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Asthma may be linked to increased incidence of diabetes, heart disease

Asthmatics were more than twice as likely to develop diabetes mellitus as non-asthmatics, according to findings presented at the 2011 Annual Meeting of the American Academy of Allergy, Asthma & Immunology in San Francisco.

The retrospective population-based study aimed to evaluate potential associations between asthma and proinflammatory conditions, including inflammatory bowel disease, rheumatoid arthritis, diabetes mellitus and coronary artery disease, in 2,392 patients with asthma and 4,784 matched controls.

The incidence rates of proinflammatory conditions were calculated per 100,000 population. The incidence of inflammatory bowel disease was 16.7 in the non-asthmatic cohort and 21.2 in the asthmatic cohort. For rheumatoid arthritis, the incidence increased from 55.3 among non-asthmatics to 81.8 among asthmatics. The incidence of diabetes mellitus increased from 104 in the non-asthmatic group to 138.4 in the asthmatic group. Asthma also was associated with an increased incidence of coronary artery disease, 134 vs. 188.6.

The HR for developing diabetes mellitus among asthmatics compared with non-asthmatics was 2.11 (95% CI, 1.43-3.13). The risk for coronary artery disease also was significantly increased (HR=1.43; 95% CI, 1.02-2.01).

The risks for inflammatory bowel disease (HR=1.31) and rheumatoid arthritis (HR=1.42) were not significantly higher in the asthma cohort.

“Given that coronary artery disease and diabetes mellitus are major morbidities in adults, we believe that clinicians need to be aware of our findings,” Young Juhn, MD, associate professor of medicine at the Mayo Clinic in Rochester, Minn., said of the findings in a press briefing. “Symptoms of coronary artery disease and diabetes should be assessed during routine follow-up care.”

Juhn said the patient and control populations were individuals from the Rochester, Minn., area who were diagnosed or contacted between 1964 and 1983. “Asthma diagnosis was based on clinical criteria for asthma, not physician diagnosis,” he said. “Outcome events were also based on clinical criteria or ICD code.”

Asthma increased the risk for the studied proinflammatory conditions by about 50%, Juhn said.

“Rheumatoid arthritis and inflammatory bowel disease did not reach statistical significance,” he said. “This could be explained by limited statistical power, meaning a small sample size. However, it should be noted that rheumatoid arthritis and inflammatory bowel disease have lower incidence than the other diseases.”

Juhn said more focus should be placed on surveillance of asthma status. “It might be prudent to monitor the impact of asthma epidemiology on the epidemiology of these proinflammatory conditions, given that they have increased over the last 2 decades,” he said.

The mean age of asthma onset was 15.1 years.

For more information:

• Juhn YJ. #293. Presented at: 2011 Annual Meeting of the American Academy of Allergy, Asthma & Immunology; March 18-22, 2011; San Francisco.

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