Abstract
Diabetes mellitus is a systematic metabolic disease characterized by persistent hyperglycemia, which complications often involve multiple organs and systems including vessels, kidneys, retinas, and nervous system. Idiopathic pulmonary fibrosis is a chronic, progressive, fibrotic disease with usual interstitial pneumonia patterns. With in-depth research, diabetic related lung injury has been confirmed, and the lung is also considered as one of the targeted organs of diabetes, which mainly manifests as the pulmonary fibrosis. Based on that, this review discusses the association between diabetes mellitus and idiopathic pulmonary fibrosis from clinical findings to possible mechanisms.
Highlights
Idiopathic pulmonary fibrosis (IPF) is defined as a chronic, progressive, fibrosing interstitial lung disease with the histologic appearance of usual interstitial pneumonia (UIP) [1]
Recent epidemiological research in populations with different genetic background are more prone to the opinion that diabetes is an independent risk factor for idiopathic pulmonary fibrosis, with the prevalence of IPF accompanied by Diabetes mellitus (DM) estimated to be 10∼42%, and the reported result is still consistent even if excluding the interference of patients treated with glucocorticoids [12,13,14,15,16,17,18]
Since the collagen is the main component of basal lamina, increasing thickness of basal lamina may be the microscopic appearance of idiopathic pulmonary fibrosis [30], and as a result, the pathological changes mentioned above further strengthen the link between diabetes and idiopathic pulmonary fibrosis
Summary
Idiopathic pulmonary fibrosis (IPF) is defined as a chronic, progressive, fibrosing interstitial lung disease with the histologic appearance of usual interstitial pneumonia (UIP) [1]. Diabetes mellitus (DM) is a systemic, metabolic disorder characterized by insulin deficiency or resistance, chronic hyperglycemia, and micro- and macro-vascular bed damage. The lung consists of abundant alveolar-capillary network and connective tissue, suggesting that it may be targeted by diabetic micro-vascular damage. Several studies have revealed that hyperglycemia could lead to interstitial fibrotic changes and alveolar microangiopathy [7,8,9,10]. We review the present clinical and experimental evidence, aiming to explore the role of diabetes on idiopathic pulmonary fibrosis (Table 1)
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