Chronic Obstructive Pulmonary Disease, Asthma, and Risk of Type 2 Diabetes in Women

  1. Jamal S. Rana, MD1,
  2. Murray A. Mittleman, MD, DRPH12,
  3. Javed Sheikh, MD3,
  4. Frank B. Hu, MD, PHD4,
  5. JoAnn E. Manson, MD, DRPH256,
  6. Graham A. Colditz, MD, DRPH25,
  7. Frank E. Speizer, MD5,
  8. R. Graham Barr, MD, DRPH57 and
  9. Carlos A. Camargo, Jr, MD, DRPH258
  1. 1Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachussetts
  2. 2Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
  3. 3Division of Allergy and Inflammation, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  4. 4Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
  5. 5Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  6. 6Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  7. 7Division of General Medicine, Department of Medicine, Columbia-Presbyterian Medical Center, New York, New York
  8. 8Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
  1. Address correspondence and reprint requests to Dr. Camargo, Channing Laboratory, 181 Longwood Ave., Boston, MA 02115. E-mail: ccamargo{at}partners.org

Abstract

OBJECTIVE—Inflammation plays a key role in chronic obstructive pulmonary disease (COPD) and asthma. Increasing evidence points toward a role of inflammation in the pathogenesis of type 2 diabetes. We wanted to determine the relation of COPD and asthma with the development of type 2 diabetes.

RESEARCH DESIGN AND METHODS—The Nurses’ Health Study is a prospective cohort study. From 1988–1996, 103,614 female nurses were asked biennially about a physician diagnosis of emphysema, chronic bronchitis, asthma, and diabetes.

RESULTS—During 8 years of follow-up, we documented a total of 2,959 new cases of type 2 diabetes. The risk of type 2 diabetes was significantly higher for patients with COPD than those without (multivariate relative risk 1.8, 95% CI 1.1–2.8). By contrast, the risk of type 2 diabetes among asthmatic patients was not increased (1.0, 0.8–1.2). The asthma results remained nonsignificant even when we evaluated diabetes risk by duration of asthma exposure.

CONCLUSIONS—Our findings suggest that COPD may be a risk factor for developing type 2 diabetes. Differences in the inflammation and cytokine profile between COPD and asthma might explain why COPD, but not asthma, is associated with increased risk of type 2 diabetes.

Footnotes

  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted July 14, 2004.
    • Received February 18, 2004.
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  1. doi: 10.2337/diacare.27.10.2478 Diabetes Care October 2004 vol. 27 no. 10 2478-2484
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