title: Association between lung capacity and abnormal glucose metabolism: findings from China and Australia.
abstract: Restricted pulmonary function is found among people with diabetes. This study aimed to investigate the dose-response relationship between pulmonary function measurements [forced expiratory volume in one second (FEV1) and forced vital capacity (FVC)] and risk of metabolic syndrome (MS)/type 2 diabetes.
  
  
  
  A total of 1454 adults in rural Victoria, Australia, and 5824 adults in Nanjing, China, from randomly selected households provided clinical history, oral glucose tolerance test, lipids, anthropometric, blood pressure and spirometric measurements. MS was defined by International Diabetes Federation criteria. Adjusted odds ratios for MS and type 2 diabetes with lung capacity measurements were estimated using logistic regression. Dose-response relationships were explored using the restricted cubic spline models.
  
  
  
  There was a nonlinear relationship between FEV1 and the risk of type 2 diabetes and MS (both P < 0·0001) in both the Australian and Chinese populations. The FEV1 associated with the lowest risk of type 2 diabetes and MS was above 2·70 l (95%CI: 2·68 to 2·72 l and 2·65 to 2·76 l in Chinese and Australian populations, respectively). The discrimination of the model could be significantly improved using the FEV1 threshold in both the Australian and Chinese populations.
  
  
  
  In both the Australian and Chinese populations, the risk of type 2 diabetes and MS is lowest with a FEV1 of 2·65-2·76 l. This might be used in clinical practice in different countries as a prompt to screen for type 2 diabetes and MS in patients with obstructive lung disease and to ensure there was no abnormal glucose metabolism before the commencement of steroids if indicated.
authors.affiliation: Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.|Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK.
authors.forename: Dahai
authors.initials: D
authors.lastname: Yu
authors.affiliation: Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.|Division of Health and Social Care, King College London, London, UK.
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.affiliation: Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Qin
authors.affiliation: Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.
authors.forename: Yamei
authors.initials: Y
authors.lastname: Cai
authors.affiliation: Jiangsu Province People's Hospital, Nanjing, China.
authors.forename: Zhixin
authors.initials: Z
authors.lastname: Jiang
authors.affiliation: Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.
authors.forename: Zhanzheng
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: Western Sydney University, Campbelltown, Sydney, NSW, Australia.|Department of Rural Health, University of Melbourne, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Simmons
mesh_terms: D000328:Adult; D000367:Age Factors; D001315:Australia; D002681:China; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008176:Lung Volume Measurements; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000503:physiopathology*; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D014797:Vital Capacity
chemical_list: D005947:Glucose