title: Prevalence of diabetes mellitus and its impact on disease severity in adult recurrent respiratory papillomatosis.
abstract: OBJECTIVE
  Following human papilloma virus (HPV) infection, recurrent respiratory papillomatosis (RRP) develops secondary to dysfunction of innate and adaptive immune responses. Diabetes mellitus (DM) is a common medical disorder; these patients are considered to be relatively immunocompromised. It is hypothesized that comorbid DM occurs more frequently than expected in a cohort of adult RRP patients and that RRP patients with DM have more severe disease than those without DM.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Tertiary care laryngology practice, 5-year period.
  
  
  METHODS
  Adult-onset RRP patients from 2007 to 2012 at the University of Washington were reviewed. The gender, age of onset of RRP, number of interventions, pathology, presence or absence of DM, and calculated anatomic Derkay severity score were recorded.
  
  
  RESULTS
  Eighty-four adult RRP patients were characterized; 64 male (76%) and 20 female (24%). Six of 84 patients (7.1%) had DM; this prevalence was not higher than an age-matched general population. The number of interventions required for disease control did not significantly differ (P = .13) between adult RRP patients with DM (avg 2.6/yr, median 2.3/year) and those without DM (avg 1.9/yr, median 1.3/yr). There was no significant difference in anatomic Derkay score at the time of intervention (P = .26) or presence of dysplasia in biopsy specimens (P = .49) between RRP patients with and without DM.
  
  
  CONCLUSIONS
  In this large series of adult RRP patients, DM does not appear to have a higher prevalence than that seen in age-matched controls, nor do RRP patients with DM appear to have more severe disease.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Shin-Kong Wu-Ho-Su Memorial Hospital, Taipei, Taiwan.
authors.forename: Chia-Jung
authors.initials: CJ
authors.lastname: Lee
authors.forename: Clint T
authors.initials: CT
authors.lastname: Allen
authors.forename: Albert L
authors.initials: AL
authors.lastname: Merati
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology*; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Derkay severity score; diabetes mellitus; recurrent respiratory papillomatosis