是否是亚洲人群 2 型糖尿病的危险因素。
我们从台湾全民健康保险研究数据库中收集了 16088 名患者的数据，包括 8044 名 COPD 患者和 8044 名年龄和性别匹配的对照组患者。使用 Cox 比例风险回归分析评估所有患者 2 型糖尿病的独立危险因素，并确定 COPD 患者的危险因素。
在 5.5 年的随访期间，发现 COPD 患者发生 2 型糖尿病的发生率明显高于对照组（P <0.001）。调整性别、年龄、居住地区、保险费、类固醇使用、高三酰甘油血症、高血压、冠心病（CAD）和脑血管疾病后，COPD 与 2 型糖尿病的危险比（HR：1.41，1.23-1.63，P <0.001）显著相关。Cox 回归分析显示，高血压（HR：1.55，1.33-1.80，P <0.001）和高三酰甘油血症（HR：1.48，1.15-1.90，P = 0.002）是 COPD 患者 2 型糖尿病的重要危险因素。
在调整性别、年龄、居住地区、保险费、类固醇使用、高三酰甘油血症、高血压、CAD 和脑血管疾病等混杂因素后，与对照组相比，COPD 患者发生 2 型糖尿病的风险更高。对于 COPD 患者，可能需要将血糖异常的信号监测纳入到护理计划中。
