Lung function measurements in the prediabetes stage: data from the ILERVAS Project

Acta Diabetol. 2019 Sep;56(9):1005-1012. doi: 10.1007/s00592-019-01333-6. Epub 2019 Apr 15.

Abstract

Aims: Patients with type 2 diabetes have been considered a susceptible group for pulmonary dysfunction. Our aim was to assess pulmonary function on the prediabetes stage.

Methods: Pulmonary function was assessed in 4,459 non-diabetic subjects, aged between 45 and 70 years, without cardiovascular disease or chronic pulmonary obstructive disease from the ongoing study ILERVAS. A "restrictive spirometric pattern", an "abnormal FEV1" and an "obstructive ventilatory defect" were assessed. Prediabetes was defined by glycosylated hemoglobin (HbA1c) between 5.7 and 6.4% according to the American Diabetes Association criteria.

Results: Population was composed of 52.1% women, aged 57 [53;63] years, a BMI of 28.6 [25.8;31.8] kg/m2, and with a prevalence of prediabetes of 29.9% (n = 1392). Subjects with prediabetes had lower forced vital capacity (FVC: 93 [82;105] vs. 96 [84;106], p < 0.001) and lower forced expired volume in the first second (FEV1: 94 [82;107] vs. 96 [84;108], p = 0.011), as well as a higher percentage of the restrictive spirometric pattern (16.5% vs. 13.6%, p = 0.015) and FEV1 < 80% (20.3% vs. 17.2%, p = 0.017) compared to non-prediabetes group. In the prediabetes group, HbA1c was negatively correlated with both pulmonary parameters (FVC: r = - 0.113, p < 0.001; FEV1: r = - 0.079, p = 0.003). The multivariable logistic regression model in the whole population showed that there was a significant and independent association between HbA1c with both restrictive spirometric pattern [OR = 1.42 (1.10-1.83), p = 0.008] and FEV1 < 80% [OR = 1.50 (1.19-1.90), p = 0.001].

Conclusions: The deleterious effect of type 2 diabetes on pulmonary function appears to be initiated in prediabetes, and it is related to metabolic control. TRIAL REGISTRATION CLINICALTRIALS.GOV: NCT03228459.

Keywords: Forced expiratory volume in the first second; Forced vital capacity; Prediabetes; Pulmonary dysfunction; Restrictive spirometric pattern.

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / physiopathology
  • Female
  • Forced Expiratory Volume
  • Glycated Hemoglobin A / analysis
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Lung / diagnostic imaging
  • Lung / physiopathology*
  • Male
  • Middle Aged
  • Prediabetic State / blood
  • Prediabetic State / diagnosis
  • Prediabetic State / epidemiology
  • Prediabetic State / physiopathology*
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Respiration Disorders / complications
  • Respiration Disorders / diagnosis*
  • Respiration Disorders / epidemiology
  • Respiratory Function Tests
  • Spirometry
  • Vital Capacity

Substances

  • Glycated Hemoglobin A

Associated data

  • ClinicalTrials.gov/NCT03228459