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Zhang Z, Xie Y, Bu Z, Xiang Y, Sheng W, Cao Y, Lian L, Zhang L, Qian W, Ji G. Genetically proxied glucokinase activation and risk of diabetic complications: Insights from phenome-wide and multi-omics mendelian randomization. Diabetes Res Clin Pract 2025; 225:112246. [PMID: 40374125 DOI: 10.1016/j.diabres.2025.112246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2024] [Revised: 03/31/2025] [Accepted: 05/12/2025] [Indexed: 05/17/2025]
Abstract
AIMS This study aims to assess the benefits and adverse effects of long-term glucokinase (GK) activation from a genetic perspective. METHODS We identified genetic variants in the GCK gene associated with glycated hemoglobin (HbA1c) levels from a genome-wide association study (GWAS) involving 146,806 individuals, which served as proxies for glucokinase activation. To assess the effects and potential pathways of GK activation on a range of diabetic complications and safety outcomes, we integrated drug-target Mendelian randomization (MR), lipidome-wide and proteome-wide MR, phenome-wide MR, and colocalization analyses. RESULTS Genetically proxied GK activation was associated with reduced risks of several predefined diabetic complications, including cardiovascular diseases, stroke and diabetic retinopathy. No kidney-related benefits were observed. Safety analysis revealed a relationship between GK activation and elevated AST levels, while impaired interaction between GK and glucokinase regulatory protein (GKRP) was associated with dyslipidemia, increased liver fat content, AST, systolic blood pressure, and uric acid. Phenome-wide MR suggested that GK activation may have potential benefits for lung function and fluid intelligence score. CONCLUSIONS Our genetic evidence supports GK as a promising target for reducing the risk of specific diabetic complications. These findings require further validation through cohort studies and randomized controlled trials in patients with diabetes.
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Affiliation(s)
- Ziqi Zhang
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanxiao Xie
- Department of Respiratory Medicine, Dongguan Hospital of Traditional Chinese Medicine, Dongguan, Guangdong, China; The Ninth Clinical Medical College, Guangzhou University of Chinese Medicine, Dongguan, Guangdong, China
| | - Zhenlin Bu
- Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, China; The Eighth Clinical Medical College, Guangzhou University of Chinese Medicine, Foshan, Guangdong, China
| | - Yingying Xiang
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Sheng
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ying Cao
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - LeShen Lian
- Department of Respiratory Medicine, Dongguan Hospital of Traditional Chinese Medicine, Dongguan, Guangdong, China; The Ninth Clinical Medical College, Guangzhou University of Chinese Medicine, Dongguan, Guangdong, China
| | - Li Zhang
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; State Key Laboratory of Integration and Innovation of Classical Formula and Modern Chinese Medicine, Shanghai, China
| | - Wei Qian
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Guang Ji
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; State Key Laboratory of Integration and Innovation of Classical Formula and Modern Chinese Medicine, Shanghai, China.
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Pham A, Corcoran R, Foer D. The role of type 2 diabetes in the severity of adult asthma. Curr Opin Allergy Clin Immunol 2025; 25:34-40. [PMID: 39607312 PMCID: PMC11695166 DOI: 10.1097/aci.0000000000001045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2024]
Abstract
PURPOSE OF REVIEW This review summarizes recent basic, translational, and clinical research on type 2 diabetes (T2D) and its relationship with asthma severity in the context of T2D mechanisms and asthma outcomes. RECENT FINDINGS Several clinical asthma outcomes, such as lung function and exacerbations, demonstrate a strong association between T2D and asthma and support that T2D contributes to worse asthma outcomes. Multiple mechanisms underlying those observed associations, and their representative biomarkers, have been proposed. However, prospective, controlled human studies in the context of both T2D and asthma are limited. SUMMARY T2D is associated with worse asthma outcomes and more severe asthma. Yet patients with more severe or uncontrolled asthma are also at a higher risk for systemic steroid exposure, which worsens glycemic control and metabolic dysregulation. Preclinical and translational studies point to metabolic dysregulation as a driver of airway inflammation. Addressing these metabolic pathways through T2D treatment may, in turn, directly or indirectly improve clinical asthma outcomes. While additional research is needed to identify biomarkers of risk and treatment response in metabolic asthma, this review highlights the importance of considering T2D as a clinically relevant asthma comorbidity.
