Cross-sectional and prospective study of the association between lung function and prediabetes.
Cross-sectional and prospective study of the association between lung function and prediabetes.
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DOI：
10.1136/bmjopen-2012-002179
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发表时间：
2013
期刊：
影响因子：
2.9
通讯作者：
Kohno N
中科院分区：
文献类型：
--
作者：
Yamane T;Yokoyama A;Kitahara Y;Miyamoto S;Haruta Y;Hattori N;Yamane K;Hara H;Kohno N
越来越多的证据表明，肺功能受损与患糖尿病（DM）的风险之间存在关联。然而，尚不清楚这是否反映了肺功能对葡萄糖代谢的因果影响。为了阐明肺功能与糖尿病发展之间的关系，我们在基线时葡萄糖耐量（NGT）正常的受试者中检测了新诊断的前驱糖尿病（糖尿病的前兆）的发生率。对职业队列进行初步分析，包括横断面和纵向数据（随访时间平均±SD: 28.4±6.1个月）。研究人员分析了横断面研究中1058名男性和纵向研究中560名男性NGT患者的数据。横断面研究中肺功能受损（用力肺活量预测值的百分比（%FVC）或用力呼气容积1 s/FVC的百分比（FEV1/FVC比率））与糖尿病前期或糖尿病前期比例的关系，纵向研究中出现新的糖尿病前期。根据75 g口服糖耐量试验诊断NGT、糖尿病前期包括糖耐量受损（IGT）和空腹血糖升高（IFG）和DM。基线时FVC %与糖尿病和前驱糖尿病的发生率显著相关，而基线时FEV1/FVC比值与此无关。在糖尿病前期，IGT而非IFG与%FVC相关。在随访期间，102名患有NGT的受试者发展为糖尿病前期。低%FVC，但不是FEV1/FVC比值，可预测发生IGT的风险增加，但不能预测IFG的风险。在日本男性中，低肺容量与糖尿病前期发展的风险增加有关，尤其是IGT。虽然有已发表的证据表明慢性阻塞性肺疾病与糖尿病之间存在关联，但前驱糖尿病与COPD的早期阶段无关。
A growing body of evidence suggests that there is a relationship between impaired lung function and the risk of developing diabetes mellitus (DM). However, it is not known if this reflects a causal effect of lung function on glucose metabolism. To clarify the relationship between lung function and the development of DM, we examined the incidence of newly diagnosed prediabetes (a precursor of DM) among subjects with normal glucose tolerance (NGT) at baseline. Primary analysis of an occupational cohort with both cross-sectional and longitudinal data (follow-up duration mean±SD: 28.4±6.1 months). Data were analysed from 1058 men in a cross-sectional study and from 560 men with NGT in a longitudinal study. Impaired lung function (per cent predicted value of forced vital capacity (%FVC) or per cent value of forced expiratory volume 1 s/FVC (FEV1/FVC ratio)) in relation to the ratio of prediabetes or DM in a cross-sectional study and development of new prediabetes in a longitudinal study. NGT, prediabetes including impaired glucose tolerance (IGT) and increased fasting glucose (IFG) and DM were diagnosed according to 75 g oral glucose tolerance tests. %FVC at baseline, but not FEV1/FVC ratio at baseline, was significantly associated with the incidences of DM and prediabetes. Among prediabetes, IGT but not IFG was associated with %FVC. During follow-up, 102 subjects developed prediabetes among those with NGT. A low %FVC, but not FEV1/FVC ratio, was predictive of an increased risk for development of IGT, but not of IFG. Low lung volume is associated with an increased risk for the development of prediabetes, especially IGT, in Japanese men. Although there is published evidence for an association between chronic obstructive pulmonary disease and DM, prediabetes is not associated with the early stage of COPD.