Is There any Correlation Between Pulmonary and Coronary Involvement in Diabetic Patients?

Mahmoud Parham; Mohammad Aghaali; Seyed Hassan Adeli; Ahmad Reza Bagheri; Masoud Sadeghi; Akram Asghari

doi:10.5812/ijem-160600

Is There any Correlation Between Pulmonary and Coronary Involvement in Diabetic Patients?

Int J Endocrinol Metab. 2025 Jul 31;23(3):e160600. doi: 10.5812/ijem-160600.

Authors

Mahmoud Parham¹, Mohammad Aghaali², Seyed Hassan Adeli¹, Ahmad Reza Bagheri³, Masoud Sadeghi¹, Akram Asghari¹

Affiliations

¹ Clinical Research Development Unit, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran.
² Department of Family and Community Medicine, School of Medicine, Qom University of Medical Sciences, Qom, Iran.
³ Department of Cardiology, School of Medicine, Qom University of Medical Sciences, Qom, Iran.

Abstract

Background: Diabetes is a major global health issue, affecting over 8.5% of adults worldwide and significantly increasing the risk of cardiovascular diseases (CVDs). However, the association between diabetes-related macrovascular complications, such as coronary artery disease (CAD), and pulmonary function remains unclear.

Objectives: The present study was designed to investigate the association between obstructive and restrictive lung patterns and the severity of coronary artery involvement.

Methods: A cross-sectional study was conducted at Shahid Beheshti Hospital, Qom, Iran, between April 2019 and August 2021. A total of 211 diabetic patients who underwent coronary angiography (CAG) were selected. They were divided into two groups: Sixty-nine patients in group 1 (non-significant CAD) and 142 patients in group 2 (significant CAD). Spirometry was performed to assess forced expiratory volume (FEV), forced vital capacity (FVC), and FEV/FVC ratio, with values adjusted for age and sex in the two groups.

Results: Among the 211 participants, 142 (67.3%) exhibited significant coronary artery involvement. Comparative analysis revealed no statistically significant differences in spirometric parameters [forced expiratory volume in one second (FEV₁), FVC, FEV₁/FVC ratio] between the groups. Notably, advancing age demonstrated a significant negative correlation with both FEF50% (β = -0.32, P < 0.01) and FVC values (β = -0.28, P < 0.05). Multivariate regression analysis identified inverse relationships between age and peak expiratory flow (PEF; β = -0.41, P < 0.001), HbA1C levels and PEF (β = -0.23, P < 0.05). Additionally, sex emerged as a significant modifier of %FEV₁/FVC (β = 0.19, P < 0.05), with female participants showing lower ratios.

Conclusions: This study failed to find an association between spirometry findings and coronary artery involvement. However, a significant relationship between small airway involvement and glycemic control was observed.

Keywords: Age-Related Changes; Coronary Artery Disease (CAD); Diabetes Mellitus; Macrovascular Complications; Spirometry.