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Affiliation(s)
- Alisa Pham
- Division of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Rose Corcoran
- Division of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Dinah Foer
- Division of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
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Wu L, Han X, Chen L, Guo L, Li Y, Alwalid O, Nie T, Wu F, Zhi X, Fan Y, Shi H, Zheng C. Impact of Diabetes on Persistent Radiological Abnormalities and Pulmonary Diffusion Dysfunction in COVID-19 Survivors: A 3-Year Prospective Cohort Study. Acad Radiol 2025; 32:471-481. [PMID: 39069434 DOI: 10.1016/j.acra.2024.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 07/30/2024]
Abstract
RATIONALE AND OBJECTIVES Little is known about the long-term impact of diabetes on lung impairment in COVID-19 survivors over a three-year period. This study evaluated the long-term impact of diabetes on persistent radiological pulmonary abnormalities and lung function impairment in COVID-19 survivors over three years. MATERIALS AND METHODS In this prospective, multicenter, cohort study, pulmonary sequelae were compared between COVID-19 survivors with and without diabetes. Serial chest CT scans, symptom questionnaires and pulmonary function tests were obtained 6 months, 12 months, 2 years and 3 years post-discharge. The independent predictors for lung dysfunction at the 3-year follow-up were analyzed. RESULTS A total of 278 COVID-19 survivors (63 [IQR 57-69] year-old, female: 103 [37.0%]) were included. At the 3-year follow-up, individuals in the diabetes group had higher incidences of respiratory symptoms, radiological pulmonary abnormalities and pulmonary diffusion dysfunction than those in the control group. Diabetes (OR: 2.18, 95% CI: 1.04-4.59, p = 0.034), allergy (OR: 2.26, 95% CI: 1.09-4.74, p = 0.029), female (OR: 2.70, 95% CI: 1.37-5.29, p = 0.004), severe COVID-19 (OR: 4.10, 95% CI: 1.54-10.93, p = 0.005), and fibrotic-like CT changes (OR: 5.64, 95% CI: 2.28-13.98, p < 0.001) were independent predictors of pulmonary diffusion dysfunction in COVID-19 survivors. CONCLUSION These results highlight the long-term deleterious effect of diabetes status on radiological pulmonary abnormalities and pulmonary dysfunction in COVID-19 survivors. This study provides important evidence support for long-term monitoring of lung abnormalities in COVID-19 recovery survivors with diabetes.
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Affiliation(s)
- Linxia Wu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.)
| | - Xiaoyu Han
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.)
| | - Lu Chen
- Department of Radiology, Wuhan Jinyintan Hospital, Tongji Medical College of HuaZhong University of Science and Technology, 430023, The People's Republic of China (L.C., Y.F.)
| | - Liyan Guo
- Department of Function, Wuhan Jinyintan Hospital, Tongji Medical College of HuaZhong University of Science and Technology, 430023, The People's Republic of China (L.G.)
| | - Yumin Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.)
| | - Osamah Alwalid
- Department of Diagnostic Imaging, Sidra Medicine, Doha 26999, Qatar (O.A.)
| | - Tong Nie
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.)
| | - Feihong Wu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.)
| | - Xiaoling Zhi
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.)
| | - Yanqing Fan
- Department of Radiology, Wuhan Jinyintan Hospital, Tongji Medical College of HuaZhong University of Science and Technology, 430023, The People's Republic of China (L.C., Y.F.)
| | - Heshui Shi
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.)
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.).
