Asthma in elite athletes - do they have Type 2 or non-Type 2 disease? A new insight on the endotypes among elite athletes.

Asthma and exercise-induced bronchoconstriction are highly prevalent in elite athletes compared with the general population. Some athletes have classic asthma with allergic sensitization; however, it seems that a proportion of athletes develop asthma as a result of several years of intensive training. It leads us to believe that asthma in athletes consists of at least two distinct endotypes - classic early-onset, Type 2 mediated asthma, and asthma with later onset caused by exercise which might be classified as non-Type 2 asthma. The purpose of this review is to evaluate the current literature on asthma in athletes focusing on inflammation and examine if asthma in athletes could be characterized as either Type 2- or non-Type 2 asthma.

Association Between Chronic Obstructive Pulmonary Disease and Type 2 Diabetes: A Systematic Review and Meta-Analysis.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) has been associated with an increased risk of type 2 diabetes (T2D). However, the mechanisms linking COPD and T2D is not fully understood and contradicting results are reported in the literature. AIM: The aim of this study is to investigate whether COPD is associated with an increased risk of T2D. METHODS: A systematic review and meta-analysis of cohort and case-control studies were performed. Search for studies and data extraction was carried out by two authors independently. Study quality was assessed by NOS. Adjusted data were pooled using the random effects model to calculate summary odds ratios (ORs) with corresponding 95% confidence intervals (CIs). RESULTS: We identified four cohort studies and three case-control studies with a total of 1,369,560 participants of whom 42,716 were COPD patients. The quality of the studies was acceptable, with an average on 7.7 indicating overall good study quality. The meta-analysis on adjusted data from all seven studies showed that the COPD group had a higher risk of T2D compared with the non-COPD group: random effect OR = 1.17 (1.01-1.35), p = 0.03. No heterogeneity was found I2 = 0%. When including only studies diagnosing both COPD and T2D according to recommended guidelines the association did not remain statistically significant, OR =1.17 (0.96-1.42), p = 0.12. CONCLUSION: This systemic review and meta-analyses showed that the association between COPD and T2D might be influenced by the diagnostic method and should be further investigated in studies using diagnostic definition according to guidelines. Nevertheless, physicians should be aware of comorbidities in COPD patients.