Alveolar Gas Exchange and Pulmonary Functions in Patients with Type II Diabetes Mellitus

Swaminathan, Anandhalakshmi; Sethuraman, Manikandan; Ganeshkumar, P.; Ramachandran, C.S.

doi:10.7860/jcdr/2013/6550.3339

Cited by 28 publications

(12 citation statements)

References 20 publications

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“…Recently, a prospective study including 7524 participants also reported that diabetes is not associated with obstructive pulmonary function impairment [ 6 ]. In addition, some studies with small sample size reported that not only DLCOc%pred but also DLCOc/VA%pred was decreased in T2DM [ 23 , 24 ]. However, in current study, there was no statistically difference in DLCOc/VA%pred, which may be associated with a decrease in alveolar ventilation (VA) induced by restrictive ventilation dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Relationship between pulmonary function and albuminuria in type 2 diabetic patients with preserved renal function

Chen

Fang

et al. 2020

BMC Endocr Disord

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Background: Albuminuria is the early manifestation of the pathogenesis of diabetic nephropathy (DN). The current study was to investigate the relationship of pulmonary function with albuminuria in type 2 diabetic patients with preserved renal function to evaluate the role of pulmonary function in the early stage of DN. Methods: A total of 326 patients with type 2 diabetes mellitus (T2DM) including 270 without albuminuria and 56 with albuminuria, and 265 non-diabetic patients were enrolled. The patients' general information, and the parameters of pulmonary function, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, total lung capacity (TLC), diffusion capacity for carbon monoxide of lung (DLCO) were compared between T2DM and control groups, as well as T2DM patients with and without albuminuria groups. All pulmonary function parameters were expressed as a percentage of those predicted (%pred). Logistic regression models were constructed to test the association of albuminuria and pulmonary function. Results: The values of FVC%pred, FEV1%pred, TLC%pred and DLCO%pred were lower, and the proportion of subjects with FVC%pred < 80, FEV1%pred < 80, and DLCOc%pred < 80 was higher in T2DM subjects than controls (all P < 0.05). Subgroup analysis of diabetic patients showed that the values of FVC%pred, FEV1%pred, TLC%pred, and DLCOc%pred (97.18 ± 13.45, 93.95 ± 14.51, 90.64 ± 9.97, 87.27 ± 13.13, respectively) were significantly lower in T2DM subjects with albuminuria than those without albuminuria (103.94 ± 14.12, 99.20 ± 14.25, 93.79 ± 10.36, 92.62 ± 13.45, all P < 0.05). There was a significantly negative correlation between the urine albumin-to-creatinine ratio (UACR) and DLCOc%pred (r = − 0.143, P = 0.010) in spearman linear correlation test. In logistic regression analysis, the FVC%pred (OR 0.965, 95%CI 0.944-0.988), FEV1%pred (OR 0.975, 95%CI 0.954-0.996), and DLCOc%pred (OR 0.974, 95%CI 0.951-0.998) were independently associated with albuminuria after adjustments for smoking index, duration, HbA1c, FBG, and TG. Conclusion: Our results demonstrated albuminuria is associated with a restrictive pulmonary function as well as pulmonary diffusion function in T2DM with preserved renal function, which remind us to be alert of the pulmonary function decline even in the early stage of DN.

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Section: Discussionmentioning

confidence: 99%

Relationship between pulmonary function and albuminuria in type 2 diabetic patients with preserved renal function

Chen

Fang

et al. 2020

BMC Endocr Disord

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“…Previous studies have shown that dysglycemia affects lung connective tissue metabolism leading to thickening of the alveolar epithelial and endothelial basement membrane [ 18 – 21 ]. Furthermore, pulmonary microangiography is a characteristic manifestation of diabetes [ 22 , 23 ]. Such findings results in reduced alveolar gas exchange in patients with type 1 and 2 DM.…”

Section: Discussionmentioning

confidence: 99%

The Association of Normal Range Glycated Hemoglobin with Restrictive Lung Pattern in the General Population