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Tang X, Huang K, Chu X, Peng Y, Huang T, Cui Y, Yang T, Wang C. Relationship between diabetes-related clinical characteristics and preserved ratio impaired spirometry (PRISm): findings from NHANES 2007-2012. BMJ PUBLIC HEALTH 2024; 2:e001313. [PMID: 40018547 PMCID: PMC11816400 DOI: 10.1136/bmjph-2024-001313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 10/16/2024] [Indexed: 03/01/2025]
Abstract
Introduction To analyse the relationship between diabetes, its severity (including blood glucose levels, disease duration, antidiabetic drug use and number of comorbidities) and preserved ratio impaired spirometry (PRISm) using data from the National Health and Nutrition Examination Survey (NHANES). Methods This cross-sectional study collected data from the NHANES database from 2007 to 2012. PRISm was defined as having a forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio ≥0.7 and an FEV1 predicted value <80%. We examined the relationship between diabetes duration, fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), log-transformed homeostasis model assessment for insulin resistance, C reactive protein and the number of comorbidities with PRISm in the entire population. We analysed the relationship between antidiabetic drug use and PRISm, specifically in the diabetes population. Logistic regression models were used, and results were reported as OR. Results A total of 5783 participants with normal spirometry or PRISm were included in the analysis. Diabetes was associated with 2.19 times higher odds of PRISm compared with non-diabetic participants. Longer disease duration increased PRISm odds by 2% per year. Each 1-unit increase in HbA1c and each 10 mg/dL increase in FPG were associated with 24% and 6% higher odds of PRISm, respectively. No relationship was found between insulin resistance and PRISm after adjusting for covariates. An increase of 1 mg/dL in CRP was associated with 18% higher odds of PRISm. A higher number of diabetes-related comorbidities was strongly associated with PRISm. No significant relationship was found between antidiabetic drug use and PRISm. Conclusions Severe diabetes status, such as higher blood glucose levels, longer disease duration and a greater number of comorbidities, is associated with an increased risk of PRISm. Effective blood glucose control, self-management and regular monitoring of lung function are crucial for diabetes management.
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Affiliation(s)
- Xingyao Tang
- China-Japan Friendship School of Clinical Medicine, Capital Medical University, Beijing, China
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Ke Huang
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Xu Chu
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Yaodie Peng
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- China-Japan Friendship School of Clinical Medicine, Peking University, Beijing, China
| | - Tingting Huang
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Yanan Cui
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Ting Yang
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Chen Wang
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Tomasello A, Benfante A, Lisotta A, Macaluso D, Viswanathan S, Cahill KN, Scichilone N. Polypharmacy in older patients with asthma: hidden risks and opportunities for improvement. Expert Rev Respir Med 2024; 18:1047-1059. [PMID: 39708058 DOI: 10.1080/17476348.2024.2444331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Revised: 11/23/2024] [Accepted: 12/16/2024] [Indexed: 12/23/2024]
Abstract
INTRODUCTION Polypharmacy can be considered the norm in elderly patients, because older individuals experience an increasing number of concomitant respiratory and non-respiratory diseases other than asthma, carrying the risk of drug-to-drug-interactions and drug-to-comorbidities interactions. In this context, asthma in older adults, conventionally aging >65 years of age, cannot be adequately managed without considering their individual characteristics, as these challenge the traditional therapeutic algorithms/management strategies commonly applied to younger populations. AREAS COVERED The current article aims at addressing pitfalls and advantages of current pharmacological strategies in older individuals with asthma. Comorbidities become more common with increasing age and are also more frequent in adults with asthma than in those without it. Multiple medications are often needed to control asthma symptoms and prevent asthma exacerbations, and older patients with asthma may also take multiple medications for common comorbidities and complex health conditions, such as chronic cardiometabolic diseases. Polypharmacy is an emerging concern in the elderly population. EXPERT OPINION A patient-centered approach is crucial and polypharmacy in asthma requires careful management. A multidisciplinary approach will allow for a more holistic care and will ensure that all aspects of a patient's health are considered, optimizing medication management.
