Asthma, chronic obstructive pulmonary disease, and type 2 diabetes in the Women's Health Study

Background: Chronic airway inflammation in asthma or chronic obstructive pulmonary disease (COPD) may be involved in the pathogenesis of type 2 diabetes; however, prospective data have been limited. Methods: A prospective cohort of 38,570 women who were aged >= 45 years, free of cardiovascular disease and cancer at baseline, and free of diabetes at baseline and in the first 12 months were analyzed. We classified all women into three groups according to the presence and absence of self-reported asthma or COPD (including emphysema, chronic bronchitis, and bronchiectasis). Results: During a median follow-up of 12.2 years, 2472 incident type 2 diabetes events were documented. Women who had ever reported asthma or COPD were associated with an increased diabetes risk; the multivariate RRs were 1.37 (95% CI, 1.20-1.57) for women who had asthma alone and 1.38 (95% CI, 1.14-1.67) for COPD without asthmatic symptoms. Furthermore, these associations were not significantly modified by age, smoking status, physical activity, BMI, alcohol intake, hormone replacement therapy, menopausal status or randomized treatment. Conclusions: Asthma and COPD were individually and independently associated with an increased risk of type 2 diabetes in women, indicating that chronic airway inflammation may contribute to diabetes pathogenesis. (C) 2010 Elsevier Ireland Ltd. All rights reserved.