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

He, Yun‐Yun; Chen, Zhe; Fang, Xiutong; Chang, Jing; Wang, Xiaojuan

doi:10.1186/s12902-020-00598-1

Cited by 3 publications

(5 citation statements)

References 30 publications

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“…Among T2D Chinese patients with preserved renal function (based on eGFR >60 mL/min/1.73m 2 ), low FEV 1 and low FVC were independently associated with albuminuria. 14 The current study among individuals with T2D with or without impairment in eGFR agrees with this previous finding. Conceivably, such associations could reflect the impact of primary lung disease with systemic manifestations (eg, COPD) on renal function.…”

Section: Discussionsupporting

confidence: 93%

“…Studies characterising the relationship between pulmonary and renal microvascular complications are limited. Among T2D Chinese patients with preserved renal function (based on eGFR >60 mL/min/1.73m 2 ), low FEV 1 and low FVC were independently associated with albuminuria 14. The current study among individuals with T2D with or without impairment in eGFR agrees with this previous finding.…”

Section: Discussionsupporting

confidence: 90%

“…While the reduction in FEV 1 and FVC has been reported in T2D,12 their clinical implications including associations with microvascular complications, and how these associations might vary across different microcirculatory beds are unclear. The few existing reports in the general population13 and individuals with diabetes14 15 have focused on the association between pulmonary dysfunction and albuminuria alone. While albuminuria is a marker of renal microvascular dysfunction, it may also reflect generalised endothelial dysfunction 16.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Associations between spirometric impairments and microvascular complications in type 2 diabetes: a cross-sectional study

Hayfron-Benjamin,

Agyemang,

van den Born

et al. 2023

BMJ Open

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ObjectiveEvidence shows that the conventional cardiometabolic risk factors do not fully explain the burden of microvascular complications in type 2 diabetes (T2D). One potential factor is the impact of pulmonary dysfunction on systemic microvascular injury. We assessed the associations between spirometric impairments and systemic microvascular complications in T2D.DesignCross-sectional study.SettingNational Diabetes Management and Research Centre in Ghana.ParticipantsThe study included 464 Ghanaians aged ≥35 years with established diagnosis of T2D without primary myocardial disease or previous/current heart failure. Participants were excluded if they had primary lung disease including asthma or chronic obstructive pulmonary disease.Primary and secondary outcome measuresThe associations of spirometric measures (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio) with microvascular complications (nephropathy (albumin-creatinine ratio ≥30 mg/g), neuropathy (vibration perception threshold ≥25 V and/or Diabetic Neuropathy Symptom score >1) and retinopathy (based on retinal photography)) were assessed using multivariable logistic regression models with adjustments for age, sex, diabetes duration, glycated haemoglobin concentration, suboptimal blood pressure control, smoking pack years and body mass index.ResultsIn age and sex-adjusted models, lower Z-score FEV1was associated with higher odds of nephropathy (OR 1.55, 95% CI 1.19–2.02, p=0.001) and neuropathy (1.27 (1.01–1.65), 0.038) but not retinopathy (1.22 (0.87–1.70), 0.246). Similar observations were made for the associations of lower Z-score FVC with nephropathy (1.54 (1.19–2.01), 0.001), neuropathy (1.25 (1.01–1.54), 0.037) and retinopathy (1.19 (0.85–1.68), 0.318). In the fully adjusted model, the associations remained significant for only lower Z-score FEV1with nephropathy (1.43 (1.09–1.87), 0.011) and neuropathy (1.34 (1.04–1.73), 0.024) and for lower Z-score FVC with nephropathy (1.45 (1.11–1.91), 0.007) and neuropathy (1.32 (1.03–1.69), 0.029). Lower Z-score FEV1/FVC ratio was not significantly associated with microvascular complications in age and sex and fully adjusted models.ConclusionOur study shows positive but varying strengths of associations between pulmonary dysfunction and microvascular complications in different circulations. Future studies could explore the mechanisms linking pulmonary dysfunction to microvascular complications in T2D.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Associations between spirometric impairments and microvascular complications in type 2 diabetes: a cross-sectional study

Hayfron-Benjamin,

Agyemang,

van den Born

et al. 2023

BMJ Open

View full text Add to dashboard Cite

show abstract

“…Diabetic nephropathy is one of the most common microvascular complications, and the lung is a relatively microvascular and collagen-rich organ and therefore vulnerable to diabetic microangiopathy and histone nonglycosylation [ 2 , 8 ]. Alterations in microvascular ultrastructure regulate the thickening of the alveolar capillary endothelial cell matrix, which in turn affects pulmonary ventilation and pulmonary diffusion function [ 9 ]. Therefore, assessing pulmonary function in patients with DN can lead to better prevention and treatment.…”