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Affiliation(s)
- Alessandra Tomasello
- Division of Respiratory Medicine, PROMISE Department, "Paolo Giaccone" University Hospital, University of Palermo, Palermo, Italy
- Division of Allergy, Pulmonary and Critical care Medicine, Vanderbilt University Medical Center, Nashville, USA
| | - Alida Benfante
- Division of Respiratory Medicine, PROMISE Department, "Paolo Giaccone" University Hospital, University of Palermo, Palermo, Italy
| | - Alessia Lisotta
- Division of Respiratory Medicine, PROMISE Department, "Paolo Giaccone" University Hospital, University of Palermo, Palermo, Italy
| | - Dario Macaluso
- Division of Respiratory Medicine, PROMISE Department, "Paolo Giaccone" University Hospital, University of Palermo, Palermo, Italy
| | | | - Katherine N Cahill
- Division of Allergy, Pulmonary and Critical care Medicine, Vanderbilt University Medical Center, Nashville, USA
| | - Nicola Scichilone
- Division of Respiratory Medicine, PROMISE Department, "Paolo Giaccone" University Hospital, University of Palermo, Palermo, Italy
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Yang Y, Wang S, Jia B, Chen S. Association Between Triglyceride-Glucose Index and Lung Function Parameters in the General Population Undergoing Health Examinations. Diabetes Metab Syndr Obes 2024; 17:4031-4047. [PMID: 39492961 PMCID: PMC11531295 DOI: 10.2147/dmso.s487744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 10/23/2024] [Indexed: 11/05/2024] Open
Abstract
Purpose To investigate the relationship between the triglyceride-glucose (TyG) index and pulmonary function metrics among the general population undergoing health examinations. Materials and Methods The enrollment totaled 696 participants. Fasting triglycerides and glucose levels were used to calculate the TyG index. Participants were divided into two categories according to their median TyG: one with high TyG and the other with low TyG. A portable spirometer was used to assess lung function. Fundamental clinical features and lung function indicators were compared between the two groups, and the relationship between the TyG index and lung function parameters was explored. Results Compared with the low TyG group, the high TyG group exhibited significantly reduced levels of FEV1/FVC, FVC% pred, FEV1% pred, FEV3% pred, FEV3/FVC, FEF75, FEF75% pred, FEF25-75% pred, and MVV% pred, suggesting poor pulmonary function. The TyG index was significantly inversely correlated with multiple pulmonary function metrics, including FVC% pred, FEV1% pred, FEV3% pred, FEV1/FVC, FEV3/FVC, FEF75, FEF75% pred and FEF25-75% pred, which persisted even after accounting for confounding variables. Conclusion In summary, the present study establishes a correlation between the TyG index and some lung function indicators, offering a new indicator of metabolic abnormalities related to lung functionality.
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Affiliation(s)
- Yu Yang
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, People’s Republic of China
- Department of Pharmacy, The Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Shuqi Wang
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Boying Jia
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Shuchun Chen
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
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Liu Q, Chang X, Lian R, Chen Q, Wang J, Fu S. Evaluation of bi-directional causal association between obstructive sleep apnoea syndrome and diabetic microangiopathy: a Mendelian randomization study. Front Cardiovasc Med 2024; 11:1340602. [PMID: 38784169 PMCID: PMC11112003 DOI: 10.3389/fcvm.2024.1340602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 04/01/2024] [Indexed: 05/25/2024] Open
Abstract
Background The relationship between obstructive sleep apnea syndrome (OSAS) and diabetic microangiopathy remains controversial. Objective This study aimed to use bidirectional two-sample Mendelian Randomization (MR) to assess the causal relationship between OSAS and diabetic microangiopathy. Methods First, we used the Linkage Disequilibrium Score Regression(LDSC) analysis to assess the genetic correlation. Then, the bidirectional two-sample MR study was conducted in two stages: OSAS and lung function-related indicators (forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)) were investigated as exposures, with diabetic microangiopathy as the outcome in the first stage, and genetic tools were used as proxy variables for OSAS and lung function-related measures in the second step. Genome-wide association study data came from the open GWAS database. We used Inverse-Variance Weighted (IVW), MR-Egger regression, Weighted median, Simple mode, and Weighted mode for effect estimation and pleiotropy testing. We also performed sensitivity analyses to test the robustness of the results. Furthermore, we performed multivariate and mediation MR analyses. Results In the LDSC analysis, We found a genetic correlation between OSAS, FVC, FEV 1, and diabetic microangiopathy. In the MR analysis, based on IVW analysis, genetically predicted OSAS was positively correlated with the incidence of diabetic retinopathy (DR), diabetic kidney disease (DKD), and diabetic neuropathy (DN). In the subgroup analysis of DR, there was a significant causal relationship between OSAS and background diabetic retinopathy (BDR) and proliferative diabetic retinopathy (PDR). The reverse MR did not show a correlation between the incidence of diabetic microangiopathy and OSAS. Reduced FVC had a potential causal relationship with increased incidence of DR and PDR. Reduced FEV1 had a potential causal relationship with the increased incidence of BDR, PDR, and DKD. Multivariate MR analysis showed that the association between OSAS and diabetic microangiopathy remained significant after adjusting for confounding factors. However, we did not find the significant mediating factors. Conclusion Our results suggest that OSAS may be a cause of the development of diabetic microangiopathy, and OSAS may also be associated with a high risk of diabetic microangiopathy, providing a reference for a better understanding of the prevention of diabetic microangiopathy.
