Jin Hwa Kim

doi:10.4093/dmj.2020.0247

Articles

Page Path: HOME > Diabetes Metab J > Volume 44(6); 2020 > Article

Letter The Association between Pulmonary Functions and Incident Diabetes: Longitudinal Analysis from the Ansung Cohort in Korea (Diabetes Metab J 2020;44: 699-710): Jin Hwa Kim; Diabetes & Metabolism Journal 2020;44(6):940-941.
DOI: https://doi.org/10.4093/dmj.2020.0247
Published online: December 23, 2020

5,266 Views
62 Download
1 Crossref
1 Scopus

Department of Endocrinology and Metabolism, Chosun University Hospital, Gwangju, Korea

Corresponding author: Jin Hwa Kim,

, Department of Endocrinology and Metabolism, Chosun University Hospital, 365 Pilmundaero, Dong-gu, Gwangju 61453, Korea, E-mail: endocrine@chosun.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

prev next

Full Article

Download PDF

NOTES
REFERENCES
About this article

See the article "The Association between Pulmonary Functions and Incident Diabetes: Longitudinal Analysis from the Ansung Cohort in Korea" on page 699.

Diabetes is a chronic systematic metabolic disease that effects multiple organs and systems, including the lungs [1]. The pulmonary system has rich vascularity and abundant connective tissue [2]. Long-standing hyperglycemia can lead to microvascular damage, non-enzymatic glycation, and proliferation of extracellular connective tissue, which result in declining lung function [3,4]. Oxidative stress, endothelial micro-injuries, platelet activation, and inflammation also can affect diabetes-related lung dysfunction [5,6].

Several studies have suggested that impaired pulmonary function can predict the development of diabetes or insulin resistance [7–9]. Lazarus et al. [10] reported that forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), and maximal mid-expiratory flow rate were associated with insulin resistance over a period of 20.9 years. Identifying individuals who are at risk of developing diabetes may allow for earlier precision interventions that would manage or prevent diabetes.

In the article entitled “The association between pulmonary functions and incident diabetes: longitudinal analysis from the Ansung cohort in Korea,” Choi et al. [11] evaluated the potential role of reduced pulmonary function as a risk factor for incident diabetes in Koreans. The authors clearly showed that FVC and FEV₁ were independent risk factors for diabetes in Koreans aged 40 to 60 years. They proposed several potential possibilities, although determining the exact biologic mechanism underlying these findings was not possible. They suggested that pulmonary factors were possible risk factors for insulin resistance and diabetes. Considering the ethnic differences in diabetes pathogenesis, this study is highly relevant to Asians with diabetes. The strength of this study is that it was a prospective community-based cohort study of pulmonary function as a risk factor for incident diabetes using 10-year follow-up data and assessing diabetes incidence using both oral glucose tolerance tests and glycosylated hemoglobin levels in order to avoid misclassification of diabetes.

In my opinion, these finding may reflect early pulmonary functional change in the course of glucose intolerance before diabetes appears. Pulmonary function may be a marker reflecting subclinical glucose intolerance status leading to lung dysfunction, and not risk factor for developing diabetes. Although the authors sought to adjust for all confounding variables, this issue remains a concern. Extending this study to longer term follow-up and other age groups would also be useful. Lastly, evaluation of the association with other chronic diabetes complications including cardiovascular disease is needed. This study’s findings appear especially relevant during the current coronavirus disease 2019 pandemic. I hope the authors further explore the association between lung dysfunction and diabetes.

NOTES

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was reported.

REFERENCES

1. American Diabetes Association. 11. Microvascular complications and foot care: standards of medical care in diabetes-2020. Diabetes Care 2020;43(Suppl 1):S135-51.Article PubMed PDF
2. Kolahian S, Leiss V, Nurnberg B. Diabetic lung disease: fact or fiction? Rev Endocr Metab Disord 2019;20:303-19.Article PubMed PMC PDF
3. Rajasurya V, Gunasekaran K, Surani S. Interstitial lung disease and diabetes. World J Diabetes 2020;11:351-7.Article PubMed PMC
4. Chance WW, Rhee C, Yilmaz C, Dane DM, Pruneda ML, Raskin P, Hsia CC. Diminished alveolar microvascular reserves in type 2 diabetes reflect systemic microangiopathy. Diabetes Care 2008;31:1596-601.Article PubMed PMC PDF
5. Scano G, Seghieri G, Mancini M, Filippelli M, Duranti R, Fabbri A, Innocenti F, Iandelli I, Misuri G. Dyspnoea, peripheral airway involvement and respiratory muscle effort in patients with type I diabetes mellitus under good metabolic control. Clin Sci (Lond) 1999;96:499-506.Article PubMed PDF
6. Forgiarini LA Jr, Kretzmann NA, Porawski M, Dias AS, Marroni NA. Experimental diabetes mellitus: oxidative stress and changes in lung structure. J Bras Pneumol 2009;35:788-91.Article PubMed
7. Engstrom G, Janzon L. Risk of developing diabetes is inversely related to lung function: a population-based cohort study. Diabet Med 2002;19:167-70.Article PubMed
8. Engstrom G, Hedblad B, Nilsson P, Wollmer P, Berglund G, Janzon L. Lung function, insulin resistance and incidence of cardiovascular disease: a longitudinal cohort study. J Intern Med 2003;253:574-81.Article PubMed
9. Ford ES, Mannino DM. National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Prospective association between lung function and the incidence of diabetes: findings from the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Diabetes Care 2004;27:2966-70.PubMed
10. Lazarus R, Sparrow D, Weiss ST. Baseline ventilatory function predicts the development of higher levels of fasting insulin and fasting insulin resistance index: the Normative Aging Study. Eur Respir J 1998;12:641-5.Article PubMed
11. Choi HS, Lee SW, Kim JT, Lee HK. The association between pulmonary functions and incident diabetes: longitudinal analysis from the Ansung cohort in Korea. Diabetes Metab J 2020;44:699-710.Article PubMed PMC PDF

Figure & Data

References

Citations

Citations to this article as recorded by

Pulmonary Spirometry in Type 2 Diabetics in Baghdad Teaching Hospital
Muhanad Hadi Abbood, Jabbar Sirhan Hassan, Aqeel Jassim Mehammed
Medical Journal of Babylon.2021; 18(4): 394. CrossRef

PubReader
ePub Link

Cite this Article

Cite this Article: export Copy Download Format; Close

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

RIS — For EndNote, ProCite, RefWorks, and most other reference management software
BibTeX — For JabRef, BibDesk, and other BibTeX-specific software

Include:

Citation for the content below
Citation and abstract for the content below

The Association between Pulmonary Functions and Incident Diabetes: Longitudinal Analysis from the Ansung Cohort in Korea (Diabetes Metab J 2020;44: 699-710)

Diabetes Metab J. 2020;44(6):940-941. Published online December 23, 2020

DOI: https://doi.org/10.4093/dmj.2020.0247

XML Download

Related articles

The Association between Pulmonary Functions and Incident Diabetes: Longitudinal Analysis from the Ansung Cohort in Korea (Diabetes Metab J 2020;44: 699-710)

About this article

Kim JH. The Association between Pulmonary Functions and Incident Diabetes: Longitudinal Analysis from the Ansung Cohort in Korea (Diabetes Metab J 2020;44: 699-710). Diabetes Metab J. 2020;44(6):940-941.

DOI: https://doi.org/10.4093/dmj.2020.0247.

Download citation ↓