Dept of Internal Medicine, Faculty of Medicine, 54703Universiti Teknologi MARA (UiTM), Sg Buloh, Malaysia.
Cardiac Vascular Lung Research Institute (CAVALRI), Sg Buloh, Malaysia.
Chron Respir Dis. 2021 Jan-Dec;18:14799731211056348. doi: 10.1177/14799731211056348.
Dysglycemia is known to be a common comorbidity of chronic obstructive pulmonary disease (COPD). However, undiagnosed dysglycemia and the associated factors remain under-reported. This study aimed to determine the prevalence and the associated factors of dysglycemia among COPD patients.
This was a cross-sectional, single-center study involving adults with established COPD ( = 186) divided into those with or without hospital admissions for acute exacerbation. Oral glucose tolerance test (OGTT) was performed in patients with no known history of dysglycemia.
There were 16 patients who had overt diabetes, and 32 had prediabetes following the OGTT. Forty percent had histories of hospital admissions for COPD exacerbations. Both groups demonstrated similar 2-h post prandial glucose, glycated hemoglobin (HbA1c) and fasting blood glucose. The incidences of newly diagnosed dysglycemia were higher in both groups (40.8% vs 34.6%, = 0.57). Cumulative days of admission (≥6 days/year) and weight (≥65 kg) were identified as predictors for dysglycemia within the study population.
This study demonstrated a high number of overt and newly diagnosed dysglycemia among COPD patients who had no previous history of abnormal glucose. Recent acute exacerbations of COPD could have a negative impact on glycemia, although the results did not attain statistical significance. However, there is a need for adequate screening for dysglycemia, particularly among those with frequent acute exacerbations of their condition.
高血糖症是慢性阻塞性肺疾病（COPD）的常见合并症。然而，未确诊的高血糖症及其相关因素仍报道不足。本研究旨在确定 COPD 患者中高血糖症的患病率和相关因素。
这是一项横断面、单中心研究，涉及已确诊的 COPD 成人（n=186），分为有或无因急性加重而住院的患者。对无已知高血糖症病史的患者进行口服葡萄糖耐量试验（OGTT）。
有 16 名患者患有显性糖尿病，32 名患者经 OGTT 后患有糖尿病前期。40%的患者有 COPD 加重住院史。两组患者的餐后 2 小时血糖、糖化血红蛋白（HbA1c）和空腹血糖均相似。两组新诊断高血糖症的发生率均较高（40.8%比 34.6%，p=0.57）。在研究人群中，住院天数（≥6 天/年）和体重（≥65kg）被确定为高血糖症的预测因素。
本研究表明，无既往异常血糖史的 COPD 患者中存在大量显性和新诊断的高血糖症。COPD 的近期急性加重可能对血糖产生负面影响，尽管结果未达到统计学意义。然而，需要对高血糖症进行充分筛查，特别是对那些病情频繁急性加重的患者。
