Lung function measurements in the prediabetes stage: data from the ILERVAS Project

Sánchez, Enric; Gutiérrez-Carrasquilla, Liliana; Barbé, Ferrán; Betriu, Àngels; López‐Cano, Carolina; Gaeta, Anna Michela; Purroy, Francisco; Pamplona, Reinald; Ortega, Marta; Fernàndez, Elvira; Hernández, Cristina; Lecube, Albert; Simó, Rafael; Rius, Ferrán; Hernández, Marta; Valdivielso, José Manuel; Bermúdez-López, Marcelino; Martínez-Alonso, Montserrat; Sánchez‐de‐la‐Torre, Manuel; Polanco, Dinora; Torres, Gerard; Suárez, Guillermo; Colàs-Campàs, Laura; Benabdelhak, Ikram; Portero‐Otín, Manuel; Jové, Mariona; Miquel, Eva; Farràs, Cristina

doi:10.1007/s00592-019-01333-6

Cited by 15 publications

(16 citation statements)

References 42 publications

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“…Recently, a study by Kopf et al found that diabetic patients are prone to interstitial lung disease [21]. Even in the prediabetes stage, the deleterious effect of T2DM on pulmonary function appears to be initiated [22].…”

Section: Discussionmentioning

confidence: 99%

Relationship between pulmonary function and albuminuria in type 2 diabetic patients with preserved renal function

Chen

Fang

et al. 2020

BMC Endocr Disord

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Background: Albuminuria is the early manifestation of the pathogenesis of diabetic nephropathy (DN). The current study was to investigate the relationship of pulmonary function with albuminuria in type 2 diabetic patients with preserved renal function to evaluate the role of pulmonary function in the early stage of DN. Methods: A total of 326 patients with type 2 diabetes mellitus (T2DM) including 270 without albuminuria and 56 with albuminuria, and 265 non-diabetic patients were enrolled. The patients' general information, and the parameters of pulmonary function, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, total lung capacity (TLC), diffusion capacity for carbon monoxide of lung (DLCO) were compared between T2DM and control groups, as well as T2DM patients with and without albuminuria groups. All pulmonary function parameters were expressed as a percentage of those predicted (%pred). Logistic regression models were constructed to test the association of albuminuria and pulmonary function. Results: The values of FVC%pred, FEV1%pred, TLC%pred and DLCO%pred were lower, and the proportion of subjects with FVC%pred < 80, FEV1%pred < 80, and DLCOc%pred < 80 was higher in T2DM subjects than controls (all P < 0.05). Subgroup analysis of diabetic patients showed that the values of FVC%pred, FEV1%pred, TLC%pred, and DLCOc%pred (97.18 ± 13.45, 93.95 ± 14.51, 90.64 ± 9.97, 87.27 ± 13.13, respectively) were significantly lower in T2DM subjects with albuminuria than those without albuminuria (103.94 ± 14.12, 99.20 ± 14.25, 93.79 ± 10.36, 92.62 ± 13.45, all P < 0.05). There was a significantly negative correlation between the urine albumin-to-creatinine ratio (UACR) and DLCOc%pred (r = − 0.143, P = 0.010) in spearman linear correlation test. In logistic regression analysis, the FVC%pred (OR 0.965, 95%CI 0.944-0.988), FEV1%pred (OR 0.975, 95%CI 0.954-0.996), and DLCOc%pred (OR 0.974, 95%CI 0.951-0.998) were independently associated with albuminuria after adjustments for smoking index, duration, HbA1c, FBG, and TG. Conclusion: Our results demonstrated albuminuria is associated with a restrictive pulmonary function as well as pulmonary diffusion function in T2DM with preserved renal function, which remind us to be alert of the pulmonary function decline even in the early stage of DN.

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Section: Discussionmentioning

confidence: 99%

Relationship between pulmonary function and albuminuria in type 2 diabetic patients with preserved renal function

Chen

Fang

et al. 2020

BMC Endocr Disord

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“…The L-shaped association between HbA1c, FPG, and 2 h-PG and the two main parameters of pulmonary function (FEV 1 and FVC) means that a negative association exists in those subjects with normal glucose, when prediabetes is diagnosed, and in those patients with diabetes that achieve better metabolic control. Research has previously demonstrated in a large cross-sectional study that the deleterious effect of type 2 diabetes on pulmonary function begins in the prediabetes stage and that it is related to metabolic control [ 17 , 18 ]. Our current data reinforces this continuous decrement of FEV 1 and FVC values from normoglycemia to diabetes and reveal the harmful effect of hyperglycemia on pulmonary function onset before the diagnosis threshold of diabetes.…”

Section: Resultsmentioning

confidence: 99%

“…However, the “saturation” phenomenon in “diabetic lung” indicates a distinct evolution between lung impairment and classical complications in T2DM. Similarly, a large cross-sectional study with 4459 participants showed that the deleterious effect of T2DM on pulmonary function begins in the prediabetes stage, and that it is related to metabolic control [ 18 ]. Our current data reinforce this continuous decrement of FEV 1 and FVC values from normoglycemia to diabetes and reveal the harmful effect of hyperglycemia on pulmonary function onset before the diagnosis threshold of diabetes.…”

