Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Int J Chron Obstruct Pulmon Dis. 2022 Feb 9;17:285-295. doi: 10.2147/COPD.S345796. eCollection 2022.
Pioglitazone's effect on chronic obstructive pulmonary disease (COPD) has rarely been studied.
This retrospective observational study investigated whether the use of pioglitazone would affect the risk of COPD in patients with type 2 diabetes mellitus.
The Taiwan's National Health Insurance database was used to enroll 9487 matched pairs of ever users and never users of pioglitazone based on propensity score from a cohort of 350,536 patients. The enrolled patients had a new diagnosis of type 2 diabetes mellitus between 1999 and 2008 and were not having a diagnosis of COPD before January 1, 2009. They were then followed up for COPD, starting from January 1, 2009 until December 31, 2011. Diagnosis of COPD was based on the codes of 491 for chronic bronchitis and 492 for emphysema based on the International Classification of Diseases, Ninth Revision, Clinical Modification. Cox regression was used to estimate hazard ratios. The interactions between pioglitazone and COPD risk factors including pneumonia, pulmonary tuberculosis and tobacco abuse were also investigated.
In 9487 never users and 9487 ever users of pioglitazone, the case numbers of incident COPD were 359 and 295, respectively. The respective incidence rates of COPD were 1484.73 and 1167.61 per 100,000 person-years. The overall hazard ratio (95% confidence interval) for COPD that compared ever to never users was 0.778 (0.667-0.908). The hazard ratios for the tertiles of cumulative duration of pioglitazone therapy (cutoffs: <11.0, 11.0-19.6 and >19.6 months) to never users were 0.904 (0.729-1.121), 0.727 (0.578-0.914) and 0.715 (0.570-0.896), respectively. No interactions between pioglitazone and COPD risk factors including pneumonia, pulmonary tuberculosis and tobacco abuse were noted.
Pioglitazone use is associated with a significantly lower risk of COPD.
吡格列酮对慢性阻塞性肺疾病（COPD）的影响鲜有研究。
本回顾性观察性研究旨在探讨 2 型糖尿病患者使用吡格列酮是否会影响 COPD 的发病风险。
利用台湾全民健康保险数据库，基于来自 350536 例患者队列的倾向评分，纳入 9487 对曾用和未用吡格列酮的匹配患者对。纳入的患者在 1999 年至 2008 年期间被确诊为 2 型糖尿病，在 2009 年 1 月 1 日之前没有 COPD 的诊断。从 2009 年 1 月 1 日开始对他们进行 COPD 的随访，随访截止日期为 2011 年 12 月 31 日。COPD 的诊断基于基于疾病国际分类第九修订版临床修正的 491 慢性支气管炎和 492 肺气肿代码。采用 Cox 回归估计危险比。还研究了吡格列酮与 COPD 风险因素（包括肺炎、肺结核和烟草滥用）之间的交互作用。
在 9487 例从未使用过和 9487 例曾使用过吡格列酮的患者中，新发 COPD 的例数分别为 359 例和 295 例。COPD 的相应发生率分别为 1484.73 和 1167.61/100000 人年。与从未使用者相比，曾使用者 COPD 的总体危险比（95%置信区间）为 0.778（0.667-0.908）。吡格列酮治疗累积时间（截断值：<11.0、11.0-19.6 和>19.6 个月）的 tertiles 与从未使用者相比，比值比分别为 0.904（0.729-1.121）、0.727（0.578-0.914）和 0.715（0.570-0.896）。未发现吡格列酮与 COPD 风险因素（包括肺炎、肺结核和烟草滥用）之间存在交互作用。
吡格列酮的使用与 COPD 的发病风险显著降低相关。
