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Diabetes associated with restricted lung function impairment

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January 9, 2018

Middle-aged and older adults with diabetes are 1.6 times more likely to develop restrictive lung function impairment over 5 years vs. those without diabetes, independent of baseline lung function, according to findings published in Metabolism.

“A meta-analysis of cross-sectional studies demonstrated that individuals with diabetes have lower forced vital capacity (FVC) than those without diabetes,” Nao Sonoda, of the department of mathematical health science at Osaka University Graduate School of Medicine, Japan, and colleagues wrote in the study background. “However, there are a few prospective studies that have investigated restrictive lung function in individuals with and without diabetes. Furthermore, their findings have been inconsistent.”

In a prospective study, Sonoda and colleagues analyzed data from 7,524 adults aged 40 to 69 years without lung function impairment at baseline who underwent a 1- or 2-day medical exam between April 2008 and March 2009, including measurements of fasting plasma glucose and HbA1c. Restrictive and obstructive lung function impairment were defined as FVC less than 80% predicted and forced expiratory volume in 1 second (FEV1) to FVC ratio (FEV1/FVC) less than 0.7, respectively. Researchers followed patients until they developed restrictive or obstructive lung function impairment or until March 2014, and they used Cox proportional hazards models to estimate HRs for the incidence of restrictive and obstructive lung function impairment in patients with diabetes vs. those without diabetes. Participants were also stratified by presence of abdominal obesity.

Within the cohort, 649 patients (8.6%) were classified as having diabetes.

During a median follow-up of 5 years, 171 patients developed restrictive lung function impairment (30 with diabetes, or 10.9 per 1,000 person-years) and 639 patients developed obstructive lung function impairment (67 with diabetes, or 25.1 per 1,000 person-years). Those with diabetes had a 1.6-fold higher risk for restrictive lung function impairment compared with patients without diabetes (adjusted HR = 1.57; 95% CI, 1.04-2.36). Results persisted after adjustment for sex, age, height, abdominal obesity, smoking status, exercise habits, systolic blood pressure, HDL cholesterol, log-transformed high-sensitivity C-reactive protein and baseline lung function. In further analysis, age and baseline FVC percentage predicted and were associated with restrictive lung function impairment, according to researchers.

In results stratified by age, the risk for restrictive lung function impairment was higher among middle-aged adults with diabetes vs. those without diabetes (aHR = 1.83; 95% CI, 1.02-3.29). The risk for older adults with diabetes was still greater than those without diabetes, but lower than middle-aged adults with diabetes (aHR = 1.3; 95% CI, 0.73-2.33), according to researchers. Researchers did not observe an association between diabetes status and obstructive lung function impairment. – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.