Abstract
BackgroundInadequate glucose control may be simultaneously associated with inflammation and decreased lung function in type 2 diabetes. We evaluated if lung function is worse in patients with inadequate glucose control, and if inflammatory markers are simultaneously increased in these subjects.MethodsSubjects were selected at the Colombian Diabetes Association Center in Bogotá. Pulmonary function tests were performed and mean residual values were obtained for forced expiratory volume (FEV1), forced vital capacity (FVC) and FEV1/FVC, with predicted values based on those derived by Hankinson et al. for Mexican-Americans. Multiple least-squares regression was used to adjust for differences in known determinants of lung function. We measured blood levels of glycosylated hemoglobin (HBA1c), interleukin 6 (IL-6), tumor necrosis factor (TNF-α), fibrinogen, ferritin, and C-reactive protein (C-RP).Results495 diabetic patients were studied, out of which 352 had inadequate control (HBA1c > 7%). After adjusting for known determinants of lung function, those with inadequate control had lower FEV1 (-75.4 mL, IC95%: -92, -59; P < 0.0001) and FVC (-121 mL, IC95%: -134, -108; P < 0,0001) mean residuals, and higher FEV1/FVC (0.013%, IC95%: 0.009, 0.018, P < 0.0001) residuals than those with adequate control, as well as increased levels of all inflammatory markers (P < 0.05), with the exception of IL-6.ConclusionsSubjects with type 2 diabetes and inadequate control had lower FVC and FEV1 than predicted and than those of subjects with adequate control. It is postulated that poorer pulmonary function may be associated with increased levels of inflammatory mediators.
Highlights
Inadequate glucose control may be simultaneously associated with inflammation and decreased lung function in type 2 diabetes
It is likely that persistent inadequate glucose control over time may alter regulation of inflammatory pathways that are involved in the impairment of lung function [2,6]. It is still unknown if inadequate glucose control in type 2 diabetes is simultaneously associated with a decrease in lung function and increased systemic levels of inflammatory markers
We compared type 2 diabetes subjects based on their glucose control profile and assessed differences in lung function and blood levels of five known systemic inflammatory markers
Summary
Inadequate glucose control may be simultaneously associated with inflammation and decreased lung function in type 2 diabetes. The first mechanism tends to unify the impairment seen in patients with emphysema with that seen in diabetes and cardiovascular disease; in this context, both type 2 diabetes and chronic lung disease, such as COPD, have been associated with increased levels of. It is still unknown if inadequate glucose control in type 2 diabetes is simultaneously associated with a decrease in lung function and increased systemic levels of inflammatory markers. We compared type 2 diabetes subjects based on their glucose control profile (adequate vs inadequate) and assessed differences in lung function (spirometry) and blood levels of five known systemic inflammatory markers
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