Department of Geriatrics, Fifth People's Hospital of Chengdu, Chengdu, China.
Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
BMC Pulm Med. 2020 May 11;20(1):137. doi: 10.1186/s12890-020-1178-y.
The association between chronic obstructive pulmonary disease (COPD), lung function and risk of type 2 diabetes mellitus (T2DM) remains controversial. We performed a meta-analysis to clarify this issue.
The PubMed and EMBASE databases were searched. Cohort studies on COPD, lung function and risk of T2DM in adults were included. A random effects model was adopted to calculate the summary risk ratio (RR) and 95% confidence interval (CI). Dose-response analysis was conducted where possible.
A total of 13 eligible cohort studies involving 307,335 incident T2DM cases and 7,683,784 individuals were included. The risk of T2DM was significantly higher in patients with COPD than those without COPD (RR = 1.25, 95% CI 1.16-1.34). Compared to the highest category of percentage forced vital capacity (FVC%), the lowest category of FVC% was associated with a higher risk of T2DM (RR = 1.43, 95% CI 1.33-1.53). Similarly, the summary RR of T2DM for the lowest versus highest category of percentage forced expiratory volume in 1 s (FEV1%) was 1.49 (95% CI 1.39-1.60). Significant linear associations of FVC% and FEV1% with risk of T2DM were found (P > 0.05); the RR of T2DM was 0.88 (95% CI 0.82-0.95) and 0.87 (95% CI 0.81-0.94) per 10% increase in FVC% and FEV1%, respectively. There was a non-significant relationship between the FEV1/FVC ratio and the risk of T2DM.
Both COPD and impaired lung function, especially restricted ventilation dysfunction, could increase the risk of T2DM. However, these findings should be interpreted with caution due to the limited number of studies, and need to be validated by future studies.
慢性阻塞性肺疾病（COPD）、肺功能与 2 型糖尿病（T2DM）风险之间的关联仍存在争议。我们进行了一项荟萃分析以阐明这一问题。
检索了 PubMed 和 EMBASE 数据库。纳入了针对成年人 COPD、肺功能与 T2DM 风险的队列研究。采用随机效应模型计算汇总风险比（RR）和 95%置信区间（CI）。在可能的情况下进行了剂量-反应分析。
共纳入了 13 项符合条件的队列研究，涉及 307335 例新发 T2DM 病例和 7683784 名个体。与无 COPD 者相比，COPD 患者发生 T2DM 的风险显著更高（RR=1.25，95%CI 1.16-1.34）。与 FVC%最高类别相比，FVC%最低类别与 T2DM 风险增加相关（RR=1.43，95%CI 1.33-1.53）。同样，与 FEV1%最低类别相比，FEV1%最高类别发生 T2DM 的汇总 RR 为 1.49（95%CI 1.39-1.60）。FVC%和 FEV1%与 T2DM 风险之间存在显著的线性关联（P>0.05）；FVC%每增加 10%，T2DM 的 RR 为 0.88（95%CI 0.82-0.95），FEV1%每增加 10%，RR 为 0.87（95%CI 0.81-0.94）。FEV1/FVC 比值与 T2DM 风险之间无显著关系。
COPD 和肺功能受损，尤其是限制性通气功能障碍，均可增加 T2DM 风险。但是，由于研究数量有限，这些发现应谨慎解释，还需要未来的研究加以验证。
