Association between insulin resistance and BMI with FEV₁ in non‐hypoxemic COPD out‐patients

Abstract

Objectives This study was conducted to determine the impact of insulin resistance using Homeostatic Model Assessment of Insulin Resistance (HOMA‐IR) score and BMI in non‐hypoxemic out‐patients with COPD on FEV1 using linear and polynomial regressions and to determine their correlation. Methods COPD patients of both genders were included after informed consent. Fasting blood sugar and serum insulin were done to calculate HOMA‐IR, which were segregated into two groups of ≥ 3 and < 3 labeled insulin resistance present and absent, these were compared with BMI. Patients were segregated into GOLD Grade 1–4 per GOLD Guidelines and compared with HOMA‐IR and BMI. Curve and linear regressions, multivariate and univariate analysis of HOMA‐IR with BMI, FVC, and FEV1 were done. Results A total of 273 subjects were inducted after informed consent. There was a linear correlation between HOMA‐IR and BMI (r2 0.498, P < 0.001) and nonlinear correlation between HOMA‐IR and FEV1 (r2 0. 617, P < 0.001) which showed little evidence of association above FEV1 > 60 predicted, but a clear negative association below that. Significant increase in HOMA‐IR was seen from GOLD‐2 to 3 and from GOLD‐3 to 4 classes. The impact of HOMA‐IR on FEV1 was 49.9% (P < 0.001) on FVC was 43.7%. Conclusions The results indicate that there is a high prevalence of IR in non‐hypoxemic COPD. A nonlinear association is present between FEV1 and HOMA‐IR which is most evident with FEV1 <60% predicted.

Associations of diabetes, prediabetes and diabetes duration with the risk of chronic obstructive pulmonary disease: A prospective UK Biobank study

“…42 A previous study has shown that hyperinsulinaemia has a negative impact on lung function. 43 COPD patients have a higher prevalence of insulin resistance, [44][45][46] which is associated with skeletal muscle weakness in COPD. 47 In addition, a retrospective study reported that BMI was moderately correlated positively with pulmonary function and negatively with exacerbations.…”

Triglyceride-Glucose Index is a Risk Marker of Incident COPD Events in Women

“…Our findings are in accordance with the results of previously published studies using HOMA-IR to assess insulin resistance. 10 , 11 , 15 , 26 , 27 Zuberi et al assessed HOMA-IR index in relation to COPD and found a high prevalence of insulin resistance in non-hypoxaemic COPD. 26 The relationship between insulin resistance using HOMA-IR index and lung function has been found in relation to lung volumes and it has therefore been suggested that this relationship may reflect childhood exposures that affect both lung growth and programming effects on insulin sensitivity.…”

“… 10 , 11 , 15 , 26 , 27 Zuberi et al assessed HOMA-IR index in relation to COPD and found a high prevalence of insulin resistance in non-hypoxaemic COPD. 26 The relationship between insulin resistance using HOMA-IR index and lung function has been found in relation to lung volumes and it has therefore been suggested that this relationship may reflect childhood exposures that affect both lung growth and programming effects on insulin sensitivity. 15 The effects of insulin and insulin resistance on the lung and airways have been found to begin early in life.…”

Influence of Diabetes Mellitus and Nutritional Parameters on Clinical and Functional Aspects and Quality of Life in Patients Hospitalized Due to Exacerbation of Chronic Obstructive Pulmonary Disease

“…However, obesity can contribute to the development of insulin resistance and DM, both prevalent comorbidities in COPD patients [13]. The presence of DM and certain nutritional alterations can cause a deterioration in overall health status and quality of life in patients during both periods of stability and severe exacerbations [14].…”