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Affiliation(s)
- Qianqian Liu
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Provincial Endocrine Disease Clinical MedicineResearch Center, Lanzhou, Gansu, China
| | - Xingyu Chang
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Rongna Lian
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qi Chen
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Provincial Endocrine Disease Clinical MedicineResearch Center, Lanzhou, Gansu, China
| | - Jialei Wang
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Provincial Endocrine Disease Clinical MedicineResearch Center, Lanzhou, Gansu, China
| | - Songbo Fu
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Provincial Endocrine Disease Clinical MedicineResearch Center, Lanzhou, Gansu, China
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Choi W, Moon JH, Choi H, Lee H, Kim HK, Kang HC, Cho NH. Trajectory of lung function in diabetic adults: A 16-year follow-up study of community-based prospective cohorts. Respirology 2024; 29:413-420. [PMID: 38185765 DOI: 10.1111/resp.14658] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/19/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND AND OBJECTIVE To investigate the difference in lung function according to diabetes status in a community-based prospective study. METHODS Individuals aged 40-69 years from two community-based cohorts were followed prospectively for 16 years. A spirometer was used to evaluate lung function at baseline, and lung function tests were carried out biennially thereafter. Multivariable linear regression analysis was performed for the cross-sectional and longitudinal analyses based on diabetes status. RESULTS Among the 6483 subjects, 2114 (32.6%) had prediabetes and 671 (10.4%) had diabetes. The prediabetes and diabetes groups had lower baseline % predicted values of forced expiratory volume in 1 s (FEV1) (mean, -1.853; 95% confidence interval [CI] -2.715 to -0.990 for prediabetes and mean, -4.088; 95% CI -5.424 to -2.752 for diabetes) and forced vital capacity (FVC) (mean, -2.087; 95% CI -2.837 to -1.337 for prediabetes and mean, -4.622; 95% CI -5.784 to -3.460 for diabetes) compared to the normoglycemia group after adjusting for relevant covariates. The rate of decline in FEV1% predicted (mean, -0.227; 95% CI -0.366 to -0.089) and FVC % predicted (mean, -0.232; 95% CI -0.347 to -0.117) during follow-up were faster in the diabetes group than in the normoglycemia group. The diabetes group had a lower proportion of normal ventilation (ptrend = 0.048) and higher proportions of restrictive (ptrend = 0.001) and mixed (ptrend = 0.035) ventilatory disorders at the last follow-up. CONCLUSION Diabetes is associated with a lower baseline lung function and a faster rate of deterioration.
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Affiliation(s)
- Wonsuk Choi
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Joon Ho Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hayoung Choi
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hee Kyung Kim
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Ho-Cheol Kang
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Nam H Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea
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9
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Davis TME, Drinkwater JJ, Davis WA. Pulmonary Function Trajectories Over 6 Years and Their Determinants in Type 2 Diabetes: The Fremantle Diabetes Study Phase II. Diabetes Care 2024; 47:483-490. [PMID: 38211617 DOI: 10.2337/dc23-1726] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE To assess whether there are clusters of people with type 2 diabetes with distinct temporal profiles of lung function changes and characteristics. RESEARCH DESIGN AND METHODS Group-based trajectory modeling (GBTM) identified groups of participants with type 2 diabetes from the community-based observational Fremantle Diabetes Study Phase II (FDS2) who had at least two biennial measurements of forced expiratory volume in 1 s as a percentage of predicted (FEV1%pred) over 6 years. Independent associates of group membership were assessed using multinomial regression. RESULTS Of 1,482 potential FDS2 participants, 1,074 (72.5%; mean age, 65.2 years; 45.5% female; median diabetes duration, 8.0 years) were included in the modeling. The best fitting GBTM model identified four groups categorized by FEV1%pred trajectory: high (19.5%; baseline FEV1%pred, 106.5 ± 9.5%; slope 0%/year), medium (47.7%; FEV1%pred, 87.3 ± 8.7%; slope, -0.32%/year), low (25.0%; baseline FEV1%pred, 68.9 ± 9.8%; slope, -0.72%/year), and very low (7.9%; baseline FEV1%pred, 48.8 ± 9.6%; slope, -0.68%/year). Compared with the high group, the other groups were characterized by nonmodifiable and modifiable risk factors associated with lung function decline in the general population (including ethnicity, marital status, smoking, obesity, coronary heart disease, and chronic respiratory disease). The main, diabetes-specific, significant predictor of group membership was a higher HbA1c in the very low group. There was a graded increase in mortality from 6.7% in the high group to 22.4% in the very low group. CONCLUSIONS Measurement of lung function in type 2 diabetes could help optimize clinical management and improve prognosis, including addressing glycemic control in those with a very low FEV1%pred.
