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Comorbidity between chronic obstructive pulmonary disease and type 2 diabetes: A nation-wide cohort twin study - 30/07/15

Doi : 10.1016/j.rmed.2015.05.015 
Howraman Meteran a, , Vibeke Backer a, Kirsten Ohm Kyvik b, c, Axel Skytthe c, Simon Francis Thomsen a
a Respiratory Research Unit, Bispebjerg University Hospital, Copenhagen, Denmark 
b Odense Patient Data Exploratory Network, Institute of Regional Health Services Research, University of Southern Denmark, Odense, Denmark 
c The Danish Twin Registry, University of Southern Denmark, Odense, Denmark 

Corresponding author. Respiratory Research Unit, Entrance 66, Bispebjerg Hospital, DK-2400 Copenhagen NV, Denmark.

Abstract

Background

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality and is associated with several systemic diseases, such as type 2 diabetes. It has been suggested that comorbidity between COPD and type 2 diabetes is due to shared genetic factors.

Aim

To examine the relationship between type 2 diabetes and chronic bronchitis and COPD in adult twins, and to examine to what extent comorbidity between these diseases is explained by shared genetic or environmental factors.

Methods

Questionnaire data on chronic bronchitis and hospital discharge data on diagnosed COPD in 13,649 twins, aged 50–71 years, from the Danish Twin Registry were cross-linked with hospital discharge diagnosis data on type 2 diabetes from the Danish National Patient Registry.

Results

The risk of type 2 diabetes was higher in persons with symptoms of chronic bronchitis than in those without symptoms (3.5 vs. 2.3%), OR = 1.57 (1.10–2.26), p = 0.014, and in individuals with diagnosed COPD than in those without the diagnosis (6.6 vs. 2.3%), OR = 2.62 (1.63–4.2), p < 0.001. The results were significant after adjusting for age, sex, smoking, and BMI. Correlations between genetic effects on chronic bronchitis and type 2 diabetes, and between genetic effects on diagnosed COPD and type 2 diabetes, respectively, were 0.33 (0.00–0.79), p = 0.103, and 0.43 (0.00–0.98), p = 0.154. Non-shared environmental correlations between chronic bronchitis and type 2 diabetes were −0.13 (−0.43 to 0), p = 0.498 and diagnosed COPD and type 2 diabetes −0.12 (−0.48 to 0), p = 0.665.

Conclusions

Patients with chronic bronchitis or COPD have an increased risk of type 2 diabetes independent of sex, age, smoking and BMI. The genetic correlation between type 2 diabetes and chronic bronchitis was 33% and type 2 diabetes and COPD was 43%, however neither were statistically significant. The increased risk of type 2 diabetes should be accommodated in the management of patients with chronic bronchitis or COPD.

Le texte complet de cet article est disponible en PDF.

Highlights

Chronic Obstructive Pulmonary Disease (COPD) is associated with several systemic comorbidities.
In a large nation wide twin study, we examined the association between chronic bronchitis or COPD and type 2 diabetes (T2D).
Patients with chronic bronchitis and to a larger extent patients with COPD had a higher risk of type 2 diabetes.
The genetic correlation between T2D and chronic bronchitis was 33% and T2D and COPD was 43%, however neither were statistically significant.

Le texte complet de cet article est disponible en PDF.

Keywords : Chronic bronchitis, COPD, Epidemiology, Comorbidity, Type 2 diabetes, Twin studies


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Vol 109 - N° 8

P. 1026-1030 - août 2015 Retour au numéro
Article précédent Article précédent
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