Abstract
To assess the variations in pulmonary function and vascular endothelial function in their early stages (without related complications). A total of 162 type 2 diabetes mellitus (T2DM) patients without diabetes complications and 55 healthy people were selected, comprising the T2DM group and the control group, respectively, to evaluate changes in vascular endothelial function and lung function and determine the correlation between them. In this study, the T2DM group exhibited significantly lower pulmonary function than that of the control group (P < 0.05). The T2DM group also showed significantly lower flow-mediated dilation (FMD) and nitric oxide (NO) (P < 0.05) than those of the control group. Pulmonary functional indexes correlated positively with FMD and NO (P < 0.05) and correlated negatively with endothelin-1 (ET-1) (P < 0.05). FMD and NO correlated negatively with diabetes duration/HbA1c (P < 0.05), whereas ET-1 correlated positively with glycosylated hemoglobinA1c (HbA1c)/diabetes duration (P < 0.05). Pulmonary functional indexes negatively correlated with HbA1c/diabetes duration (P < 0.05). Multiple linear regression was used to analyze the relationship between vascular endothelial function indexes (FMD, ET-1, and NO) and pulmonary functional indexes. The results indicated that each vascular endothelial function index (FMD, ET-1, and NO) was significantly correlated with the pulmonary functional index (P < 0.05). The patients with T2DM presented changes in the subclinical vascular endothelial and pulmonary function. They also had impaired vascular endothelial functions, which were characterized by reduced vascular endothelial function relative to those of healthy people. Regulating glycemia may improve vascular endothelial and pulmonary functions. Moreover, microvascular lesions in preclinical stages, vascular endothelial function indexes (FMD, ET-1, and NO) were valid predictors of alterations in pulmonary function in T2DM patients without related complications.Clinical Trial Registration ClinicalTrials.gov, identifier NCT03575988.
Highlights
Type 2 diabetes mellitus (T2DM) is one of the most common chronic diseases worldwide
A total of 180 T2DM patients without related complications were recruited as the diabetes group, and 60 healthy subjects were recruited as the control group
The diabetes group consisted of 162 T2DM subjects (86 males and 76 females) with a mean diabetes duration of 8.03 ± 1.95 y, whereas the control group consisted of 55 subjects (30 males and 25 females) (Figure 1)
Summary
Type 2 diabetes mellitus (T2DM) is one of the most common chronic diseases worldwide. As a metabolic disorder (characterized by a relative lack of insulin), the prevalence of T2DM has increased worldwide, in developing countries [1]. The International Diabetes Federation estimates that by 2045, the prevalence of diabetes mellitus will increase to 693 million globally [2]. Disabilities related to diabetes mellitus have grown substantially over the past decades. T2DM markedly increases the risk for acute and chronic atherosclerotic cardiovascular disease (CVD) despite adequate glycemic control. T2DM is an independent risk factor for microvascular lesions (such as diabetes retinopathy [DR] and diabetic nephropathy [DN]) and cardiovascular disease [3, 4]
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