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Affiliation(s)
- Timothy M E Davis
- University of Western Australia Medical School, Fremantle Hospital, Fremantle, Western Australia, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley and Fremantle Hospitals Group, Murdoch, Western Australia, Australia
| | - Jocelyn J Drinkwater
- University of Western Australia Medical School, Fremantle Hospital, Fremantle, Western Australia, Australia
- Lions Outback Vision, Lions Eye Institute, Nedlands, Australia
| | - Wendy A Davis
- University of Western Australia Medical School, Fremantle Hospital, Fremantle, Western Australia, Australia
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10
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Bartziokas K, Papaioannou AI, Drakopanagiotakis F, Gouveri E, Papanas N, Steiropoulos P. Unraveling the Link between Ιnsulin Resistance and Bronchial Asthma. Biomedicines 2024; 12:437. [PMID: 38398039 PMCID: PMC10887139 DOI: 10.3390/biomedicines12020437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
Evidence from large epidemiological studies has shown that obesity may predispose to increased Th2 inflammation and increase the odds of developing asthma. On the other hand, there is growing evidence suggesting that metabolic dysregulation that occurs with obesity, and more specifically hyperglycemia and insulin resistance, may modify immune cell function and in some degree systemic inflammation. Insulin resistance seldom occurs on its own, and in most cases constitutes a clinical component of metabolic syndrome, along with central obesity and dyslipidemia. Despite that, in some cases, hyperinsulinemia associated with insulin resistance has proven to be a stronger risk factor than body mass in developing asthma. This finding has been supported by recent experimental studies showing that insulin resistance may contribute to airway remodeling, promotion of airway smooth muscle (ASM) contractility and proliferation, increase of airway hyper-responsiveness and release of pro-inflammatory mediators from adipose tissue. All these effects indicate the potential impact of hyperinsulinemia on airway structure and function, suggesting the presence of a specific asthma phenotype with insulin resistance. Epidemiologic studies have found that individuals with severe and uncontrolled asthma have a higher prevalence of glycemic dysfunction, whereas longitudinal studies have linked glycemic dysfunction to an increased risk of asthma exacerbations. Since the components of metabolic syndrome interact with one another so much, it is challenging to identify each one's specific role in asthma. This is why, over the last decade, additional studies have been conducted to determine whether treatment of type 2 diabetes mellitus affects comorbid asthma as shown by the incidence of asthma, asthma control and asthma-related exacerbations. The purpose of this review is to present the mechanism of action, and existing preclinical and clinical data, regarding the effect of insulin resistance in asthma.
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Affiliation(s)
| | - Andriana I. Papaioannou
- 1st University Department of Respiratory Medicine, “Sotiria” Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece;
| | - Fotios Drakopanagiotakis
- Department of Pneumonology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Evanthia Gouveri
- Diabetes Centre, 2nd Department of Internal Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.G.); (N.P.)
| | - Nikolaos Papanas
- Diabetes Centre, 2nd Department of Internal Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.G.); (N.P.)
| | - Paschalis Steiropoulos
- Department of Pneumonology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
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11
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Dai Y, Zhou S, Qiao L, Peng Z, Zhao J, Xu D, Wu C, Li M, Zeng X, Wang Q. Non-apoptotic programmed cell deaths in diabetic pulmonary dysfunction: the new side of advanced glycation end products. Front Endocrinol (Lausanne) 2023; 14:1126661. [PMID: 37964954 PMCID: PMC10641270 DOI: 10.3389/fendo.2023.1126661] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 09/26/2023] [Indexed: 11/16/2023] Open
Abstract
Diabetes mellitus (DM) is a chronic metabolic disorder that affects multiple organs and systems, including the pulmonary system. Pulmonary dysfunction in DM patients has been observed and studied for years, but the underlying mechanisms have not been fully understood. In addition to traditional mechanisms such as the production and accumulation of advanced glycation end products (AGEs), angiopathy, tissue glycation, oxidative stress, and systemic inflammation, recent studies have focused on programmed cell deaths (PCDs), especially the non-apoptotic ones, in diabetic pulmonary dysfunction. Non-apoptotic PCDs (NAPCDs) including autophagic cell death, necroptosis, pyroptosis, ferroptosis, and copper-induced cell death have been found to have certain correlations with diabetes and relevant complications. The AGE-AGE receptor (RAGE) axis not only plays an important role in the traditional pathogenesis of diabetes lung disease but also plays an important role in non-apoptotic cell death. In this review, we summarize novel studies about the roles of non-apoptotic PCDs in diabetic pulmonary dysfunction and focus on their interactions with the AGE-RAGE axis.
