title: Relationship between pulmonary function and elevated glycated hemoglobin levels in health checkups: A cross-sectional observational study in Japanese participants.
abstract: BACKGROUND
  Insulin resistance has been associated with cytokines, including interleukin-6 and tumor necrosis factor alpha soluble receptor, both of which are elevated in chronic obstructive pulmonary disease (COPD). Few studies have investigated the relationship between pulmonary function tests using spirometry (PFT) and fasting plasma glucose (FPG) or glycated hemoglobin (HbA1c) levels in Japanese participants. The purpose of this study was to clarify the relationship between PFT in Japanese people who had health checkups and their FPG or HbA1clevels. In the context of preventative medicine, we intend to connect early detection of COPD to an index of blood sugar.
  
  
  METHODS
  From August 2013 through March 2014, 1019 participants underwent health checkups. PFT, FPG, and HbA1cmeasurements were conducted. HbA1clevels were measured according to National Glycohemoglobin Standardization Program guidelines.
  
  
  RESULTS
  Participants with FPG ≥100 mg/dL and HbA1c≥5.6% showed a significantly lower forced expiratory volume in 1 s:forced vital capacity ratio (FEV1/FVC) compared to participants with lower FPG and Hb1Ac levels. Prevalence of FEV1/FVC values <70% in PFT differed significantly depending on sex, age, body mass index, FPG, HbA1c, and smoking habits. Age (≥60 years), HbA1c(≥5.6%), and current or former smoking were associated with FEV1/FVC values <70%.
  
  
  CONCLUSIONS
  In Japan, HbA1clevels were higher in participants with FEV1/FVC values <70% in PFT than in those with FEV1/FVC ≥70%. In preventive medicine, PFT by spirometry should be performed in elderly participants with elevated HbA1clevels who are current or former smokers.
authors.affiliation: International University of Health and Welfare, Department of Nursing, Fukuoka, Japan. Electronic address: saigo@iuhw.ac.jp.
authors.forename: Saigo
authors.initials: S
authors.lastname: Baba
authors.affiliation: International University of Health and Welfare, Department of Nursing, Fukuoka, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Takashima
authors.affiliation: Japan Community Health Care Organization (JCHO), Saga Central Hospital Health Administration Center, Saga, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Hirota
authors.affiliation: Japan Community Health Care Organization (JCHO), Saga Central Hospital, Saga, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Kawashima
authors.affiliation: Mobility Research Laboratory, Center for Comprehensive and Community Medicine, Graduate School of Medicine, Saga University, Saga, Japan.
authors.forename: Etsuo
authors.initials: E
authors.lastname: Horikawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D005215:Fasting / Q000097:blood; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology*; D012907:Smoking / Q000453:epidemiology / Q000503:physiopathology; D013147:Spirometry; D014797:Vital Capacity / Q000502:physiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Diabetes mellitus; FEV(1)/FVC; Glycated hemoglobin; Health checkups; Pulmonary function tests