Chronic obstructive pulmonary disease: a risk factor for type 2 diabetes: a nationwide population-based study

Authors

  • Charles T.-C. Lee,

    1. Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
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  • I-Chieh Mao,

    1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
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  • Ching-Hsiung Lin,

    1. Division of Chest medicine, Department of internal medicine, Changhua Christian Hospital, Changhua, Taiwan
    2. Department of respiratory care, College of health sciences, Chang Jung Christian University, Tainan, Taiwan
    3. Taiwan School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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  • Sheng-Hao Lin,

    1. Division of Chest medicine, Department of internal medicine, Changhua Christian Hospital, Changhua, Taiwan
    2. Graduate Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan
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  • Ming-Chia Hsieh

    Corresponding author
    1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
    2. Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
    • Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
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Correspondence to: Dr Ming-Chia Hsieh, Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, 135 Nanhsiao street, Changhua 50006, Taiwan. Tel.: 886 4 7238595 Ext. 4751; fax: 886 4 7277982; e-mail: mingchiah@gmail.com

Abstract

Background

Type 2 diabetes mellitus (DM) is a common medical disorder and a leading cause of morbidity and mortality worldwide. We investigated whether chronic obstructive pulmonary disease (COPD) was the risk factor for type 2 diabetes in an Asian population.

Materials and methods

From Taiwan's National Health Insurance Research Database, we collected data from 16 088 patients, including 8044 COPD patients and 8044 age- and gender- matched control subjects. Cox proportional hazard regression was performed to evaluate independent risk factors for type 2 diabetes in all patients and identify risk factors in patients with COPD.

Results

During the 5·5-year follow-up, patients with COPD were found to have a significantly higher rate of incident type 2 diabetes than the control group (P < 0·001). COPD was significantly associated with type 2 diabetes hazard ratio (HR : 1·41, 1·23–1·63, P < 0·001) after adjusting sex, age, residential area, insurance premium, steroid use, hypertriglycemia, hypertension, coronary artery disease (CAD) and cerebrovascular disease. Cox regression analysis showed that hypertension (HR : 1·55, 1·33–1·80, P < 0·001) and hypertriglycemia (HR : 1·48, 1·15–1·90, P = 0·002) were important risk factors for type 2 diabetes in patients with COPD.

Conclusions

Patients with COPD have a higher risk of type 2 diabetes compared with control subjects after adjusting for confounding factors such as sex, age, residential area, insurance premium, steroid use, hypertriglycemia, hypertension, CAD and cerebrovascular disease. Continuous surveillance of signals of dysglycemia may be incorporated into care programmes for patients with COPD.

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