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Affiliation(s)
- Yimin Dai
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Shuang Zhou
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Lin Qiao
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Zhao Peng
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Jiuliang Zhao
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Dong Xu
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Chanyuan Wu
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Mengtao Li
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Qian Wang
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
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12
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Mizab C, Sánchez E, Gutiérrez-Carrasquilla L, Balsells N, Arqué A, Ruano R, Mateu M, Zorzano-Martínez M, Pomés A, García-Aguilera E, Martí R, Manzanares JM, Hernández C, Simó R, Lecube A. Assessment of dyspneic sensation in patients with type 2 diabetes. Front Endocrinol (Lausanne) 2023; 14:1208020. [PMID: 37635958 PMCID: PMC10457144 DOI: 10.3389/fendo.2023.1208020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/14/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Individuals with type 2 diabetes (T2D) should be considered a susceptible group for pulmonary dysfunction. So, we aimed to evaluate the sensation of breathlessness in this population by administering two well-validated questionnaires. Methods This is a crosssectional study with 592 people without known respiratory disease (353 with T2D) who answered the modified Medical Research Council (mMRC) questionnaire. In addition, 47% also responded to the St George Respiratory Questionnaire, a specific instrument designed to be applied to patients with obstructive airway disease. Results Patients with T2D showed a higher mMRC score in comparison to the control group [1.0 (0.0 - 4.0) vs. 0.0 (0.0 - 4.0), p<0.001]. A higher prevalence of subjects with mMRC ≥2 was observed in T2D that in the control group (20.2% vs. 11.6%, p=0.004). Participants with T2D and mMRC ≥2 showed a higher HbA1c (8.2 ± 1.6% vs. 7.8 ± 1.6%, p=0.048), longer T2D evolution and higher prevalence of nephropathy. In the multivariate analysis, the presence of T2D [OR=1.95 (1.19 to 3.22), p=0.008] in all the population, and HbA1c [OR=1.19 (1.01 to 1.41), p=0.034] and the presence of diabetic nephropathy [OR=2.00 (1.14 to 3.52), p=0.015] in patients with T2D, predicted a mMRC ≥2. Finally, no differences were observed regarding the SGRQ score among groups. Conclusions Patients with T2D showed a greater sensation of dyspnea than subjects with normal carbohydrate metabolism. Risk factors included poor metabolic control and the presence of renal disease.
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Affiliation(s)
- Chadia Mizab
- Endocrinology and Nutrition Department, University Hospital Sant Joan de Reus, Reus, Spain
| | - Enric Sánchez
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
- Obesity, Diabetes and Metabolism (ODIM) Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
- Medicine and Surgery Department, University of Lleida, Lleida, Spain
| | | | - Núria Balsells
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
| | - Anaïs Arqué
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
| | - Raquel Ruano
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
- Obesity, Diabetes and Metabolism (ODIM) Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Magda Mateu
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
| | - Marta Zorzano-Martínez
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
- Obesity, Diabetes and Metabolism (ODIM) Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Anna Pomés
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
| | - Esther García-Aguilera
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
| | - Raquel Martí
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
- Obesity, Diabetes and Metabolism (ODIM) Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - José María Manzanares
- Endocrinology and Nutrition Department, University Hospital Sant Joan de Reus, Reus, Spain
| | - Cristina Hernández
- Endocrinology and Nutrition Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Diabetes and Metabolism Research Unit, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Rafael Simó
- Endocrinology and Nutrition Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Diabetes and Metabolism Research Unit, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Albert Lecube
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
- Obesity, Diabetes and Metabolism (ODIM) Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
- Medicine and Surgery Department, University of Lleida, Lleida, Spain
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13
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Yassari F, Marashian SM, Ghasemi Monfared A, Lookzadeh S. Mutual Effects of Coincident Chronic Renal Failure and Chronic Obstructive Pulmonary Disease. TANAFFOS 2023; 22:426-432. [PMID: 39176135 PMCID: PMC11338508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 09/18/2023] [Indexed: 08/24/2024]
Abstract
Background The current study tried to assess the effects of CKD on the severity and outcome of COPD in a population of patients who referred to our tertiary center in Tehran through a 3-year time section. Materials and Methods Through a retrospective cross-sectional design, the current study tried to assess the effects of chronic kidney disease (CKD) on the health situation and some spirometric and para-clinical parameters as well as their outcomes in patients who had been hospitalized for COPD. The participants had already COPD and we separate them into two groups with or without CKD. Results Regarding the outcome of hospitalizations, 94% of the COPD and 77.9% of the COPD+CKD group were discharged in good health condition while 6% and 22.1% deceased, respectively. This shows significantly higher death rate in the latter group and the findings obtained the odds ratio of 4.5 for CKD to raise this rate. Conclusion The current study could suggest an absolute relationship between CKD and COPD in terms of respiratory and blood parameters as well as the mutual effects of the diseases on the outcome of each.
