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特发性肺纤维化与糖尿病:荟萃分析与系统综述。

Idiopathic pulmonary fibrosis and diabetes mellitus: a meta-analysis and systematic review.

机构信息

Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.

Department of GCP Research Center, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China.

出版信息

Respir Res. 2021 Jun 8;22(1):175. doi: 10.1186/s12931-021-01760-6.


DOI:10.1186/s12931-021-01760-6
PMID:34103046
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8188656/
Abstract

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a chronic diffuse interstitial lung disease, of which the etiology has been poorly understood. Several studies have focused on the relationship between IPF and diabetes mellitus (DM) in the past years but have failed to reach a consensus. This meta-analysis aimed to examine the association between diabetes to IPF. METHODS: We accumulated studies investigating the association between DM and IPF from databases including Medline, Cochrane Library, Embase, Web of Science, and China National Knowledge Infrastructure. RevMan 5.3 and the Newcastle-Ottawa Scale (NOS) were utilized to analyze the data and assess the quality of the included studies. The value of odds ratio (OR) with 95% confidence interval (CI) was used as the measure to estimate the risk of DM in IPF. Heterogeneity was assessed by I statistics. We also performed subgroup analysis, meta-regression, and Egger's test for bias analysis. RESULTS: Nine case-control studies with 5096 IPF patients and 19,095 control subjects were included in the present meta-analysis, which indicated a positive correlation between DM and IPF (OR 1.65, 95% CI 1.30-2.10; P < 0.0001). Meta-regression and subgroup analysis negated the influence of covariates like cigarette smoking, age and gender, but the heterogeneity existed and could not be fully explained. CONCLUSION: IPF and DM may be associated, but the causal relationship remains indeterminate till now. Further rigorously designed studies are required to confirm the present findings and investigate the possible mechanisms behind the effect of DM on IPF.

摘要

背景:特发性肺纤维化(IPF)是一种慢性弥漫性间质性肺疾病,其病因尚未完全了解。过去几年,已有多项研究关注 IPF 与糖尿病(DM)之间的关系,但尚未达成共识。本荟萃分析旨在探讨糖尿病与 IPF 之间的关联。

方法:我们从 Medline、Cochrane 图书馆、Embase、Web of Science 和中国国家知识基础设施等数据库中收集了研究 DM 与 IPF 之间关系的研究。RevMan 5.3 和纽卡斯尔-渥太华量表(NOS)用于分析数据和评估纳入研究的质量。使用比值比(OR)及其 95%置信区间(CI)值来衡量 DM 发生在 IPF 中的风险。通过 I ²统计量评估异质性。我们还进行了亚组分析、meta 回归和 Egger 检验以进行偏倚分析。

结果:本荟萃分析纳入了 9 项病例对照研究,共纳入 5096 例 IPF 患者和 19095 例对照,结果表明 DM 与 IPF 之间存在正相关(OR 1.65,95%CI 1.30-2.10;P < 0.0001)。Meta 回归和亚组分析排除了吸烟、年龄和性别等混杂因素的影响,但仍存在异质性,无法完全解释。

结论:IPF 和 DM 之间可能存在关联,但因果关系尚不确定。需要进一步设计严谨的研究来证实目前的发现,并探讨 DM 对 IPF 影响的可能机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd62/8188656/3a64fd011177/12931_2021_1760_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd62/8188656/eb1bba92401b/12931_2021_1760_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd62/8188656/1b261f7f376b/12931_2021_1760_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd62/8188656/ea9d1260cb5a/12931_2021_1760_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd62/8188656/0e3436b76466/12931_2021_1760_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd62/8188656/3b7326a91bf7/12931_2021_1760_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd62/8188656/3a64fd011177/12931_2021_1760_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd62/8188656/eb1bba92401b/12931_2021_1760_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd62/8188656/1b261f7f376b/12931_2021_1760_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd62/8188656/ea9d1260cb5a/12931_2021_1760_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd62/8188656/0e3436b76466/12931_2021_1760_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd62/8188656/3b7326a91bf7/12931_2021_1760_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd62/8188656/3a64fd011177/12931_2021_1760_Fig6_HTML.jpg

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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Incidence and predictors of idiopathic pulmonary fibrosis complicating Type 2 diabetes: the Fremantle Diabetes Study Phase I.

Intern Med J. 2021-2

[2]
Diabetes, metabolic disease, and telomere length.

Lancet Diabetes Endocrinol. 2021-2

[3]
Telomere length and risk of idiopathic pulmonary fibrosis and chronic obstructive pulmonary disease: a mendelian randomisation study.

Lancet Respir Med. 2021-3

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The Interplay of the Genetic Architecture, Aging, and Environmental Factors in the Pathogenesis of Idiopathic Pulmonary Fibrosis.

Am J Respir Cell Mol Biol. 2021-2

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Diabetes Mellitus Contributes to Idiopathic Pulmonary Fibrosis: A Review From Clinical Appearance to Possible Pathogenesis.

Front Public Health. 2020

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Metformin attenuates TGF-β1-induced pulmonary fibrosis through inhibition of transglutaminase 2 and subsequent TGF-β pathways.

3 Biotech. 2020-6

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Eur Respir J. 2020-8-13

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Metformin ameliorates bleomycin-induced pulmonary fibrosis in mice by suppressing IGF-1.

Am J Transl Res. 2020-3-15

[9]
Concomitant medications and clinical outcomes in idiopathic pulmonary fibrosis.

Eur Respir J. 2019-12-12

[10]
Metformin induces lipogenic differentiation in myofibroblasts to reverse lung fibrosis.

Nat Commun. 2019-7-5

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