Department of Pulmonary and Infectious Diseases, Nordsjællands Hospital-Hillerød.
Faculty of Health and Medical Sciences.
Clin Infect Dis. 2017 Nov 29;65(12):2091-2098. doi: 10.1093/cid/cix703.
Diabetes mellitus is an important risk factor for community-acquired pneumonia, whereas the prevalence of undiagnosed diabetes mellitus and prediabetes in patients with community-acquired pneumonia is largely unknown. We aimed to determine the prevalence of prediabetes, undiagnosed diabetes mellitus, and risk factors associated with undiagnosed diabetes mellitus in a large European community-acquired pneumonia cohort.
This was a multicenter prospective cohort study of hospitals and private practices in Germany and Austria encompassing 1961 adults with community-acquired pneumonia included in the German Community-Acquired Pneumonia Competence Network (CAPNETZ) study between 2007 and 2014. The prevalence of undiagnosed diabetes mellitus and prediabetes was estimated based on hemoglobin A1c measurements. Logistic regression was used to assess risk factors for undiagnosed diabetes mellitus.
Fifteen percent of patients had known diabetes mellitus. Among patients without known diabetes mellitus, 5.0% had undiagnosed diabetes mellitus and 37.5% had prediabetes. Male sex (odds ratio [OR], 2.45 [95% confidence interval {CI}, 1.35-4.45]), body mass index ≥25 kg/m2 (OR, 2.64 [95% CI, 1.48-4.72]), and hyperglycemia at admission (6-11 mM: OR, 2.93 [95% CI, 1.54-5.60] and ≥11 mM: OR, 44.76 [95% CI, 17.58-113.98]) were associated with undiagnosed diabetes mellitus. Patients with undiagnosed diabetes mellitus had a higher 180-day mortality rate compared to patients without diabetes mellitus (12.1% vs 3.8%, respectively; P = .001).
Undiagnosed diabetes mellitus was prevalent among community-acquired pneumonia. Male sex, overweight, and hyperglycemia at admission were associated with undiagnosed diabetes mellitus. The long-term mortality among patients with undiagnosed diabetes mellitus was high compared to patients without diabetes mellitus.
糖尿病是社区获得性肺炎的一个重要危险因素，而社区获得性肺炎患者中未确诊的糖尿病和糖尿病前期的患病率尚不清楚。我们旨在确定大型欧洲社区获得性肺炎队列中糖尿病前期、未确诊的糖尿病以及与未确诊的糖尿病相关的危险因素的患病率。
这是一项多中心前瞻性队列研究，纳入了 2007 年至 2014 年间德国和奥地利的医院和私人诊所的 1961 名成人社区获得性肺炎患者，这些患者均包含在德国社区获得性肺炎网络（CAPNETZ）研究中。根据血红蛋白 A1c 测量值估计未确诊的糖尿病和糖尿病前期的患病率。使用逻辑回归评估未确诊的糖尿病的危险因素。
15%的患者患有已知的糖尿病。在没有已知糖尿病的患者中，有 5.0%患有未确诊的糖尿病，37.5%患有糖尿病前期。男性（比值比[OR]，2.45[95%置信区间{CI}，1.35-4.45]）、体重指数（BMI）≥25 kg/m2（OR，2.64[95%CI，1.48-4.72]）和入院时的高血糖（6-11mM：OR，2.93[95%CI，1.54-5.60]和≥11mM：OR，44.76[95%CI，17.58-113.98]）与未确诊的糖尿病有关。与无糖尿病的患者相比，患有未确诊的糖尿病的患者在 180 天的死亡率更高（分别为 12.1%和 3.8%；P =.001）。
社区获得性肺炎患者中未确诊的糖尿病较为普遍。男性、超重和入院时的高血糖与未确诊的糖尿病有关。与无糖尿病的患者相比，患有未确诊的糖尿病的患者的长期死亡率较高。
