Ji Mingxia, Chen Mengyan, Hong Xiaofei, Chen Tiejiang, Zhang Ning
Department of Emergency.
Department of Science and Education, Yiwu Central Hospital, Yiwu.
Medicine (Baltimore). 2019 Mar;98(13):e15095. doi: 10.1097/MD.0000000000015095.
The role of pre-existing diabetes in acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is still controversial. This systematic review and meta-analysis of observational studies aimed to evaluate the effect of diabetes on the risk and mortality of ALI/ARDS.
A comprehensive literature search was performed in PubMed, Scopus, Cochrane Central Register of Controlled Trails and Web of Science for their inception to September 2018. Summary risk estimates were calculated with a DerSimonian and Laird random-effects model. Heterogeneity was evaluated using Cochran chi-square test and the I statistic.
Ultimately, 14 studies with a total of 6613 ALI/ARDS cases were included. The risk of ALI/ARDS was not significantly reduced in diabetes patients (OR 0.82, 95% CI 0.57-1.18, P = .283), with obvious heterogeneity across studies (I = 72.5%, P < .001). Further analyses in the meta-analysis also showed no statistically significant associations between pre-existing diabetes and in-hospital mortality (OR 0.79, 95% CI 0.51-1.21, P = .282) or 60-day mortality of ALI/ARDS (OR 0.91, 95% CI 0.75-1.11, P = .352).
This systematic review and meta-analysis of observational studies indicates that pre-existing diabetes have no effect on the risk and mortality of ALI/ARDS.
既往糖尿病在急性肺损伤/急性呼吸窘迫综合征（ALI/ARDS）中的作用仍存在争议。这项对观察性研究的系统评价和荟萃分析旨在评估糖尿病对ALI/ARDS风险和死亡率的影响。
在PubMed、Scopus、Cochrane对照试验中央注册库和Web of Science中进行了全面的文献检索，检索时间从各数据库建库至2018年9月。采用DerSimonian和Laird随机效应模型计算汇总风险估计值。使用Cochran卡方检验和I统计量评估异质性。
最终纳入了14项研究，共6613例ALI/ARDS病例。糖尿病患者发生ALI/ARDS的风险未显著降低（OR=0.82，95%CI为0.57-1.18，P=0.283），各研究间存在明显异质性（I=72.5%，P<0.001）。荟萃分析中的进一步分析还显示，既往糖尿病与住院死亡率（OR=0.79，95%CI为0.51-1.21，P=0.282）或ALI/ARDS的60天死亡率（OR=0.91，95%CI为0.75-1.11，P=0.352）之间无统计学显著关联。
这项对观察性研究的系统评价和荟萃分析表明，既往糖尿病对ALI/ARDS的风险和死亡率没有影响。