Section: Resultsmentioning

confidence: 99%

Non-linear association between diabetes mellitus and pulmonary function: a population-based study

et al. 2020

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Background There is increasing evidence that the lung is a target organ of diabetes. This study aimed to examine in detail the association between diabetes mellitus and pulmonary function using a national cohort. We also aimed to explore the non-linear association between pulmonary function and blood glucose, insulin resistance, and C-reactive protein (CRP). Methods A total of 30,442 participants from the National Health and Nutrition Examination Survey from the period between 2007 and 2012 were included. The cross-sectional association between diabetes mellitus and pulmonary function was assessed using multiple linear regression. Where there was evidence of non-linearity, we applied a restricted cubic spline with three knots to explore the non-linear association. Partial mediation analysis was performed to evaluate the underlying mechanism. All analyses were weighted to represent the US population and to account for the intricate survey design. Results A total of 8584 people were included in the final study population. We found that diabetes was significantly associated with reduced forced expiratory volume in one second (FEV1) and forced vital capacity. We further found L-shaped associations between hemoglobin A1c (HbA1c) and pulmonary function. There was a negative association between HbA1c and FEV1 in diabetes participants with good glucose control (HbA1c < 7.0%), but not in patients with poor glucose control. A non-linear association was also found with fasting plasma glucose, 2 h-plasma glucose after oral glucose tolerance test, insulin resistance, and CRP. Finally, we found that diabetes duration did not affect pulmonary function, and the deleterious effect of diabetes on pulmonary function was mediated by hyperglycemia, insulin resistance, low-grade chronic inflammation (CRP), and obesity. Conclusions Diabetes mellitus is non-linearly associated with pulmonary function. Our finding of a negative association between HbA1c and FEV1 in diabetes patients with good glucose control but not in patients with poor glucose control indicates that a stricter glycemic target should be applied to diabetic patients to improve pulmonary function. Given, the cross-sectional nature of this research, a longitudinal study is still needed to validate our findings.

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“…It is clear that subjects with this metabolic condition are estimated to have a 40% to 50% risk of developing type 2 diabetes [2]. In addition, prediabetes is also associated with an accumulation of metabolic abnormalities, an increased risk of microangiopathy and cardiovascular disease, dementia, cancer, and lung dysfunction that occur before fasting plasma glucose reaches the threshold diagnosis of type 2 diabetes mellitus [3][4][5][6]. Therefore, So, this long asymptomatic stage needs more attention, and the detection of prediabetes in patients with a high metabolic risk should be considered [7].…”

Section: Introductionmentioning

confidence: 99%

Clinical Usefulness of Anthropometric Indices to Predict the Presence of Prediabetes. Data from the ILERVAS Cohort

Sánchez

Bermúdez-López

et al. 2021

Nutrients

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Prediabetes is closely related to excess body weight and adipose distribution. For this reason, we aimed to assess and compare the diagnostic usefulness of ten anthropometric adiposity indices to predict prediabetes. Cross-sectional study with 8188 overweight subjects free of type 2 diabetes from the ILERVAS project (clinicaltrials.gov: NCT03228459). Prediabetes was diagnosed by levels of glycated hemoglobin (HbA1c). Total body adiposity indices [BMI, Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) and Deurenberg’s formula] and abdominal adiposity (waist and neck circumferences, conicity index, waist to height ratio, Bonora’s equation, A body shape index, and body roundness index) were calculated. The area under the receiver-operating characteristic (ROC) curve, the best cutoff and the prevalence of prediabetes around this value were calculated for every anthropometric index. All anthropometric indices other than the A body adiposity were higher in men and women with prediabetes compared with controls (p < 0.001 for all). In addition, a slightly positive correlation was found between indices and HbA1c in both sexes (r ≤ 0.182 and p ≤ 0.026 for all). None of the measures achieved acceptable levels of discrimination in ROC analysis (area under the ROC ≤ 0.63 for all). Assessing BMI, the prevalence of prediabetes among men increased from 20.4% to 36.2% around the cutoff of 28.2 kg/m2, with similar data among women (from 29.3 to 44.8% with a cutoff of 28.6 kg/m2). No lonely obesity index appears to be the perfect biomarker to use in clinical practice to detect individuals with prediabetes.

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Lung function measurements in the prediabetes stage: data from the ILERVAS Project

Cited by 15 publications

References 42 publications

Relationship between pulmonary function and albuminuria in type 2 diabetic patients with preserved renal function

Relationship between pulmonary function and albuminuria in type 2 diabetic patients with preserved renal function

Non-linear association between diabetes mellitus and pulmonary function: a population-based study

Clinical Usefulness of Anthropometric Indices to Predict the Presence of Prediabetes. Data from the ILERVAS Cohort

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