Cross-sectional and prospective study of lung function in adults with type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) study.
OBJECTIVE
The aim of this study was to test the hypothesis that diabetes is independently associated with reduced lung function, both cross-sectionally and longitudinally.


METHODS
We conducted cross-sectional and prospective analyses of diabetes status and lung function decline using baseline and 3-year follow-up data on 1,100 diabetic and 10,162 nondiabetic middle-aged adults from the Atherosclerosis Risk in Communities (ARIC) Study. Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV(1)) were measured at baseline and at the 3-year follow-up using standard spirometry.


RESULTS
At baseline, adults with diabetes had significantly lower predicted FVC (96 vs. 103%, P < 0.001) and predicted FEV(1) (92 vs. 96%, P < 0.001) than those without diabetes. These differences remained significant after adjustment for demographic characteristics, adiposity, smoking, physical activity index, education, and ARIC field center. Graded, inverse associations were observed between hyperglycemia, diabetes severity (i.e., duration of diabetes and types of antidiabetes medications), and FVC and FEV(1) (all P(trend) < 0.001). In prospective analyses, FVC declined faster in diabetic adults than in their nondiabetic counterparts (64 vs. 58 ml/year, P = 0.01). Diabetes severity as indicated by intensity of antidiabetic treatment also showed graded relationships with the rate of FVC decline (P < 0.01).


CONCLUSIONS
These data support the notion that the lung is a target organ for diabetic injury. Additional research is required to identify pathophysiologic mechanisms and to determine clinical significance.
Department of Epidemiology, The Johns Hopkins University, Baltimore, Maryland 21205, USA.
Hsin-Chieh
HC
Yeh
Naresh M
NM
Punjabi
Nae-Yuh
NY
Wang
James S
JS
Pankow
Bruce B
BB
Duncan
Christopher E
CE
Cox
Elizabeth
E
Selvin
Frederick L
FL
Brancati
D050197:Atherosclerosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000453:epidemiology*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012129:Respiratory Function Tests; D012307:Risk Factors; D014797:Vital Capacity