Abstract
BackgroundThe association between impaired lung function and diabetes risk has been established in the past, however the temporal and causal relationships between the two remain unclear. We assessed the relationship between baseline FEV1 and FVC and risk of incident diabetes at different time intervals for participants in the Malmö Preventive Project cohort.MethodsBaseline lung function was assessed in 20,295 men and 7416 women during 1974–1992; mean age 43.4 ± 6.6 and 47.6 ± 7.8, respectively. Sex-specific quartiles of FEV1%predicted and FVC%predicted were created (Q4 = highest; reference). Follow-up time was divided into 10-year time intervals from baseline examination. Cox proportional hazards regression was used to assess the incidence of diabetes according to quartiles of FEV1 and FVC%predicted, after adjustments for baseline glucose and potential confounding factors.ResultsOver 37-years’ follow-up there were 3753 and 993 incident diabetes events in men and women, respectively. When comparing FEV1%predicted in men (Q1 vs. Q4), the HR for diabetes was 1.64 (1.21–2.22) for events <10 years after baseline, 1.52 (1.27–1.81) for events 10–20 years after baseline, 1.39 (1.22–1.59) for events 20–30 years after baseline, and 1.46 (1.08–1.97) for events occurring >30 years after baseline. A broadly similar pattern was seen for FVC%predicted and for women.ConclusionsLow FEV1 precedes and significantly predicts future diabetes. This risk is still significant many years after the baseline FEV1 measurement in middle-aged men. These results suggest that there is a relationship between impaired lung function and diabetes risk beyond the effects of hyperglycemia on lung function.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-016-0227-z) contains supplementary material, which is available to authorized users.
Highlights
The association between impaired lung function and diabetes risk has been established in the past, the temporal and causal relationships between the two remain unclear
Cross-sectional studies have found that patients with diabetes tend to have poorer lung function than non-diabetics [2,3,4,5,6], the temporality of a causal relationship has remained controversial in longitudinal studies
We aim to do this by firstly establishing if poor lung function (as defined by low %predicted forced expiratory volume in one second (FEV1) or forced vital capacity (FVC)) is a predictor of future diabetes and secondly if so, how long time-wise from the baseline lung function measurement this risk can be observed
Summary
The association between impaired lung function and diabetes risk has been established in the past, the temporal and causal relationships between the two remain unclear. We assessed the relationship between baseline FEV1 and FVC and risk of incident diabetes at different time intervals for participants in the Malmö Preventive Project cohort. The aim of the present longitudinal cohort study is to add clarity to the temporal relationship between poor lung function and diabetes in a prospective study from the general population. We aim to do this by firstly establishing if poor lung function (as defined by low %predicted forced expiratory volume in one second (FEV1) or FVC) is a predictor of future diabetes and secondly if so, how long time-wise from the baseline lung function measurement this risk can be observed. As systemic inflammation is often thought to be a common factor that links both poor lung function and diabetes, we aim to analyse if the relationship is affected by various inflammatory factors
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