Abstract
BackgroundAn impairment of CO diffusing capacity has been shown in diabetic patients without lung disease. We analyzed how diffusing capacity in patients with COPD is affected by the concurrent diagnosis of diabetes.MethodsData from the initial visit of the German COPD cohort COSYCONET were used for analysis. 2575 patients with complete lung function data were included, among them 358 defined as diabetics with a reported physician diagnosis of diabetes and/or specific medication. Pairwise comparisons between groups and multivariate regression models were used to identify variables predicting the CO transfer factor (TLCO%pred) and the transfer coefficient (KCO%pred).ResultsCOPD patients with diabetes differed from those without diabetes regarding lung function, anthropometric, clinical and laboratory parameters. Moreover, gender was an important covariate. After correction for lung function, gender and body mass index (BMI), TLCO%pred did not significantly differ between patients with and without diabetes. The results for the transfer coefficient KCO were similar, demonstrating an important role of the confounding factors RV%pred, TLC%pred, ITGV%pred, FEV1%pred, FEV1/FVC, age, packyears, creatinine and BMI. There was not even a tendency towards lower values in diabetes.ConclusionThe analysis of data from a COPD cohort showed no significant differences of CO transport parameters between COPD patients with and without diabetes, if BMI, gender and the reduction in lung volumes were taken into account. This result is in contrast to observations in lung-healthy subjects with diabetes and raises the question which factors, among them potential anti-inflammatory effects of anti-diabetes medication are responsible for this finding.
Highlights
An impairment of carbon monoxide (CO) diffusing capacity has been shown in diabetic patients without lung disease
The analysis of data from a large chronic obstructive pulmonary disease (COPD) cohort showed that there was no significant difference of CO transport parameters, especially CO transfer factor (TLCO)%pred and CO transfer coefficient (KCO)%pred, between patients with COPD and diabetes compared to non-diabetes COPD patients, provided that lung volumes, body mass index (BMI) and gender were taken into account as confounders
The analysis of data from a large COPD cohort showed that the transfer factor TLCO in terms of %predicted did not significantly differ between patients with and without diabetes, if other differences, especially those of lung function and body weight, were taken into account
Summary
An impairment of CO diffusing capacity has been shown in diabetic patients without lung disease. Kahnert et al Respiratory Research (2017) 18:14 hand, patients with diabetes without known lung disease may show a decreased CO diffusing capacity [5, 6], and impairment of pulmonary function in type I diabetes patients treated with insulin was linked to the quality of metabolic control [7]. In patients with COPD and diabetes only studies on spirometry are available [8], whereas the CO transfer factor has been measured only in diabetic patients without COPD. These considerations suggest a link between diabetes, emphysema and reduced diffusing capacity, but diabetes has been associated with predominant airway obstruction [9] which would imply a higher but not lower CO diffusing capacity relative to obstruction
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