1. ≥3 respiratory symptoms§
Diabetes mellitus and asthma: a cross-sectional survey Rajkumar H1, Macsali F1,2 , Svanes C 2, Omenaas ER2, Norbäck D3, Lindberg E3, Jõgi R4, Franklin KA5, Gislason T6, Torén K7, Schlünssen V8, Janson C3, Gómez Real F1
1 Dept Gyn Obst, Haukeland Univ Hosp, Bergen, Norway 2 Inst Med, Bergen Univ 3 Dept Med Sci, Uppsala Univ, Sweden 4 Lung Clinic, Tartu Univ, Estonia 5 Dept Pulm Med Umeå Univ, Sweden 6 Dept Pulm Med, Reykjavik Univ, Iceland 7 Dept Occup Env Med, Sahlgrenska Univ, Sweden 8 Dept Env Occup Med, Aarhus Univ, Denmark
BACKGROUND
RESULTS
TABLE 2. Characteristics of the study population according to the presence of recalled doctor-diagnosed diabetes or not
There is growing awareness that asthma might be related to systemic inflammation and metabolic factors, while there is limited information about the association of diabetes with asthma.
Self-reported diabetes was associated with asthma (OR=1.63 [95% CI= ]), wheeze (1.77 [ ]), having three or more asthma symptoms (1.58 [ ]), and hay fever (1.34 [ ]), but not with chronic bronchitis (0.80 [ ]).
no diabetes*
(n=13568)
diabetes*
(n=231)
p-value
Age (median, years) 40 44
0.00**
Gender
0.6
-women n (%) ♀
7228
119 (1.62)
-men n (%) ♂
6340
112 (1.74)
BMI (median, kg/m2)
24.3
26.3
Smoking status:
0.02
- Current smokers (%) 28 35
- Ex-smokers (%) 25 26
- Never smokers (%) 47 38
Dwelling:
0.04
- Detached house 42 39
- Semidetached house 15 11
- Apartment 41 49
- Other
1.61
0.44
OBJECTIVES
We aimed to investigate whether diabetes was related to asthma in general populations from Northern Europe.
FIGURE: Prevalence of asthma and respiratory symptoms according to diabetes or not
METHODS
A postal questionnaire was sent to population based samples in Denmark, Estonia, Iceland, Norway and Sweden participating in RHINE (Respiratory Health In Northern Europe) in
16190 subjects aged 25 to 56 years responded (77 %). Analyses included persons with complete data, of which 231 (1.43 %) reported diabetes.
Logistic regressions with adjustments for smoking, BMI, age, centre and social class were performed.
* Diabetes defined as answering yes to the question “Has any doctor ever told you that you have diabetes?”
**For continuous variables: Kruskal-Wallis equality-of-populations rank test
TABLE 3. Associations of diabetes with asthma, respiratory symptoms and allergy, as compared with persons not reporting diabetes
no diabetes
( n=13568)
diabetes*
(n=231) %
OR (95 % CI)*
p-value
Asthma†
6.7
10.1
1.63 ( )
0.03
Wheeze‡ 20 35
1.77 ( )
0.00
≥3 Respiratory symptoms§ 14 28
1.58 ( )
Chronic bronchitis** 31 37
0.80 ( )
0.5
Hay fever†† 23 27
1.34 ( )
0.06
Allergic asthma‡‡
4.3
5.2
1.33 ( )
0.35
TABLE 1. Characteristics of persons aged 25 to 55 years in 7 north European centres
Centre
study population
median age
women / men
median BMI
current smokers
diabetes*
asthma†
hay fever‡
≥3 respiratory symptoms§ n
years
%/%
kg/m2 %
n (%)
Aarhus
2607 39
48/52
23.7 35
6 (1.63)
6.4 22 13
Reykjavik
1969 41
45/55
24.8 31
18 (0.93) 21 11
Bergen
2506 40
24.2
43 (1.74)
6.3 24 16
Gothenburg
2188
46/54
24.5 30
43 (1.99)
7.3 26
Umeå
2640
49/51
24.7 19
53 (2.02)
9.2 23 15
Uppsala
2572
47/53
24.1 20
43 (1.69)
7.5 25
Tartu
1708
44/56
23.4
25 (1.48)
2.1
Total
16190 29
231 (1.43)
6.7
23.2
14.4
CONCLUSION
Diabetes is associated with asthma and asthma symptoms.
The findings support the hypothesis of a metabolic component in asthma.
REFERENCES
*From logistic regression models with adjustment for smoking, BMI, age, centre and social class (dwelling)
†Asthma medication and/or asthma attacks last 12 months
‡Wheeze in the last 12 months
§Symptoms included: wheeze, wheeze with shortness of breath, wheeze without cold, waking with tightness in chest, waking with shortness of breath, waking with cough, asthma attacks, current asthma medication
** Answering yes to the questions “Do you cough up phlegm in this way almost every day for at least three months every year?” and “Have you had periods of this kind for at least two years in a row?”
††Hay fever or nasal allergies
‡‡Asthma and hay fever
Printed by
1. Shore SA. Obesity and asthma: possible mechanisms. J Allergy Clin Immunol 2008;121(5): ; quiz
2. Alves C, Diniz AB, Souza MB, Ponte EV, Araujo MI. [Controversies in the association between type 1 diabetes and asthma]. Arq Bras Endocrinol Metabol 2007;51(6):930-7.
3. Bjornvold M, Munthe-Kaas MC, Egeland T, Joner G, Dahl-Jorgensen K, Njolstad PR, et al. A TLR2 polymorphism is associated with type 1 diabetes and allergic asthma. Genes Immun 2009.
* Diabetes defined as answering yes to the question “Has any doctor ever told you that you have diabetes?”
† Asthma defined as current asthma medication and/or asthma attacks last 12 months
‡ Hay fever defined as current hay fever or nasal allergies
§ Symptoms included: wheeze, wheeze with shortness of breath, wheeze without cold, waking with tightness in chest, waking with shortness of breath, waking with cough, asthma attacks, current asthma medication