Abstract
Aim
Asthma is believed to increase the risk for several proinflammatory diseases, yet
epidemiologic studies on asthma in relation to risk of developing type 2 diabetes
are sparse and have reported inconsistent results. In the present study, we investigated
the hypothesis that asthma is associated with an increased risk of incident type 2
diabetes in Chinese adults.
Methods
We used data from the Singapore Chinese Health Study, including Chinese men and women
aged 45–74 years, free of cancer, heart disease, stroke, and diabetes at baseline
(1993–1998) and followed through 2004 for incident physician-diagnosed diabetes. Cox
regression models were used to examine the associations between self-reported history
of physician-diagnosed asthma and risk of diabetes.
Results
During an average follow-up of 5.7 years per person, 2234 of the 42,842 participants
included in the current analyses reported diagnoses of type 2 diabetes. After adjustment
for potential confounders, not including body mass index (BMI), asthma was associated
with a 31% increased risk of incident diabetes (HR = 1.31; 95% CI: 1.00–1.72). The association was attenuated after adjustment for adult
BMI (HR = 1.25; 95% CI: 0.95–1.64). The asthma–diabetes association appeared stronger for adult-
vs. child-diagnosed asthma cases, and for participants who were obese compared to
non-obese.
Conclusions
In Singaporean Chinese adults we observed a positive association between self-reported,
physician-diagnosed asthma and risk of developing type 2 diabetes that was modestly
attenuated by adjustment for BMI.
Keywords
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References
- Is the prevalence of asthma declining? Systematic review of epidemiological studies.Allergy. 2010; 65: 152-167
- Vital signs: asthma prevalence, disease characteristics, and self-management education—United States, 2001–2009.Morb Mortal Wkly Rep. 2011; 60: 547-552
- Asthma and proinflammatory conditions: a population-based retrospective matched cohort study.Mayo Clin Proc. 2012; 87: 953-960
- Chronic obstructive pulmonary disease, asthma, and risk of type 2 diabetes in women.Diabetes Care. 2004; 27: 2478-2484
- Asthma, chronic obstructive pulmonary disease, and type 2 diabetes in the Women's Health Study.Diabetes Res Clin Pract. 2010; 90: 365-371
- Asthma and endocrine disorders: shared mechanisms and genetic pleiotropy.Mol Cell Endocrinol. 2011; 333: 103-111
- Oxygen-regulated transcription factors and their role in pulmonary disease.Respir Res. 2000; 1: 159-162
- Vital capacity as a predictor of incident type 2 diabetes: the Atherosclerosis Risk in Communities Study.Diabetes Care. 2005; 28: 1472-1479
- Effects of acute intermittent hypoxia on glucose metabolism in awake healthy volunteers.J Appl Physiol. 2009; 106: 1538-1544
- Hypoxia causes glucose intolerance in humans.Am J Respir Crit Care Med. 2004; 169: 1231-1237
- The effect of altitude hypoxia on glucose homeostasis in men.J Physiol. 1997; 504: 241-249
- Relation of birth weight and childhood repiratory infection to adult lung function and death from chroic obstructive airways disease.BMJ. 1991; 303: 671-675
- Fetal and infant growth and impaired glucose tolerance at age 64.BMJ. 1991; 303: 1019-1022
- Do patients with severe asthma run an increased risk from ischaemic heart disease?.Int J Epidemiol. 1996; 25: 617-620
- Are patients with asthma at increased risk of coronary heart disease?.Int J Epidemiol. 2004; 33: 743-748
- Asthma and incident cardiovascular disease: the Atherosclerosis Risk in Communities Study.Thorax. 2005; 60: 633-638
- Adult-onset asthma is associated with increased carotid atherosclerosis among women in the Atherosclerosis Risk in Communities (ARIC) Study.Atherosclerosis. 2007; 195: 129-137
- Relation of adult-onset asthma to coronary heart disease and stroke.Am J Cardiol. 2008; 101: 1247-1252
- Clinical phenotypes of asthma.Curr Opin Pulm Med. 2004; 10: 44-50
- Asthma: defining of the persistent adult phenotypes.Lancet. 2006; 368: 804-813
- C reactive protein levels are increased in non-allergic but not allergic asthma: a multicentre epidemiological study.Thorax. 2005; 60: 451-454
- Singapore Chinese Health Study: development, validation, and calibration of the quantitative food frequency questionnaire.Nutr Cancer. 2001; 39: 187-195
- Epidemiology standardization project (American Thoracic Society).Am Rev Respir Dis. 1978; 118: 1-120
- Coffee, tea, and incident type 2 diabetes: the Singapore Chinese Health Study.Am J Clin Nutr. 2008; 88: 979-985
- Soft drink and juice consumption and risk of physician-diagnosed incident type 2 diabetes: the Singapore Chinese Health Study.Am J Epidemiol. 2010; 171: 701-708
- Report of a World Health Organization Consultation: use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus.Diabetes Res Clin Pract. 2011; 93: 299-309
- Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies.Lancet. 2004; 363: 157-163
- Lung function and risk of type 2 diabetes and fatal and nonfatal major coronary heart disease events: possible associations with inflammation.Diabetes Care. 2010; 33: 1990-1996
- Cross-sectional and prospective study of lung function in adults with type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) Study.Diabetes Care. 2008; 31: 741-746
- Targeting the NF-kappaB pathway in asthma and chronic obstructive pulmonary disease.Pharmacol Ther. 2009; 121: 1-13
- Emerging role of adipose tissue hypoxia in obesity and insulin resistance.Int J Obes (Lond). 2009; 33: 54-66
- A prospective study of inflammatory cytokines and diabetes mellitus in a multiethnic cohort of postmenopausal women.Arch Intern Med. 2007; 167: 1676-1685
- Circulating levels of endothelial adhesion molecules and risk of diabetes in an ethnically diverse cohort of women.Diabetes. 2007; 56: 1898-1904
- Hypoxia response in asthma: differential modulation on inflammation and epithelial injury.Am J Respir Cell Mol Biol. 2012; 47: 1-10
- Obstructive sleep apnea syndrome and asthma: what are the links?.J Clin Sleep Med. 2009; 15: 71-78
- Proposed mechanisms for the induction of insulin resistance by oxidative stress.Antioxid Redox Signal. 2005; 7: 1553-1567
Gibeon D, Batuwita R, Osmond M, Heaney LG, Brightling CE, Niven RM, et al. Obesity associated severe asthma represents a distinct clinical phenotype – analysis of the British Thoracic Society Difficult Asthma Registry patient cohort according to body mass index. Chest 2012 October 8 [Epub ahead of print].
- Asthma and asthma-like symptoms in adults assessed by questionnaires. A literature review.Chest. 1993; 104: 600-608
- Gender bias in the diagnosis of COPD.Chest. 2001; 119: 1691-1695
- Using the age at onset may increase the reliability of longitudinal asthma assessment.J Clin Epidemiol. 2007; 60: 704-711
- Risk of new onset diabetes mellitus in patients with asthma or COPD taking inhaled corticosteroids.Respir Med. 2012; 106: 1487-1493
- Bias.J Epidemiol Community Health. 2004; 58: 635-641
Article info
Publication history
Published online: December 20, 2012
Accepted:
November 23,
2012
Received in revised form:
November 8,
2012
Received:
September 17,
2012
Identification
Copyright
© 2012 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
