糖尿病与特发性肺纤维化之间的关联：2600 万人的研究水平汇总分析。

Associations Between Diabetes and Idiopathic Pulmonary Fibrosis: a Study-level Pooled Analysis of 26 Million People.

机构信息

The National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, the Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, P.R. China.

State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100050, China.

出版信息

J Clin Endocrinol Metab. 2021 Oct 21;106(11):3367-3380. doi: 10.1210/clinem/dgab553.

DOI:10.1210/clinem/dgab553

PMID:34302736

Abstract

CONTEXT

Diabetes mellitus (DM) is a systemic disease characterized by chronic hyperglycemia associated with inflammation and oxidative stress, and the lung may be a target organ of diabetic microvascular damage. Several studies have indicated a positive association between idiopathic pulmonary fibrosis (IPF) and diabetes with controversial findings.

OBJECTIVE

Primary outcomes were to compare the prevalence of DM among individuals with IPF to non-IPF controls, and the prevalence of IPF among individuals with DM to non-DM controls.

METHODS

Data sources include PubMed, EMBASE, and the Cochrane Library. Studies contained sufficient data to calculate the prevalence of DM among individuals with and without IPF, or the prevalence of IPF among individuals with and without DM. Two investigators independently identified eligible studies and extracted data. Pooled odds ratio (OR) with 95% CI was the summary effect measure.

RESULTS

Eighteen studies including 26 410 623 individuals met the eligibility criteria, of whom 16 recruited people with IPF and 2 recruited people with DM. The OR of DM in IPF patients was 1.54 (95% CI, 1.30-1.84; P < .001) compared to that in non-IPF controls. However, compared with that in non-DM patients, the risk of IPF in DM patients was not found to be significantly reduced (OR: 0.89; 95% CI, 0.64-1.25; P = .497).

CONCLUSION

This meta-analysis suggests that people with IPF have 1.54 times increased odds of diabetes compared to non-IPF controls, while whether patients with DM have an increased risk of IPF is still controversial. Further large, prospective cohort studies investigating the prevalence of IPF in diabetic patients are warranted.

摘要

背景

糖尿病（DM）是一种以慢性高血糖为特征的系统性疾病，与炎症和氧化应激有关，肺部可能是糖尿病微血管损伤的靶器官。有几项研究表明，特发性肺纤维化（IPF）和糖尿病之间存在正相关，但结果存在争议。

目的

主要结局是比较 IPF 患者与非 IPF 对照组之间 DM 的患病率，以及 DM 患者与非 DM 对照组之间 IPF 的患病率。

方法

数据来源包括 PubMed、EMBASE 和 Cochrane Library。研究包含足够的数据来计算有和无 IPF 的个体中 DM 的患病率，或有和无 DM 的个体中 IPF 的患病率。两名调查员独立确定合格的研究并提取数据。汇总优势比（OR）及其 95%置信区间（CI）为汇总效应量。

结果

纳入了 18 项研究，共 26410623 名个体，其中 16 项研究招募了 IPF 患者，2 项研究招募了 DM 患者。与非 IPF 对照组相比，IPF 患者的 DM 患病比值比（OR）为 1.54（95%CI，1.30-1.84；P<0.001）。然而，与非 DM 患者相比，DM 患者发生 IPF 的风险并未显著降低（OR：0.89；95%CI，0.64-1.25；P=0.497）。