Glycemic disorders and their impact on lung function. Cross-sectional study

Velázquez, Andrés Ledesma; Serna, David Castro; Ayala, Germán Vargas; Pérez, Angélica Paniagua; Acero, Ivan Meneses; Ramírez, Samuel

doi:10.1016/j.medcle.2019.10.001

Cited by 4 publications

(6 citation statements)

References 11 publications

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“…In recent years, several studies have explored the relationship between lung function and DM. A crosssectional study reported that patients with DM had lower peak flow than those without DM, with no statistically significant differences in FEV1 or FVC [19]. While this finding differs from that of our study, that study did not focus on patients with COPD.…”

Section: Discussioncontrasting

confidence: 99%

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

Correa-Gutiérrez,

Ji,

Aragón-Espinosa

et al. 2023

JCM

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Patients with chronic obstructive pulmonary disease (COPD) may experience exacerbations. During severe exacerbations, nutritional and endocrinological comorbidities can play an important role in the clinical and functional aspects of these patients. The aim of this study was to analyse the influence of the presence of diabetes mellitus (DM) and nutritional parameters on the deterioration of symptoms and quality of life during a severe exacerbation in patients with COPD. An observational study was conducted on COPD patients admitted due to an exacerbation. The COPD Assessment Test (CAT) questionnaire was administered, and clinical and functional parameters were compared based on the presence of nutritional and endocrinological alterations. A total of 50 patients were included, of whom 30 (60%) were male. The mean age was 70.5 years (standard deviation (SD) 9.6). The median CAT score during exacerbation was 25 (interquartile range (IQR) 17.5–30), and the baseline score was 13.5 (IQR 7–19), which represented a statistically significant difference (p < 0.001). Patients with iron deficiencies had a lower total CAT score (p = 0.041), specifically for items related to daily activity (p = 0.009) and energy (p = 0.007). Diabetic patients exhibited a greater decline in pulmonary function during exacerbation (p = 0.016), while patients with high thyroid-stimulating hormone (TSH) levels had a shorter hospital stay (p = 0.016). For COPD patients admitted due to an exacerbation, the metabolic assessment is useful and relevant in the clinical set-up, as endocrinological comorbidities negatively affect clinical and functional aspects of these patients.

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Section: Discussioncontrasting

confidence: 99%

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

Correa-Gutiérrez,

Ji,

Aragón-Espinosa

et al. 2023

JCM

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“…59,60 Cross-sectional studies reported that indicators of glucose metabolism disturbance, such as glucose, HbA1c, serum insulin and C-peptide, are associated with a reduction in lung function. 61,62 Casecontrol and cohort studies found that higher HbA1c levels were associated with an elevated COPD risk. 63,64 In addition, evidence from diabetes patients revealed that poor glycaemic control was associated with lower lung function compared with well-controlled diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, glucose metabolic disturbance is the most characteristic feature of diabetes and is common in COPD patients as well 59,60 . Cross‐sectional studies reported that indicators of glucose metabolism disturbance, such as glucose, HbA1c, serum insulin and C‐peptide, are associated with a reduction in lung function 61,62 . Case‐control and cohort studies found that higher HbA1c levels were associated with an elevated COPD risk 63,64 .…”

Section: Discussionmentioning

confidence: 99%

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

Wan

et al. 2023

Diabetes Obesity Metabolism

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Aim: To investigate the associations of diabetes, prediabetes and diabetes duration with chronic obstructive pulmonary disease (COPD) risk and survival in the UK Biobank. Materials and Methods:We conducted a prospective analysis among 452 680 participants without COPD at baseline using UK Biobank data. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from Cox regression models. The dose-response relationship was explored using restricted cubic splines. A separate survival analysis was conducted for 12 595 patients with incident COPD.Results: Over a median follow-up of 12.3 years, 12 595 cases of COPD were documented. Compared with the reference group, those with prediabetes and diabetes were associated with an 18% (HR 1.18 [95% CI: 1.13-1.24]) and 35% (HR 1.35 [95% CI: 1.24-1.47]) higher risk of COPD, respectively. Diabetes duration was associated with COPD risk, with multivariable HRs (95% CIs) of 1.23 (1.05-1.44), 1.20 (1.04-1.39) and 1.18 (1.01-1.37) for diabetes duration of 7 years or longer, 3 to less than 7 years, and 1 to less than 3 years versus less than 1 year, respectively. Doseresponse analysis revealed a non-linear relationship between diabetes duration and COPD risk. Regarding COPD survival, COPD patients with prediabetes and diabetes had a 9% (HR 1.09 [95% CI: 1.00-1.19]) and 21% (HR 1.21 [95% CI: 1.05-1.41]) higher risk of overall death, respectively. Compared with the cases with a diabetes duration of less than 1 year, those with a diabetes duration of 7 years or longer were associated with a 46% higher risk of overall death ).

