Association of Pulmonary Function Decline over Time with Longitudinal Change of Glycated Hemoglobin in Participants without Diabetes Mellitus.

Wen-Hsien Lee,Chao-Hung Kuo,Ying-Chih Chen,Da-Wei Wu,Chih-Hsing Hung,Yi-Hsueh Liu,Wei-Sheng Liao,Szu-Chia Chen,Ho-Ming Su

doi:10.3390/jpm11100994

Abstract

Pulmonary damage and function impairment were frequently noted in patients with diabetes mellitus (DM). However, the relationship between lung function and glycemic status in non-DM subjects was not well-known. Here, we evaluated the association of longitudinal changes of lung function parameters with longitudinal changes of glycated hemoglobin (HbA1c) in non-DM participants. The study enrolled participants without prior type 2 DM, hypertension, and chronic obstructive pulmonary disease (COPD) from the Taiwan Biobank database. Laboratory profiles and pulmonary function parameters, including forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), were examined at baseline and follow-up. Finally, 7055 participants were selected in this study. During a mean 3.9-year follow-up, FVC and FEV1 were significantly decreased over time (both p < 0.001). In the multivariable analysis, the baseline (unstandardized coefficient β = −0.032, p < 0.001) and longitudinal change (unstandardized coefficient β = −0.025, p = 0.026) of FVC were negatively associated with the baseline and longitudinal change of HbA1c, respectively. Additionally, the longitudinal change of FVC was negatively associated with the risk of newly diagnosed type 2 DM (p = 0.018). During a mean 3.9-year follow-up, our present study, including participants without type 2 DM, hypertension, and COPD, demonstrated that the baseline and longitudinal change of FVC were negatively and respectively correlated with the baseline and longitudinal change of HbA1c. Furthermore, compared to those without new-onset DM, participants with new-onset DM had a more pronounced decline of FVC over time.

Highlights

Type 2 Diabetes mellitus (DM) is a globally common disease and a major risk factor of cardiovascular mortality and morbidity [1]
Micro-vascular and macro-vascular complications in particular organs and tissues, such as heart, kidney, and retina, are well established in patients with type 2 DM [2]. The lung is another target of organ damage of DM, and pulmonary function decline is frequently noted in patients with type 2 DM [3]
Compared to the baseline variables, age, systolic blood pressure, body mass index, fasting blood glucose, HbA1c, total cholesterol, triglyceride, forced vital capacity (FVC)-predicted, FVE1-predicted, and FVE1/FVC were significantly increased and FVC and forced expiratory volume in 1 s (FEV1) were significantly decreased at follow-up

Summary

Introduction

Type 2 Diabetes mellitus (DM) is a globally common disease and a major risk factor of cardiovascular mortality and morbidity [1]. Micro-vascular and macro-vascular complications in particular organs and tissues, such as heart, kidney, and retina, are well established in patients with type 2 DM [2]. The lung is another target of organ damage of DM, and pulmonary function decline is frequently noted in patients with type 2 DM [3]. Hyperglycemia is associated with pulmonary functional damage in type 2 diabetic patients with chronic obstructive pulmonary disease (COPD) and asthma [4,5,6]. Anti-glycemic control in patients with type 2 DM can improve their pulmonary function [9]

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Discussion

Conclusion