title: Association of restrictive ventilatory dysfunction with the development of prediabetes and type 2 diabetes in Koreans.
abstract: OBJECTIVE
  This study was performed to investigate whether ventilatory dysfunction is a predictor for the development of prediabetes and type 2 diabetes in Koreans.
  
  
  METHODS
  We analyzed the clinical and laboratory data of 16,195 Korean adults (age 20-79 years) who underwent routine medical checkups with a mean 4.7-years (range 3.0-5.9 years) interval. Spirometry results were categorized into three patterns: normal, obstructive ventilatory dysfunction [OVD; forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <0.70], and restrictive ventilatory dysfunction (RVD; FVC < 80 % predicted, FEV1/FVC ≥ 0.70).
  
  
  RESULTS
  Compared with subjects with normal ventilatory function, subjects with RVD had a higher incidence of type 2 diabetes (3.7 vs. 6.3 %; P < 0.001), whereas subjects with OVD did not (3.7 vs. 4.8 %; P = 0.119). On multivariate logistic regression analysis, the odds ratio (OR) of RVD for type 2 diabetes was significantly increased after adjusting for age, sex, and lifestyle factors (1.40; 95 % CI 1.10-1.78). However, further adjustment for body mass index (BMI), waist circumference, and baseline glucose level attenuated the OR to become insignificant (1.12; 95 % CI 0.86-1.47). Among the 9,461 participants who had normal fasting glucose and HbA1c levels at baseline, the OR for progression to prediabetes or diabetes in the RVD group was significantly increased (1.30; 95 % CI 1.12-1.51). The increased OR remained significant after adjusting for BMI, waist circumference, and baseline glucose level (1.26; 95 % CI 1.07-1.47).
  
  
  CONCLUSIONS
  Our results indicate that restrictive, but not obstructive ventilatory dysfunction, is independently associated with development of prediabetes and precedes the development of type 2 diabetes.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, South Korea.
authors.forename: Chul-Hee
authors.initials: CH
authors.lastname: Kim
authors.forename: Hong-Kyu
authors.initials: HK
authors.lastname: Kim
authors.forename: Eun-Hee
authors.initials: EH
authors.lastname: Kim
authors.forename: Sung-Jin
authors.initials: SJ
authors.lastname: Bae
authors.forename: Young-Ju
authors.initials: YJ
authors.lastname: Jung
authors.forename: Jaewon
authors.initials: J
authors.lastname: Choi
authors.forename: Joong-Yeol
authors.initials: JY
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000473:pathology / Q000503:physiopathology*; D012123:Pulmonary Ventilation; D056910:Republic of Korea; D012189:Retrospective Studies; D013147:Spirometry; D055815:Young Adult