Diabetes, Impaired Glucose Tolerance, and Metabolic Biomarkers in Individuals with Normal Glucose Tolerance are Inversely Associated with Lung Function: The Jackson Heart Study

Abstract

The objectives of this study were to test the hypothesis that diabetes and impaired glucose tolerance (IGT), diabetes control and diabetes duration, and metabolic biomarkers in adults with normal glucose tolerance (NGT) are inversely associated with spirometry-measured lung function. We conducted a cross-sectional observational cohort study that included nonsmoking African American adults (n = 2,945; mean age = 52.5 ± 12.6 years; 69.2% female), who were free of cardiovascular disease, from the Jackson Heart Study. The interventions were diabetes, metabolic biomarkers and lung function. We measured the associations of glycemia with forced expiratory volume (FEV) in 1 s, FEV in 6 s, and vital capacity. Multivariable adjusted mean lung function values were lower among adults with diabetes and IGT (in women only, but not after adjustment for waist circumference) than adults with NGT. Among adults with diabetes, no associations were observed between lung function and diabetes control or duration. In women with NGT, lower lung function was consistently associated with higher glucose levels and less consistently with higher insulin levels and insulin resistance. Lower lung function was consistently associated with higher insulin levels and insulin resistance and less consistently associated with insulin and hemoglobin A1c in men with NGT. Overall, our findings generally support the hypothesis that diabetes, IGT, and increased levels of metabolic biomarkers in individuals with NGT are inversely associated with lung function in African Americans, independent of adiposity.

Low Lung Function and Risk of Type 2 Diabetes in Japanese Men: The Toranomon Hospital Health Management Center Study 9 (TOPICS 9)

“…24 In the present study of Japanese men without diabetes, we found a stronger association of lung function indices with HbA 1c than with FPG concentrations. Although we cannot determine the reasons for this finding from our observational study, because HbA 1c measurements reflect glycemic exposure over the previous 2 to 3 months that would include the influence of post- In the prospective analyses, we found that restrictive lung function measures of FVC, FVC %pre , FEV 1 , and FEV 1%pre , rather than the obstructive lung function measure of the FEV 1 :FVC ratio, were more likely to be associated with development of diabetes, although adjustment for elevated HbA 1c concentrations at baseline attenuated the association of restrictive lung dysfunction and diabetes risk.…”

Lung function in poorly controlled type 1 North African diabetic patients: A case-control study

“…In addition, T1DM seems accelerating the respiratory ageing. Tables 1E and 2E describe, respectively, the five international and the four African published studies [10,14,17,[19][20][21][22][23][24]. The above studies have controversial conclusions and used limited methodology:…”

“…That was hence the first results in the literature suggesting that the lung may be a ''target organ'' of T1DM. Since then, studies analysing T1DM ventilatory mechanics and/or pulmonary exchanger are more numerous with controversial conclusions: no effect [9][10][11][12][13], abnormal data [14][15][16][17][18][19][20][21][22][23][24][25][26][27] with conflicting reports on the nature of spirometric alterations: restrictive [14][15][16][17] and/or large-airways obstructive [16,17]-ventilatory-defects (respectively, RVD, and LAOVD) and/or decreased DLCO [14,15,18,23,26], and normal spirometry data but decreased DLCO [27]. In addition, the majority of these studies [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]…”

Tipo de tratamiento farmacológico y deterioro de la función pulmonar en pacientes con diabetes tipo 2: un estudio de corte transversal

“…En algunos estudios longitudinales se ha encontrado que mucho antes del diagnóstico de la enfermedad los pacientes ya acusaban cambios en la función pulmonar (3,25,26). Los valores elevados de los biomarcadores pueden estar relacionados con la fisiopatología de las enfermedades cardiovasculares, renales y pulmonares, e incluso del cáncer, en los pacientes diabéticos (27,28).…”