Exp Clin Endocrinol Diabetes 2014; 122(06): 322-326
DOI: 10.1055/s-0034-1372579
Article
© Georg Thieme Verlag KG Stuttgart · New York

Effect of Type 2 Diabetes Mellitus on Pulmonary Function

H. Huang*
1   Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
,
Q. Guo*
1   Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
,
L. Li
1   Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
,
S. Lin
1   Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
,
Y. Lin
1   Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
,
X. Gong
1   Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
,
J. Yao
1   Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
,
J. Liang
1   Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
,
L. Lin
1   Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
,
J. Wen
1   Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
,
G. Chen
1   Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
› Author Affiliations
Further Information

Publication History

received 09 December 2013
first decision 26 February 2014

accepted 17 March 2014

Publication Date:
18 June 2014 (online)

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a metabolic disease with debilitating effects on multiple organs. The alveolar-capillary network in the lung is a large microvascular unit which may be affected by T2DM-associated microangiopathy.

Methods: This retrospective study investigated whether type 2 diabetes mellitus (T2DM) affected pulmonary function. Of the 584 patients enrolled in the study, 292 had T2DM and 292 did not. Forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), maximum voluntary ventilation (MVV) and total lung capacity (TLC) are values as percent of predicted, as well as FEV₁/FVC ratio which were values measured.

Results: FEV₁, FVC, FEV₁/FVC ratio, MVV, and TLC were significantly lower in T2DM than in non-T2DM (P-values<0.010). Multiple linear regression analysis found that for the entire study population fasting plasma glucose levels was negatively associated with FEV₁, FVC, FEV₁/FVC ratio and maximum voluntary ventilation (P-values<0.030). Patients with T2DM were negatively associated with total lung capacity (P-values=0.025). Multiple linear regression analysis found for patients with T2DM that fasting plasma glucose was negatively associated with FEV₁, FVC, FEV₁/FVC ratio and maximum voluntary ventilation (P-values<0.020). In T2DM patient, height was negatively correlated with FEV₁ and FVC (all P-values<0.020), triglycerides were negatively correlated with FEV₁/FVC ratio (P-values=0.048), and creatinine was negatively correlated with total lung capacity (P-values=0.017).

Conclusions: In summary, T2DM is associated with impaired pulmonary function consistent with obstructive ventilation pattern and fasting plasma glucose is an independent risk factor of reduced pulmonary function.

* The first 2 authors contributed equally to the study.


 
  • References

  • 1 Klein OL, Krishnan JA, Glick S et al. Systematic review of the association between lung function and type 2 diabetes mellitus. Diabet Med 2010; 27: 977-987
  • 2 Chance WW, Rhee C, Yilmaz C et al. Diminished alveolar microvascular reserves in type 2 diabetes reflect systemic microangiopathy. Diabetes care 2008; 31: 1596-1601
  • 3 Marvisi M, Bartolini L, del Borrello P et al. Pulmonary function in non-insulin-dependent diabetes mellitus. Respiration 2001; 68: 268-272
  • 4 Walter RE, Beiser A, Givelber RJ et al. Association between glycemic state and lung function: the Framingham Heart Study. Am J Respir Crit Care Med 2003; 167: 911-916
  • 5 Yeh HC, Punjabi NM, Wang NY et al. Vital capacity as a predictor of incident type 2 diabetes: The atherosclerosis risk in communities study. Diabetes Care 2005; 28: 1472-1479
  • 6 Lange P, Parner J, Schnohr P et al. Copenhagen city heart study: Longitudinal analysis of ventilatory capacity in diabetic and nondiabetic adults. Eur Respir J 2002; 20: 1406-1412
  • 7 Litonjua AA, Lazarus R, Sparrow D et al. Lung function in type 2 diabetes: The normative aging study. Respir Med 2005; 99: 1583-1590
  • 8 Davis TM, Knuiman M, Kendall P et al. Reduced pulmonary function and its associations in type 2 diabetes: The fremantle diabetes study. Diabetes Res Clin Pract 2000; 50: 153-159
  • 9 Lawlor DA, Ebrahim S, Smith GD. Associations of measures of lung function with insulin resistance and type 2 diabetes: Findings from the British women's heart and health study. Diabetologia 2004; 47: 195-203
  • 10 Ford ES, Mannino DM, National H. Nutrition Examination Survey Epidemiologic Follow-up S . Prospective association between lung function and the incidence of diabetes: Findings from the national health and nutrition examination survey epidemiologic follow-up study. Diabetes Care 2004; 27: 2966-2970
  • 11 Engstrom G, Hedblad B, Nilsson P et al. Lung function, insulin resistance and incidence of cardiovascular disease: A longitudinal cohort study. J Intern Med 2003; 253: 574-581
  • 12 Lecube A, Sampol G, Munoz X et al. Type 2 diabetes impairs pulmonary function in morbidly obese women: A case-control study. Diabetologia 2010; 53: 1210-1216
  • 13 Davis WA, Knuiman M, Kendall P et al. Fremantle Diabetes S . Glycemic exposure is associated with reduced pulmonary function in type 2 diabetes: The fremantle diabetes study. Diabetes Care 2004; 27: 752-757
  • 14 Niranjan V, McBrayer DG, Ramirez LC et al. Glycemic control and cardiopulmonary function in patients with insulin-dependent diabetes mellitus. Am J Med 1997; 103: 504-513
  • 15 Benbassat CA, Stern E, Kramer M et al. Pulmonary function in patients with diabetes mellitus. Am J Med Sci 2001; 322: 127-132
  • 16 McKeever TM, Weston PJ, Hubbard R et al. Lung function and glucose metabolism: An analysis of data from the third national health and nutrition examination survey. Am J Epidemiol 2005; 161: 546-556
  • 17 van den Borst B, Gosker HR, Zeegers MP et al. Pulmonary function in diabetes: A metaanalysis. Chest 2010; 138: 393-406
  • 18 Anadhalakshmi S, Manikandan S, Ganeshkumar P et al. Alveolar gas exchange and pulmonary functions in patients with type II diabetes mellitus. J Clin Diagn Res 2013; 7: 1874-1877
  • 19 Mirrakhimov AE. Chronic obstructive pulmonary disease and glucose metabolism: A bitter sweet symphony. Cardiovasc Diabetol 2012; 11: 132
  • 20 Saler T, Cakmak G, Saglam ZA et al. The assessment of pulmonary diffusing capacity in diabetes mellitus with regard to microalbuminuria. Intern Med 2009; 48: 1939-1943
  • 21 Aparna A. Pulmonary function tests in type 2 diabetics and non-diabetic people – a comparative study. J Clin Diagn Res 2013; 7: 1606-1608
  • 22 Shah SH, Sonawane P, Nahar P et al. Pulmonary function tests in type 2 diabetes mellitus and their association with glycemic control and duration of the disease. Lung India 2013; 30: 108-112
  • 23 Pellegrino R, Viegi G, Brusasco V et al. Interpretative strategies for lung function tests. Eur Respir J 2005; 26: 948-968
  • 24 Rosenecker J, Höfler R, Steinkamp G et al. Diabetes mellitus in patients with cystic fibrosis: The impact of diabetes mellitus on pulmonary function and clinical outcome. Eur J Med Res 2001; 6: 345-350
  • 25 Sun Z, Liu L, Liu N et al. Muscular response and adaptation to diabetes mellitus. Front Biosci 2008; 13: 4765-4794
  • 26 Kabitz HJ, Sonntag F, Walker D et al. Diabetic polyneuropathy is associated with respiratory muscle impairment in type 2 diabetes. Diabetologia 2008; 51: 191-197