Section: Introductionmentioning

confidence: 99%

Impact of Diabetic Nephropathy on Pulmonary Function and Clinical Outcomes

Niu

Liu

Yang

et al. 2022

Computational Intelligence and Neuroscience

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Objective. The main objective is to study the effect of diabetic nephropathy on pulmonary function and clinical outcomes. Methods. The method is to retrospectively analyze patients with diabetic nephropathy (DN) in our hospital from April 2018 to March 2022 as study subjects. The differences in baseline data, serum indicators, renal function indicators, and pulmonary function of patients at different clinical stages were analyzed and then explored. Finally, logistic regression was used to analyze the risk factors affecting patients’ clinical outcomes and to evaluate the diagnostic effects. Results. Baseline information (age, disease duration, BMI, and systolic and diastolic blood pressure), serum indicators (HbA1c, FBG, 2hPG, TG, TC, and LDLC), renal function indicators (CysC, BUN, and Scr), and pulmonary function (TLC, VC, FEV1, FEV1/FVC, MVV, MEF25, MEF50 MEF75, DLCO, and DLCO/VA) were significantly different P < 0.01 ; multiple logistic regression analysis showed that SBP, HbA1c, FBG, 2hPG, BUN, Scr, TLC, VC, FEV1/FVC, MVV, DLCO, and DLCO/VA were all key factors in the development of clinical outcomes in DN P < 0.05 . ROC analysis showed that all of these important factors had an AUC greater than 0.75 for the diagnosis of DN with high sensitivity and specificity. Conclusion. Serum and renal function indices of DN patients gradually increased with stage, accompanied by a decrease in pulmonary ventilation, and diffusion function; SBP, HbA1c, FBG, 2hPG, BUN, Scr, TLC, VC, FEV1/FVC, MVV, DLCO, and DLCO/VA were all key factors affecting the clinical outcome of DN; controlling blood glucose, lipids, improving pulmonary ventilation, and diffusion function can better prevent the occurrence and worsening of DN.

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“…Similarly, the National Health and Nutrition Examination Survey study of participants with chronic kidney disease showed that albuminuria was independently associated with obstructive and restrictive pulmonary function [ 7 ]. Furthermore, a study of 326 patients with type 2 diabetes mellitus revealed that renal dysfunction was associated not only with restrictive pulmonary function, but also with pulmonary diffusion function [ 8 ]. However, limited studies have confirmed the relationship between kidney and lung functions in the general population.…”

Section: Introductionmentioning

confidence: 99%

Association between serum creatinine levels and pulmonary function of Korean adults: the 2016-2019 Korea National Health and Nutrition Examination Survey

Yeun¹,

Kwak²,

Kim³

2023

Phys Act Nutr

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[Purpose] Research on the interaction between renal and lung functions has been conducted; however, studies on the general adult population are limited. This study aimed to investigate the association between serum creatinine levels and pulmonary function in Korean adults.[Methods] From the 2016–2019 Korean National Health and Nutrition Examination Survey, we recruited 11,380 participants who were 40 years or older for this study. Serum creatinine levels were divided into three groups: low, normal, and high. Pulmonary function was divided into three groups: normal, restrictive, and obstructive. The odds ratios for abnormal pulmonary function patterns were calculated using weighted multinomial logistic regression analysis.[Results] The odds ratios were 0.97 for low vs. normal (0.40–2.33) and 2.00 for high vs. normal (1.18–3.38) for the restrictive pattern, and 0.12 for low vs. normal (0.02–0.49) and 1.74 for high vs. normal (0.90–3.35) for the obstructive pattern after being adjusted for age, sex, smoking status, alcohol consumption, regular exercise, body mass index, diabetes mellitus, hypertension, cardiovascular disease, total energy, and total proteins.[Conclusion] High serum creatinine levels were associated with an increased odds ratio for restrictive and obstructive pulmonary function patterns. The odds ratio of the restrictive pattern was higher than that of the obstructive pattern. Screening for abnormal pulmonary function in individuals with high serum creatinine levels may be useful to ensure that there is no abnormal pulmonary function before the onset of potential pulmonary problems. Thus, this study highlights the relationship between renal and pulmonary function using serum creatine levels, which can be easily tested in the primary medical environment of the general population.

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

Cited by 3 publications

References 30 publications

Associations between spirometric impairments and microvascular complications in type 2 diabetes: a cross-sectional study

Associations between spirometric impairments and microvascular complications in type 2 diabetes: a cross-sectional study

Impact of Diabetic Nephropathy on Pulmonary Function and Clinical Outcomes

Association between serum creatinine levels and pulmonary function of Korean adults: the 2016-2019 Korea National Health and Nutrition Examination Survey

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