糖化血红蛋白的极值与2型糖尿病患者慢性阻塞性肺疾病风险增加相关：台湾糖尿病研究全国队列中的竞争风险分析
Extreme values of hemoglobin a1c are associated with increased risks of chronic obstructive pulmonary disease in patients with type 2 diabetes: a competing risk analysis in national cohort of Taiwan diabetes study.
作者信息
Li Chia-Ing, Li Tsai-Chung, Liu Chiu-Shong, Lin Wen-Yuan, Chen Ching-Chu, Yang Sing-Yu, Lin Cheng-Chieh
机构信息
From the Department of Medical Research (C-IL, C-SL, C-CL), China Medical University Hospital; School of Medicine (C-IL, C-SL, W-YL, C-CL), College of Medicine; Graduate Institute of Biostatistics (T-CL, S-YY), College of Management, China Medical University; Department of Healthcare Administration (T-CL), College of Health Science, Asia University; Department of Family Medicine (C-SL, C-CL, W-YL); Division of Endocrinology and Metabolism (C-CC), Department of Medicine, China Medical University Hospital; and School of Chinese Medicine (C-CC), College of Chinese Medicine, China Medical University, Taichung, Taiwan.
出版信息
Medicine (Baltimore). 2015 Jan;94(1):e367. doi: 10.1097/MD.0000000000000367.
The purpose of this study was to evaluate the relationship between glycated hemoglobin (HbA1c) and chronic obstructive pulmonary disease (COPD) in patients with type 2 diabetes.We conducted a retrospective cohort study involving 45,753 patients with type 2 diabetes, who participated in the National Diabetes Case Management Program in Taiwan. HbA1c at baseline and COPD events over the subsequent years were analyzed.After multivariate adjustment, the COPD risk increased among patients with HbA1c levels <6.0%, compared with that in patients with HbA1c levels ranging from 6.0% to 7.0% (hazard ratio: 1.19, 95% confidence interval (CI): 1.06-1.34). Similarly, high HbA1c levels (≥10%) were independently associated with COPD (1.19, 95% CI: 1.06-1.32). A U-shaped relationship was observed between HbA1c levels and COPD incidence.HbA1c levels lower than 6.0% and higher than 10% are associated with an increased risk of COPD in patients with type 2 diabetes. These findings suggest that meeting the recommended HbA1c targets might reduce the risk of COPD, but care should be taken not to pose risks to this population.
本研究旨在评估2型糖尿病患者糖化血红蛋白（HbA1c）与慢性阻塞性肺疾病（COPD）之间的关系。我们进行了一项回顾性队列研究，纳入了45753例参与台湾地区国家糖尿病病例管理计划的2型糖尿病患者。分析了基线时的HbA1c水平以及随后几年的COPD事件。多变量调整后，与HbA1c水平在6.0%至7.0%之间的患者相比，HbA1c水平<6.0%的患者COPD风险增加（风险比：1.19，95%置信区间（CI）：1.06 - 1.34）。同样，高HbA1c水平（≥10%）与COPD独立相关（1.19，95%CI：1.06 - 1.32）。观察到HbA1c水平与COPD发病率之间呈U型关系。2型糖尿病患者中，HbA1c水平低于6.0%和高于10%与COPD风险增加相关。这些发现表明，达到推荐的HbA1c目标可能会降低COPD风险，但应注意避免给该人群带来风险。
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