Rogliani Paola, Calzetta Luigino, Segreti Andrea, Barrile Annapina, Cazzola Mario
Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
Acta Diabetol. 2014 Dec;51(6):933-40. doi: 10.1007/s00592-014-0584-0. Epub 2014 Apr 13.
Type 2 diabetes mellitus is a common comorbidity of COPD, but there are still many doubts about the relation among diabetes and COPD. We retrospectively collected data from patients afferent to our Respiratory Diseases outpatient clinic at the Tor Vergata University Hospital between 2010 and 2012. The study population was analyzed by clusters of age, gender, body mass index (BMI), smoking status, lung function, concomitant pharmacologic therapies and comorbidities. The values of the association between variables were expressed as odds ratio. Data were adjusted for gender, age and possible confounding variables by Mantel-Haenszel method. We identified 493 patients with COPD. Ninety-two (18.7 %) patients were affected by type 2 diabetes mellitus, with no significant gender differences. The prevalence distribution was similar among the different age clusters, but the association was stronger in patients younger than 65 years. The association was present only in obese subjects in whom it was significant only in patients with moderate-to-severe COPD, but not mild COPD. The presence of cardiovascular diseases was significantly associated with diabetes mellitus in patients with COPD. There was a slight association of inhaled corticosteroid (ICS) use with the presence of diabetes mellitus in COPD, but the combination of an ICS with a β2-agonist apparently reduced this association. The association with type 2 diabetes mellitus was greater in patients with COPD respect to general population, and correlated with the increase in BMI and the presence of other comorbidities, suggesting that both diseases may be targets of systemic inflammation.
2型糖尿病是慢性阻塞性肺疾病(COPD)常见的合并症,但糖尿病与COPD之间的关系仍存在诸多疑问。我们回顾性收集了2010年至2012年期间罗马第二大学医院呼吸疾病门诊收治患者的数据。通过年龄、性别、体重指数(BMI)、吸烟状况、肺功能、伴随的药物治疗及合并症对研究人群进行分析。变量之间的关联值以比值比表示。采用Mantel-Haenszel法对性别、年龄及可能的混杂变量进行数据校正。我们确定了493例COPD患者。92例(18.7%)患者患有2型糖尿病,无显著性别差异。患病率分布在不同年龄组中相似,但在65岁以下患者中关联更强。该关联仅存在于肥胖受试者中,且仅在中度至重度COPD患者中显著,轻度COPD患者中不显著。COPD患者中,心血管疾病的存在与糖尿病显著相关。COPD患者中吸入性糖皮质激素(ICS)的使用与糖尿病的存在有轻微关联,但ICS与β2受体激动剂联合使用时这种关联明显减弱。与普通人群相比,COPD患者与2型糖尿病的关联更强,且与BMI增加及其他合并症的存在相关,提示这两种疾病可能都是全身炎症的靶点。