Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA.
University College Dublin School of Medicine, Education and Research Centre, St. Vincent's University Hospital, D04 T6F4 Dublin, Ireland.
Medicina (Kaunas). 2022 Aug 1;58(8):1030. doi: 10.3390/medicina58081030.
Chronic obstructive pulmonary disease (COPD) patients frequently suffer from multiple comorbidities, resulting in poor outcomes for these patients. Diabetes is observed at a higher frequency in COPD patients than in the general population. Both type 1 and 2 diabetes mellitus are associated with pulmonary complications, and similar therapeutic strategies are proposed to treat these conditions. Epidemiological studies and disease models have increased our knowledge of these clinical associations. Several recent genome-wide association studies have identified positive genetic correlations between lung function and obesity, possibly due to alterations in genes linked to cell proliferation; embryo, skeletal, and tissue development; and regulation of gene expression. These studies suggest that genetic predisposition, in addition to weight gain, can influence lung function. Cigarette smoke exposure can also influence the differential methylation of CpG sites in genes linked to diabetes and COPD, and smoke-related single nucleotide polymorphisms are associated with resting heart rate and coronary artery disease. Despite the vast literature on clinical disease association, little direct mechanistic evidence is currently available demonstrating that either disease influences the progression of the other, but common pharmacological approaches could slow the progression of these diseases. Here, we review the clinical and scientific literature to discuss whether mechanisms beyond preexisting conditions, lifestyle, and weight gain contribute to the development of COPD associated with diabetes. Specifically, we outline environmental and genetic confounders linked with these diseases.
慢性阻塞性肺疾病（COPD）患者常患有多种合并症，导致这些患者的预后较差。与一般人群相比，COPD 患者中更常观察到 1 型和 2 型糖尿病。1 型和 2 型糖尿病均与肺部并发症有关，提出了类似的治疗策略来治疗这些疾病。流行病学研究和疾病模型增加了我们对这些临床关联的认识。几项最近的全基因组关联研究已经确定了肺功能与肥胖之间的积极遗传相关性，这可能是由于与细胞增殖、胚胎、骨骼和组织发育以及基因表达调控相关的基因发生改变所致。这些研究表明，除了体重增加之外，遗传易感性也可能影响肺功能。吸烟也会影响与糖尿病和 COPD 相关的基因中 CpG 位点的差异甲基化，与吸烟有关的单核苷酸多态性与静息心率和冠心病有关。尽管有大量关于临床疾病关联的文献，但目前几乎没有直接的机制证据表明这两种疾病相互影响，但常见的药物治疗方法可能会减缓这些疾病的进展。在这里，我们回顾了临床和科学文献，以讨论是否存在超出预先存在的疾病、生活方式和体重增加的机制导致与糖尿病相关的 COPD 的发展。具体而言，我们概述了与这些疾病相关的环境和遗传混杂因素。
