基于美国国家健康与营养检查调查数据库老年慢性阻塞性肺疾病与糖尿病的关联性研究

Research on association between chronic obstructive pulmonary disease and diabetes mellitus in elderly patients based on data-base of National Health and Nutrition Examination Survey

中文关键词: 老年, 慢性阻塞性肺疾病, 糖尿病

英文关键词: elderly  chronic obstructive pulmonary disease  diabetes mellitus

中文摘要:

      目的 探讨老年慢性阻塞性肺疾病(COPD)与糖尿病(DM)之间的相关性.方法 选择2013-2018年美国国家健康与营养检查调查数据库中年龄≥60岁的5 000例受试者,分为COPD组(n=422)和非COPD组(n=4 578).比较2组的性别、种族、受教育程度、体质量指数(BMI)、吸烟、酗酒、高血压、糖尿病、收缩压(SBP)、舒张压(DBP)、天冬氨酸转氨酶、丙氨酸转氨酶(ALT)、血肌酐(Scr)、糖化血红蛋白(HbA1c)、血尿酸(UA)和总胆固醇(TC).多元Logistic回归确定COPD与DM之间的关联,多变量回归进行亚组分析.结果 与非COPD组相比,COPD组男性、吸烟、酗酒、高血压、糖尿病构成比较多,受教育程度较低,SBP、DBP、ALT和TC水平较低,Scr和UA水平较高.2组种族构成比差异有统计学意义(P＜0.05).不包含任何协变量调整的模型1显示,COPD与DM呈负相关(β=-0.748,95％CI:-1.008～-0.488,P＜0.001).调整性别和种族因素后模型2显示,COPD与DM间仍呈负相关(β=-0.395,95％CI:-0.680～-0.110,P=0.007).进一步调整性别、种族、受教育程度、BMI、SBP、DBP、Scr、HbA1c、UA、TC和高血压后模型 3 显示,COPD 与 DM 呈正相关(β=0.102,95％CI:-0.026～0.230,P=0.119).亚组分析显示,COPD 与 DM的正相关关系在种族亚组中存在交互作用(P交互=0.003).结论 控制混杂因素后,COPD与DM 一定程度上呈正相关,且这种正相关在不同种族间存在差异.

英文摘要:

      Objective To explore the association between chronic obstructive pulmonary disease(COPD)and diabetes mellitus(DM)in elderly patients.Methods 5 000 subjects aged 60 years or older were selected from the database of the Na-tional Health and Nutrition Examination Survey in the United States from 2013 to 2018,and they were divided into two groups:COPD group(n=422)and non-COPD group(n=4 578).The gender,race,education level,body mass index(BMI),smoking,alcohol abuse,hypertension,DM,systolic blood pressure(SBP),diastolic blood pressure(DBP),aspartate amin-otransferase,alanine aminotransferase(ALT),serum creatinine(Scr),glycosylated hemoglobin(HbA1c),serum uric acid(UA)and total cholesterol(TC)were compared between the two groups.Multivariate Logistic regression was used to deter-mine the association between COPD and DM.Multivariate regression was used for subgroup analysis.Results Compared with the non-COPD group,the COPD group had higher rates of male,smokers,alcoholics,hypertension and DM;the levels of the education,SBP,DBP,ALT and TC of the COPD group were lower,and the levels of Scr and UA were higher.There was a statistically significant difference in the racial composition ratio between the two groups(P＜0.05).Model 1 without any co va-riate adjustment showed a negative correlation between COPD and DM(β=-0.748,95％CI:-1.008--0.488,P＜0.001).After adjusting for gender and race,Model 2 showed a negative correlation between COPD and DM(β=-0.395,95％CI:-0.680--0.110,P=0.007).After further adjusting for gender,race,education level,BMI,SBP,DBP,Scr,HbA1c,UA,TC and hypertension,Model 3 showed a positive correlation between COPD and DM(β=0.102,95％CI:-0.026-0.230,P=0.119).Subgroup analysis showed that the positive correlation between COPD and DM had an interactive effect in the racial subgroup(P for interaction=0.003).Conclusion After controlling for confounding factors,COPD is pos-itively correlated with DM to some extent,but this positive correlation varies among different races.