Park

Lee

et al. 2015

PLoS ONE

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Glycated hemoglobin (HbA1c) is an important diagnostic indicator of diabetes mellitus, and some authors have argued that it is related to impaired lung function in the diabetic population. However, there was rare study for association between lung function and HbA1c in the non-diabetic population. We investigated whether HbA1c below the diagnostic threshold is related to deficits in lung function. We analyzed biochemical and spirometry data from a nation-wide, population-based, case-control study (the KNHANES IV and V). Eligible as cases were all native Koreans aged 40 years or more with no medical illness. A total of 3670 participants were divided into 4 groups according to HbA1c (%) as follows: Group I (n = 842), ≥ 4.0 and ≤ 5.3; Group II (n = 833), > 5.3 and ≤ 5.5; Group III (n = 898), > 5.5 and ≤ 5.7; and Group IV (n = 1097), > 5.7 and ≤ 6.4. Group I had the greatest forced vital capacity (FVC, 96.3 ± 0.5% pred, P < 0.0001), forced expiratory volume per second (FEV1, 93.8 ± 0.5% pred, P < 0.0001) and FEV1/FVC (0.792 ± 0.003, P < 0.0001) compared with the other groups. Linear regression showed that HbA1c was closely related to FVC (β = -6.972154, P < 0.0001) and FEV1 (β = -5.591589, P < 0.0001), but not to FEV1/FVC. Logistic regression analysis revealed a significant association between HbA1c and a restrictive spirometric pattern (FVC < 80% pred., FEV1/FVC ≥ 0.70; OR = 3.772, 95% CI = 1.234-11.53), indicating that elevated HbA1c is closely associated with lung impairment in the non-diabetic population. In the healthy population, relatively high HbA1c level is associated with decrements of FVC and FEV1 and may be a reliable predictor of poor lung function, especially the restrictive pattern.

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“…BGB–alveolar gas exchange defects are present in diabetic patients and may be linked to rapid progression of COVID-19 requiring assisted ventilation as well as increased morbidity and mortality ( Figures 1 , 2 ). 4 – 7 …”

Section: Introductionmentioning

confidence: 99%

Endothelial activation and dysfunction in metabolic syndrome, type 2 diabetes and coronavirus disease 2019

Hayden

2020

J Int Med Res

113

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The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 infection is a serious global concern. Increased morbidity and mortality is associated with older age, male gender, cardiovascular disease, diabetes, and smoking. As COVID-19 spreads from coastal borders, both state to state and country to country, our understanding of its pathophysiology has evolved. Age and type 2 diabetes mellitus (T2DM) play especially important roles in COVID-19 progression. T2DM is an age-related disease associated with metabolic syndrome, obesity, insulin resistance (hyperinsulinemia), hyperlipidemia, hypertension, hyperglycemia, and endothelial activation and dysfunction. This review evaluates the relationships and intersection between endothelial cell activation and dysfunction in T2DM and COVID-19. COVID-19 induces multiple injuries of the terminal bronchioles and alveolar blood-gas barrier and associated ultrastructural tissue remodeling. COVID-19 may unmask multiple vulnerabilities associated with T2DM including damage to the endothelial glycocalyx and multiple end-organ macro and microvascular diseases. Unmasking existing vulnerabilities in diabetic patients with COVID-19 is important. Globally, we must come together to better understand why T2DM is associated with increased COVID-19 morbidity and mortality.

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Alveolar Gas Exchange and Pulmonary Functions in Patients with Type II Diabetes Mellitus

Cited by 28 publications

References 20 publications

Relationship between pulmonary function and albuminuria in type 2 diabetic patients with preserved renal function

Relationship between pulmonary function and albuminuria in type 2 diabetic patients with preserved renal function

The Association of Normal Range Glycated Hemoglobin with Restrictive Lung Pattern in the General Population

Endothelial activation and dysfunction in metabolic syndrome, type 2 diabetes and coronavirus disease 2019

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