Evaluating the impact of type 2 diabetes mellitus on interstitial lung disease prevalence in patients with systemic lupus erythematosus: A national inpatient sample analysis.

IF 1.9 4区 医学 Q3 RHEUMATOLOGY Lupus Pub Date : 2024-10-14 DOI:10.1177/09612033241292162
Fares Saliba, Georges Khattar, Omar Mourad, Laurence Aoun, Elie Bou Sanayeh, Fatema Arafa, Ibrahim Al Saidi, Erica Abidor, Michel Al Achkar, Taqi Rizvi, Koushik Sangaraju, Gaetano Di Pietro, Fadi Haddadin, Shaza Almardini, Khalil El Gharib, Halim El-Hage
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Abstract

Background: Systemic lupus erythematosus (SLE) increases the risk of interstitial lung disease (ILD). SLE is also linked to an elevated risk of type 2 diabetes mellitus (T2DM). However, the impact of T2DM on ILD risk in patients with SLE is still unclear. This study aimed to compare the prevalence of ILD in patients with SLE based on the presence of T2DM (SLE + T2DM+) or its absence (SLE + T2DM-).

Methods: This was a retrospective cohort study using the 2019-2020 National Inpatient Sample database. Adult SLE patients were identified and stratified by T2DM status. Comparable cohorts were created using propensity score matching, resulting in 10,532 patients in each cohort. Multivariate logistic regression assessed the association between T2DM and ILD.

Results: T2DM was associated with a lower prevalence of ILD in patients with SLE (OR 0.798, 95% CI: 0.695-0.918, p = .002), occurring in 371 (3.5%) patients with T2DM compared to 463 (4.4%) patients without T2DM. Specifically, this difference was mainly driven by pulmonary fibrosis, which was significantly less frequent in the T2DM group (1.3% vs 1.8%, OR 0.7, 95% CI: 0.560-0.875, p = .002). No differences were found in secondary outcomes, including death rates, length of hospital stay, ARDS, pneumothorax, pleural effusion, or pulmonary arterial hypertension.

Conclusion: Our study suggests that T2DM significantly reduced ILD risk in patients with SLE, specifically diminishing pulmonary fibrosis prevalence. Further research should explore mechanisms for this protective association between T2DM and ILD development in SLE. These findings may guide management strategies for this vulnerable population.

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评估2型糖尿病对系统性红斑狼疮患者间质性肺病患病率的影响:全国住院病人样本分析。
背景:系统性红斑狼疮(SLE系统性红斑狼疮(SLE)会增加间质性肺病(ILD)的风险。系统性红斑狼疮还与2型糖尿病(T2DM)风险升高有关。然而,T2DM 对系统性红斑狼疮患者 ILD 风险的影响仍不清楚。本研究旨在比较系统性红斑狼疮患者在患有 T2DM(系统性红斑狼疮 + T2DM+)或不患有 T2DM(系统性红斑狼疮 + T2DM-)的基础上的 ILD 患病率:这是一项使用2019-2020年全国住院患者抽样数据库进行的回顾性队列研究。成人系统性红斑狼疮患者被识别出来,并按 T2DM 状态进行分层。使用倾向得分匹配法创建了可比队列,每个队列中有 10,532 名患者。多变量逻辑回归评估了T2DM与ILD之间的关联:结果:T2DM与系统性红斑狼疮患者较低的ILD患病率相关(OR 0.798,95% CI:0.695-0.918,p = .002),371例(3.5%)T2DM患者与463例(4.4%)无T2DM患者相比,ILD发生率较低。具体来说,这种差异主要是由肺纤维化引起的,肺纤维化在 T2DM 组中的发生率明显较低(1.3% vs 1.8%,OR 0.7,95% CI:0.560-0.875,p = .002)。在次要结果方面,包括死亡率、住院时间、ARDS、气胸、胸腔积液或肺动脉高压,均未发现差异:我们的研究表明,T2DM能显著降低系统性红斑狼疮患者的ILD风险,尤其是降低肺纤维化的患病率。进一步的研究应探索 T2DM 与系统性红斑狼疮 ILD 发生之间的保护性关联机制。这些发现可为这一易感人群的管理策略提供指导。
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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
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