Type 2 diabetes impairs pulmonary function in morbidly obese women: a case–control study

Lecube, Albert; Sampol, Gabriel; Muñoz, Xavier; Hernández, Cristina; Mesa, Jordi; Simó, Rafael

doi:10.1007/s00125-010-1700-5

Cited by 35 publications

(26 citation statements)

References 32 publications

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“…As type 2 diabetes, insulin resistance, metabolic syndrome [17-19], anemia and cardiac insufficiency have been shown to be associated with lung function and/or dyspnea, we also investigated the relationships between dyspnea in daily living and biological parameters. A mMRC scale ≥ 1 was associated with a lower hemoglobin level.…”

Section: Resultsmentioning

confidence: 99%

“…Although the mechanisms of dyspnea in obesity remain unclear, it is moderately correlated with lung function [3,10-16]. Of note, type 2 diabetes [17], insulin resistance [18] and metabolic syndrome [19] have been shown to be associated with reduced lung function in obesity. It must be pointed out that dyspnea is a complex subjective sensation which is difficult to assess in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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The modified Medical Research Council scale for the assessment of dyspnea in daily living in obesity: a pilot study

et al. 2012

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BackgroundDyspnea is very frequent in obese subjects. However, its assessment is complex in clinical practice. The modified Medical Research Council scale (mMRC scale) is largely used in the assessment of dyspnea in chronic respiratory diseases, but has not been validated in obesity. The objectives of this study were to evaluate the use of the mMRC scale in the assessment of dyspnea in obese subjects and to analyze its relationships with the 6-minute walk test (6MWT), lung function and biological parameters.MethodsForty-five obese subjects (17 M/28 F, BMI: 43 ± 9 kg/m2) were included in this pilot study. Dyspnea in daily living was evaluated by the mMRC scale and exertional dyspnea was evaluated by the Borg scale after 6MWT. Pulmonary function tests included spirometry, plethysmography, diffusing capacity of carbon monoxide and arterial blood gases. Fasting blood glucose, total cholesterol, triglyceride, N-terminal pro brain natriuretic peptide, C-reactive protein and hemoglobin levels were analyzed.ResultsEighty-four percent of patients had a mMRC ≥ 1 and 40% a mMRC ≥ 2. Compared to subjects with no dyspnea (mMRC = 0), a mMRC ≥ 1 was associated with a higher BMI (44 ± 9 vs 36 ± 5 kg/m2, p = 0.01), and a lower expiratory reserve volume (ERV) (50 ± 31 vs 91 ± 32%, p = 0.004), forced expiratory volume in one second (FEV1) (86 ± 17 vs 101 ± 16%, p = 0.04) and distance covered in 6MWT (401 ± 107 vs 524 ± 72 m, p = 0.007). A mMRC ≥ 2 was associated with a higher Borg score after the 6MWT (4.7 ± 2.5 vs 6.5 ± 1.5, p < 0.05).ConclusionThis study confirms that dyspnea is very frequent in obese subjects. The differences between the “dyspneic” and the “non dyspneic” groups assessed by the mMRC scale for BMI, ERV, FEV1 and distance covered in 6MWT suggests that the mMRC scale might be an useful and easy-to-use tool to assess dyspnea in daily living in obese subjects.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The modified Medical Research Council scale for the assessment of dyspnea in daily living in obesity: a pilot study

et al. 2012

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“…People with chronic obstructive pulmonary disease (COPD) and diabetes have worse airways obstruction and significantly increased mortality compared with those with COPD without diabetes [21,22 ]. Furthermore, the degree of respiratory dysfunction correlates with worsening glycemic control.…”

Section: Lung Dysfunction and Diabetes In Individuals With Underlyingmentioning

confidence: 99%

Update on cystic fibrosis-related diabetes

Stecenko

Moran

2010

Current Opinion in Pulmonary Medicine

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CFRD remains one of the most important co-morbidities in CF. Early recognition of the disease and therapeutic intervention may diminish the negative impact that diabetes has on lung health in CF. Although a clearer understanding of the role of oxidant stress and genetics in the pathogenesis of CFRD is being elucidated, much needs to be learned before more targeted, specific therapies can be developed for this distinct form of diabetes.

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“…Our results are generally consistent with previous studies on graded lung capacity in MS and type 2 diabetes, but this is the first time that a similar risk threshold has been reported. A similar FEV1 threshold for type 2 diabetes and MS suggests that the pathological process assumed to be inflammation, but potentially glycation commences early. This is supported by the relationship between fasting glycaemia and lung function in the general populations in both populations.…”

Section: Resultsmentioning

confidence: 95%

Association between lung capacity and abnormal glucose metabolism: findings from China and Australia

Chen

Qin

et al. 2016

Clinical Endocrinology

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Acknowledgement: Nothing to declare. AcknowledgementsWe thank the Nanjing team and Crossroads team for their work and the local communities for their support. Funding:Funding was received from the International Diabetes Institute and the University of Melbourne. The Department of Rural Health is funded by the Department of Health and Ageing Rural Health programme. Author contributions:DY: Acquisition of data, analysis and interpretation of the data, drafted the manuscript, has provided final approval of the version to be published. TC:Validated the analysis, edited the manuscript and has provided final approval of the version to be published. RQ and ZJ:Contributed to collect data from communities in Nanjing, edited the manuscripts and has provided final approval of the version to be published. YC:Contributed to questionnaire design, data manipulation edited the manuscript and has provided final approval of the version to be published.ZZ: Conception and design of the Nanjing study, interpretation of the data, co-led this joint study, edited the manuscript, has provided final approval of the version to be published. DS:Conception and design of the Crossroads study, co-led the joint study, acquisition of data, analysis and interpretation of the data, revised the manuscript, has provided final approval of the version to be published, has agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Accepted ArticleThis article is protected by copyright. All rights reserved. Adjusted odds ratios for MS and type 2 diabetes with lung capacity measurements were estimated using logistic regression. Dose-response relationships were explored using restricted cubic spline models.Results: There was a non-linear relationship between FEV1 and the risk of type 2 diabetes and MS (both P<0.0001) both in Australian and Chinese populations. The FEV1 associated with the lowest risk of type 2 diabetes and MS was above 2.70L (95%CI: 2.68 to 2.72L and 2.65 to 2.76L in Chinese and Australian populations respectively). The discrimination of the model could be significantly improved using the FEV1 threshold both in the Australian and Chinese populations. Conclusions:In both Australian and Chinese populations, the risk of type 2 diabetes and MS is lowest with a FEV1 of 2.65-2.76 L. This might be used in clinical practice in different countries as a prompt to screen for type 2 diabetes and MS in patients with obstructive lung disease and to ensure there was no abnormal glucose metabolism before the commencement of steroids if indicated.

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Type 2 diabetes impairs pulmonary function in morbidly obese women: a case–control study

Cited by 35 publications

References 32 publications

The modified Medical Research Council scale for the assessment of dyspnea in daily living in obesity: a pilot study

The modified Medical Research Council scale for the assessment of dyspnea in daily living in obesity: a pilot study

Update on cystic fibrosis-related diabetes

Association between lung capacity and abnormal glucose metabolism: findings from China and Australia

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