Rasmussen Søren Malte, Brok Jesper, Backer Vibeke, Thomsen Simon Francis, Meteran Howraman
a Respiratory Research Unit , Bispebjerg University Hospital , Copenhagen , Denmark.
b Department of Paediatric and Adolescent Medicine, Rigshospitalet , University of Copenhagen , Copenhagen , Denmark.
COPD. 2018 Oct;15(5):526-535. doi: 10.1080/15412555.2018.1532495.
Chronic obstructive pulmonary disease (COPD) has been associated with an increased risk of type 2 diabetes (T2D). However, the mechanisms linking COPD and T2D is not fully understood and contradicting results are reported in the literature.
The aim of this study is to investigate whether COPD is associated with an increased risk of T2D.
A systematic review and meta-analysis of cohort and case-control studies were performed. Search for studies and data extraction was carried out by two authors independently. Study quality was assessed by NOS. Adjusted data were pooled using the random effects model to calculate summary odds ratios (ORs) with corresponding 95% confidence intervals (CIs).
We identified four cohort studies and three case-control studies with a total of 1,369,560 participants of whom 42,716 were COPD patients. The quality of the studies was acceptable, with an average on 7.7 indicating overall good study quality. The meta-analysis on adjusted data from all seven studies showed that the COPD group had a higher risk of T2D compared with the non-COPD group: random effect OR = 1.17 (1.01-1.35), p = 0.03. No heterogeneity was found I = 0%. When including only studies diagnosing both COPD and T2D according to recommended guidelines the association did not remain statistically significant, OR =1.17 (0.96-1.42), p = 0.12.
This systemic review and meta-analyses showed that the association between COPD and T2D might be influenced by the diagnostic method and should be further investigated in studies using diagnostic definition according to guidelines. Nevertheless, physicians should be aware of comorbidities in COPD patients.
慢性阻塞性肺疾病（COPD）与2型糖尿病（T2D）风险增加相关。然而，COPD与T2D之间的关联机制尚未完全明确，文献报道的结果相互矛盾。
本研究旨在调查COPD是否与T2D风险增加相关。
对队列研究和病例对照研究进行系统评价和荟萃分析。由两位作者独立进行文献检索和数据提取。采用NOS评估研究质量。使用随机效应模型对调整后的数据进行合并，以计算汇总比值比（OR）及相应的95%置信区间（CI）。
我们纳入了四项队列研究和三项病例对照研究，共1369560名参与者，其中42716名是COPD患者。研究质量尚可，平均分为7.7分，表明总体研究质量良好。对所有七项研究的调整后数据进行的荟萃分析显示，与非COPD组相比，COPD组患T2D的风险更高：随机效应OR = 1.17（1.01 - 1.35），p = 0.03。未发现异质性（I = 0%）。仅纳入根据推荐指南诊断COPD和T2D的研究时，该关联在统计学上不再显著，OR = 1.17（0.96 - 1.42），p = 0.12。
本系统评价和荟萃分析表明，COPD与T2D之间的关联可能受诊断方法影响，应在使用指南诊断定义的研究中进一步探讨。尽管如此，医生应意识到COPD患者的合并症。
