Rayner Louise H, Mcgovern Andrew, Sherlock Julian, Gatenby Piers, Correa Ana, Creagh-Brown Ben, deLusignan Simon
Department of Clinical and Experimental Medicine, University of Surrey, Guildford, United Kingdom.
Royal Surrey County Hospital NHS Foundation Trust, Guildford, United Kingdom.
Clin Respir J. 2019 May;13(5):299-305. doi: 10.1111/crj.13011. Epub 2019 Apr 2.
There are limited data about the risk of asthma in people with diabetes. We examined the incidence of asthma in subjects with type 2 diabetes (T2DM) compared to controls, and the association with metformin, sulphonylureas and insulin therapy.
We conducted a retrospective cohort study using a representative UK primary care database (N = 894 646 adults). We used 1:1 propensity score matching (age, gender, socio-economic deprivation, body mass index and smoking status) to match 29 217 pairs of T2DM cases and controls. We used Cox proportional hazard regression to compare the incidence of asthma in both groups over 8 years of follow-up. In those with T2DM, we used Cox proportional hazard regression to assess for any impact of antidiabetic medications on asthma incidence.
Individuals with T2DM were less likely to develop asthma than matched controls (hazard ratio [HR] 0.85, 95% CI 0.77-0.93). Insulin increased the risk of incident asthma (HR 1.25, 95% CI 1.01-1.56), whilst metformin and sulphonylureas were associated with reduced risk (HR 0.80, 95% CI 0.69-0.93 and HR 0.76, 95% CI 0.60-0.97, respectively). There was no association with diabetes duration, complications or glycaemic control.
T2DM may have a protective effect against asthma development. Insulin use was associated with an increased risk of asthma, while metformin and sulphonylureas reduced the risk in those with T2DM.
关于糖尿病患者患哮喘风险的数据有限。我们比较了2型糖尿病（T2DM）患者与对照组哮喘的发病率，以及与二甲双胍、磺脲类药物和胰岛素治疗的关联。
我们使用具有代表性的英国初级保健数据库（N = 894646名成年人）进行了一项回顾性队列研究。我们采用1:1倾向评分匹配（年龄、性别、社会经济剥夺程度、体重指数和吸烟状况）来匹配29217对T2DM病例和对照。我们使用Cox比例风险回归来比较两组在8年随访期间哮喘的发病率。在T2DM患者中，我们使用Cox比例风险回归来评估抗糖尿病药物对哮喘发病率的任何影响。
T2DM患者患哮喘的可能性低于匹配的对照组（风险比[HR] 0.85，95%可信区间0.77 - 0.93）。胰岛素增加了新发哮喘的风险（HR 1.25，95%可信区间1.01 - 1.56），而二甲双胍和磺脲类药物与风险降低相关（分别为HR 0.80，95%可信区间0.69 - 0.93和HR 0.76，95%可信区间0.60 - 0.97）。与糖尿病病程、并发症或血糖控制无关。
T2DM可能对哮喘的发生有保护作用。使用胰岛素与哮喘风险增加相关，而二甲双胍和磺脲类药物降低了T2DM患者的风险。
