Abstract
Background - Reduced lung function in diabetes has been described for long but its clinical importance is not yet clear. Also, limited literature is available regarding its association with sugar control, and its correlation with inflammatory markers. Thus, we aimed to study the pulmonary function test abnormalities and systemic inflammation in type 2 diabetes mellitus. Methods 100 patients of type 2 diabetes were divided into two groups depending on control of diabetes (group A-HbA1C≤7% and group B-HbA1C >7%). All the subjects selected underwent detailed evaluation including testing for HbA1C, HsCRP (high-sensitivity C-reactive protein), serum ferritin and serum fibrinogen, along with pulmonary function testing. Results Percentage predicted FVC (forced vital capacity), FEV1 (forced expiratory volume in 1 second) and SVC (slow vital capacity) were significantly reduced, while mean values of inflammatory markers [fibrinogen (p <0.001) and hsCRP (p 0.002)] were significantly higher in uncontrolled diabetes group. There was a significant negative correlation between FEV1 (r = -0.739, p<0.001), FVC ( r = -0.370, p<0.001), SVC (r = -0.635, p< 0.001) with HbA1C. HbA1C had a positive correlation with hsCRP (r = -0.308, p 0.002) and fibrinogen (r = 0.388 ,p 0.001). Conclusion Pulmonary functions were decreased and inflammatory markers like hsCRP, fibrinogen, and ferritin significantly increased in uncontrolled diabetics. Also, a potential association was seen between higher values of inflammatory markers like hsCRP and fibrinogen and decrease in lung function. This information, requiring confirmation with larger multicentre studies, remains important because of potential epidemiological, clinical and therapeutic implications.
Highlights
Reduced lung function in diabetes has been described for long but its clinical importance is not yet clear
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 [5]
On correlating pulmonary functions with glycemic control we found that there was a negative correlation between Forced expiratory volume in 1 second (FEV1) (r = –0.739, p < 0.001), FVC (r= –0.370, p < 0.001) and SVC (r= –0.635, p
Summary
Reduced lung function in diabetes has been described for long but its clinical importance is not yet clear. Results: Percentage predicted FVC (forced vital capacity), FEV1 (forced expiratory volume in 1 second) and SVC (slow vital capacity) were significantly reduced, while mean values of inflammatory markers [fibrinogen (p < 0.001) and hsCRP (p < 0.002)] were significantly higher in uncontrolled diabetes group. Conclusion: Pulmonary functions were decreased and inflammatory markers like hsCRP, fibrinogen, and ferritin significantly increased in uncontrolled diabetics. A potential association was seen between higher values of inflammatory markers like hsCRP and fibrinogen and decrease in lung function. This information, requiring confirmation with larger multicentre studies, remains important because of potential epidemiological, clinical and therapeutic implications. Microvascular and macrovascular complications are the important cause of morbidity affecting various organ systems in diabetic patients. 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 [5]
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