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“…Several cross-sectional and case-control studies found that participants with high HbA1c levels have a more damaging effect on lung function impairment. 5,[22][23][24] A Korean study based on 17 568 healthy individuals reported a negative association between HbA1c levels and lung function. 25 To the best of our knowledge, our study is the first to reveal the association between HbA1c…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies reported a negative association between HbA1c levels and lung function. Several cross‐sectional and case‐control studies found that participants with high HbA1c levels have a more damaging effect on lung function impairment 5,22–24 . A Korean study based on 17 568 healthy individuals reported a negative association between HbA1c levels and lung function 25 .…”

Section: Discussionmentioning

confidence: 99%

Association between glycated haemoglobin and the risk of chronic obstructive pulmonary disease: A prospective cohort study in UK biobank

Li,

Wan,

Zhu

et al. 2023

Diabetes Obesity Metabolism

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AimsTo investigate the association between glycated haemoglobin (HbA1c) levels and chronic obstructive pulmonary disease (COPD) incidents in the general population, and the association between HbA1c levels and mortality in patients with COPD.Materials and MethodsWe investigated the association of HbA1c levels with COPD risk in the general population in the UK Biobank, using data from 420 065 participants. Survival analysis was conducted for 18 854 patients with COPD. We used restricted cubic spline analysis to assess the dose‐response relationship between HbA1c levels and COPD risk and survival. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).ResultsDuring a median follow‐up of 12.3 years, 11 556 COPD cases were recorded. HbA1c had a non‐linear relationship with COPD risk (p for non‐linearity < .05). Compared with the quintile 2 (32.2‐<34.3 mmol/mol), those with HbA1c levels above 38.7 mmol/mol (quintile 5) had a 22% (HR, 1.22, 95% CI: 1.15‐1.30) higher risk of COPD. Compared with the HbA1c decile 2 (30.5‐<32.2 mmol/mol), the HRs (95% CI) of COPD risk were 1.16 (1.03‐1.30) and 1.36 (1.24‐1.50) in the lowest HbA1c decile (<30.5 mmol/mol) and highest decile (≥41.0 mmol/mol), respectively. The increased COPD risk associated with HbA1c was more pronounced in younger, current smokers, passive smokers, and participants with a higher Townsend deprivation index (all p for interaction < .05). Among patients with COPD, 4569 COPD cases died (488 because of COPD) during a median follow‐up of 5.4 years. Regarding COPD survival, HbA1c had a non‐linear relationship with all‐cause death (p for non‐linearity < .05). Those with HbA1c quintile 5 (≥38.7 mmol/mol) had a 23% (HR, 1.23, 95% CI: 1.10‐1.37) higher risk of all‐cause death compared with the quintile 2 (32.2‐<34.3 mmol/mol). Compared with the HbA1c decile 4 (33.3‐<34.3 mmol/mol), those in the lowest HbA1c decile (<30.5 mmol/mol) and highest HbA1c decile (≥41.0 mmol/mol) had 22% (HR, 1.22; 95% CI: 1.01‐1.47) and 28% (HR, 1.28; 95% CI: 1.11‐1.48) higher risk for overall death. However, no significant association was observed between HbA1c levels and the risk of COPD‐specific death.ConclusionsOur findings indicated that lower and higher HbA1c levels were associated with a higher risk of COPD. In COPD cases, lower and higher HbA1c levels were associated with a higher COPD all‐cause death risk.

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Glycemic disorders and their impact on lung function. Cross-sectional study

Cited by 4 publications

References 11 publications

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

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

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

Association between glycated haemoglobin and the risk of chronic obstructive pulmonary disease: A prospective cohort study in UK biobank

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