Abstract
The main objectives of this study were to assess the early changes in pulmonary function and intrarenal haemodynamics and to determine the correlation between pulmonary function and intrarenal haemodynamics in patients with type 2 diabetes mellitus (T2DM). 96 patients with T2DM (diabetes group) without diabetes kidney disease (DKD) and 33 healthy subjects (control group) were enrolled in studies intended to assess the early changes in pulmonary function and intrarenal haemodynamics associated with diabetes, as well as to determine the correlation between pulmonary function and intrarenal haemodynamics. Pulmonary functional parameters were negatively correlated with HbA1c levels and diabetes duration (P< 0.05). Moreover, renal functional parameters were positively correlated with HbA1c levels and diabetes duration (P<0.05). Additionally, pulmonary functional parameters were negatively correlated with renal functional parameters (P<0.05). Multiple linear regression analysis of the relationship between pulmonary functional parameters and the bilateral kidney arterial resistivity index (RI) showed that all the pulmonary functional parameters were significantly correlated with the arterial RI (P< 0.05). Patients displayed changes in pulmonary function and intrarenal haemodynamics during the preclinical stages of DKD. Regulating glycaemia may improve intrarenal haemodynamics in the bilateral interlobular renal arteries. Moreover, during the preclinical stages of DKD, the right kidney RI is a effective predictor of early changes in pulmonary function in adult T2DM patients. ClinicalTrials.gov (NCT02798198); registered 8 June 2016.
Highlights
The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide, in Asian countries [1]
Pulmonary functional parameters were negatively correlated with glycosylated hemoglobinA1c (HbA1c) levels and diabetes duration (P< 0.05)
During the preclinical stages of diabetes kidney disease (DKD), the right kidney resistivity index (RI) is a effective predictor of early changes in pulmonary function in adult T2DM patients
Summary
The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide, in Asian countries [1]. Hyperglycaemia-induced pulmonary vascular injury is a complication of T2DM that has been overlooked by researchers attempting to devise treatments for the numerous complications associated with the disease [6]. Colour doppler ultrasound (CDU), a modality that is widely used in a variety of medical fields, evaluates blood flow velocity based on shifts in Doppler signals [7]. Patients with hyperglycaemia and uncontrolled blood pressure have significantly increased blood flow compared to patients with systemic hypertension without diabetes [8]. The Doppler resistivity index (RI) [peak systolic velocity (PSV) − end-diastolic velocity (PED)/PSV] that reflects intrarenal vascular resistance has been widely used to quantify the alterations in renal blood flow that may develop in renal disease [9]
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