哮喘联盟

   摘要
   1型糖尿病(T1DM)与哮喘之间的联系仍然存在争议，并且这种争议导致人们对于这两种疾病产生了新的兴趣。本研究的目的是探查年轻人中T1DM和哮喘之间的联系，并且为Th1和Th2应答之间的平衡提供临床证明。我们通过使用台湾国民健康保险(NHI)系统的数据进行了一项回顾性队列研究。这个队列由3545例T1DM患者和14,180例在1998年到2011年间确立的对照者组成。在3545例T1DM患者中，55.1%是女孩并且26.5%在＜8岁的年龄组。 T1DM队列的哮喘总体发病率比对照队列高47%(6.49 vs 4.42 每1000 人-年)，校正后的危害比(HR)为1.34 (95% 置信区间[CI] = 1.11-1.62)。此外，因糖尿病至急诊室就诊两次以上的T1DM患者罹患哮喘的校正HR更高，为17.4(95% CI = 12.9-23.6). 因糖尿病而住院治疗两次以上的T1DM患者患哮喘的校正HR为38.6 (95% CI = 28.5-52.2). 我们还观察到年轻的T1DM患者哮喘的发病率显著高于总体人群。患有T1DM的年轻患者中由于糖尿病至急诊室就诊次数更多或住院治疗频率更高的患者患哮喘风险增加，这可能预示着血糖控制不佳将显著增加患哮喘风险。
 

（杨冬 审校）
Medicine (Baltimore). 2015 Sep;94(36):e1466. doi: 10.1097/MD.0000000000001466.


 

Type 1 Diabetes and Increased Risk of Subsequent Asthma: A Nationwide Population-Based Cohort Study.
 

Hsiao YT1, Cheng WC, Liao WC, Lin CL, Shen TC, Chen WC, Chen CH, Kao CH.
 

Abstract
The association between type 1 diabetes mellitus (T1DM) and asthma remains controversial and has led to new interest in these 2 disorders. The purpose of this study was to examine the associations among young people with T1DM and asthma and offer a clinical demonstration of the balance between Th1 and Th2 responses.We conducted a retrospective cohort study by using data from the National Health Insurance (NHI) system of Taiwan. The cohort consisted of 3545 T1DM cases and 14,180 controls established during the 1998 to 2011 period. Of the 3545 T1DM patients, 55.1% were girls and 26.5% were in the age group <8 years.The overall incidence of asthma was 47% higher in the T1DM cohort than in the control cohort (6.49 vs 4.42 per 1000 person-y), with an adjusted hazard ratio (HR) of 1.34 (95% confidence interval [CI] = 1.11-1.62). Moreover, T1DM patients who visited the emergency room (ER) more than twice for diabetes had a higher adjusted HR of 17.4 (95% CI = 12.9-23.6) of developing asthma. The adjusted HR of asthma was 38.6 (95% CI = 28.5-52.2) in T1DM patients who had been hospitalized more than twice for diabetes.We observed a significantly higher incidence of asthma in young patients with T1DM than in the general population. Among young people of T1DM with more ER visits or frequent hospitalization because of diabetes mellitus were associated with risk of asthma, may indicate that poor glycemic control significantly contributes to asthma risk.
 

Medicine (Baltimore). 2015 Sep;94(36):e1466. doi: 10.1097/MD.0000000000001466.