Inadequate glucose control in type 2 diabetes is associated with impaired lung function and systemic inflammation: a cross-sectional study.
BACKGROUND
Inadequate glucose control may be simultaneously associated with inflammation and decreased lung function in type 2 diabetes. We evaluated if lung function is worse in patients with inadequate glucose control, and if inflammatory markers are simultaneously increased in these subjects.


METHODS
Subjects were selected at the Colombian Diabetes Association Center in Bogotá. Pulmonary function tests were performed and mean residual values were obtained for forced expiratory volume (FEV1), forced vital capacity (FVC) and FEV1/FVC, with predicted values based on those derived by Hankinson et al. for Mexican-Americans. Multiple least-squares regression was used to adjust for differences in known determinants of lung function. We measured blood levels of glycosylated hemoglobin (HBA1c), interleukin 6 (IL-6), tumor necrosis factor (TNF-alpha), fibrinogen, ferritin, and C-reactive protein (C-RP).


RESULTS
495 diabetic patients were studied, out of which 352 had inadequate control (HBA1c > 7%). After adjusting for known determinants of lung function, those with inadequate control had lower FEV1 (-75.4 mL, IC95%: -92, -59; P < 0.0001) and FVC (-121 mL, IC95%: -134, -108; P < 0,0001) mean residuals, and higher FEV1/FVC (0.013%, IC95%: 0.009, 0.018, P < 0.0001) residuals than those with adequate control, as well as increased levels of all inflammatory markers (P < 0.05), with the exception of IL-6.


CONCLUSIONS
Subjects with type 2 diabetes and inadequate control had lower FVC and FEV1 than predicted and than those of subjects with adequate control. It is postulated that poorer pulmonary function may be associated with increased levels of inflammatory mediators.
Dennis
Rodolfo J
RJ
Department of Research, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia. rdennis@cardioinfantil.org
Maldonado
Dario
D
Rojas
Maria X
MX
Aschner
Pablo
P
Rondón
Martin
M
Charry
Laura
L
Casas
Alejandro
A
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000276:immunology / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000276:immunology / Q000378:metabolism; D005260:Female; D005293:Ferritins / Q000097:blood; D005340:Fibrinogen / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000276:immunology / Q000378:metabolism; D007249:Inflammation / Q000150:complications / Q000276:immunology / Q000378:metabolism; D015850:Interleukin-6 / Q000097:blood; D008171:Lung Diseases / Q000150:complications / Q000276:immunology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015415:Biomarkers; D001786:Blood Glucose; D002097:C-Reactive Protein; D005293:Ferritins; D005340:Fibrinogen; D006442:Glycated Hemoglobin; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; C508600:IL6 protein, human; C517652:hemoglobin A1c protein, human