Abstract
Lung function is often impaired in diabetic patients, especially in a restrictive pattern, which has recently been described as the diabetic lung. Since hypertension (HTN) is common in diabetic patients, our study investigated whether HTN acts as an aggravating factor in diabetic lung. Within the cross-sectional study from the 6th Korean National Health and Nutrition Examination Survey (KNHANES), fasting plasma glucose (FPG), blood pressure (BP), pulmonary function, and laboratory data were examined in 4644 subjects aged between 40 and 79 years. A multivariate regression model was used to investigate the relationship between BP, FPG, and pulmonary function. Lung function was significantly reduced in the HTN (p = 0.001), impaired fasting glucose (IFG) (p < 0.001), and diabetes mellitus (DM) (p < 0.001) groups. Next, a multivariate logistic regression model was used to derive the odds ratio (OR) of reduced lung function based on the presence of IFG, DM, and HTN. The OR of reduced forced vital capacity (FVCp < 80%) was 3.30 (p < 0.001) in the HTN-DM group and 2.30 (p < 0.001) in the normal BP-DM group, when compared with the normal BP-normal FPG group. The combination of HTN and DM had the strongest negative effect on FVC. The results presented in this study indicate that diabetes and hypertension have a synergistic association with impaired lung function.
Highlights
Over the past few decades, many researchers have revealed that diabetes impairs pulmonary function in a restrictive pattern—known as the diabetic lung [1,2,3,4]
systolic BP (SBP) was significantly lower in the nondiabetes group than in the diabetes group
The odds ratio (OR) of restrictive lung disease (FVCp < 80%) was 3.30 in the hypertension and diabetes group and 2.30 in the normal blood pressure (BP) and diabetes group
Summary
Over the past few decades, many researchers have revealed that diabetes impairs pulmonary function in a restrictive pattern—known as the diabetic lung [1,2,3,4]. Glycation of collagen and elastin of lung tissue cause stiffening of the parenchyma [6]. Abnormal regulation of inflammatory mechanisms could cause exaggerated inflammatory responses in the lung, resulting in impaired lung function [7]. Since the Framingham study found an inverse relationship between forced vital capacity (FVC) and cardiovascular diseases in 1983 [8], several studies consistently showed an association between hypertension and impaired pulmonary function [9,10]. Some studies even revealed that the coexistence of hypertension and reduced lung function was associated with a higher mortality
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