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Affiliation(s)
- Fatemeh Yassari
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mehran Marashian
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Somayeh Lookzadeh
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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14
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Tattersall MC, Lee KE, Tsuchiya N, Osman F, Korcarz CE, Hansen KM, Peters MC, Fahy JV, Longhurst CA, Dunican E, Wentzel SE, Leader JK, Israel E, Levy BD, Castro M, Erzurum SC, Lempel J, Moore WC, Bleecker ER, Phillips BR, Mauger DT, Hoffman EA, Fain SB, Reeder SB, Sorkness RL, Jarjour NN, Denlinger LC, Schiebler ML. Skeletal Muscle Adiposity and Lung Function Trajectory in the Severe Asthma Research Program. Am J Respir Crit Care Med 2023; 207:475-484. [PMID: 36194556 PMCID: PMC9940151 DOI: 10.1164/rccm.202203-0597oc] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 10/04/2022] [Indexed: 01/05/2023] Open
Abstract
Rationale: Extrapulmonary manifestations of asthma, including fatty infiltration in tissues, may reflect systemic inflammation and influence lung function and disease severity. Objectives: To determine if skeletal muscle adiposity predicts lung function trajectory in asthma. Methods: Adult SARP III (Severe Asthma Research Program III) participants with baseline computed tomography imaging and longitudinal postbronchodilator FEV1% predicted (median follow-up 5 years [1,132 person-years]) were evaluated. The mean of left and right paraspinous muscle density (PSMD) at the 12th thoracic vertebral body was calculated (Hounsfield units [HU]). Lower PSMD reflects higher muscle adiposity. We derived PSMD reference ranges from healthy control subjects without asthma. A linear multivariable mixed-effects model was constructed to evaluate associations of baseline PSMD and lung function trajectory stratified by sex. Measurements and Main Results: Participants included 219 with asthma (67% women; mean [SD] body mass index, 32.3 [8.8] kg/m2) and 37 control subjects (51% women; mean [SD] body mass index, 26.3 [4.7] kg/m2). Participants with asthma had lower adjusted PSMD than control subjects (42.2 vs. 55.8 HU; P < 0.001). In adjusted models, PSMD predicted lung function trajectory in women with asthma (β = -0.47 Δ slope per 10-HU decrease; P = 0.03) but not men (β = 0.11 Δ slope per 10-HU decrease; P = 0.77). The highest PSMD tertile predicted a 2.9% improvement whereas the lowest tertile predicted a 1.8% decline in FEV1% predicted among women with asthma over 5 years. Conclusions: Participants with asthma have lower PSMD, reflecting greater muscle fat infiltration. Baseline PSMD predicted lung function decline among women with asthma but not men. These data support an important role of metabolic dysfunction in lung function decline.
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Affiliation(s)
| | | | - Nanae Tsuchiya
- Division of Cardiothoracic Imaging, Department of Radiology, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, Wisconsin
- Department of Radiology, School of Medicine, University of the Ryukyus, Nishihara, Japan
| | | | | | | | - Michael C. Peters
- Division of Pulmonary and Critical Care, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - John V. Fahy
- Division of Pulmonary and Critical Care, Department of Medicine, University of California, San Francisco, San Francisco, California
| | | | - Eleanor Dunican
- Department of Medicine, School of Medicine, University College Dublin, Dublin, Ireland
- St. Vincent’s Hospital Elm Park, Dublin, Ireland
| | - Sally E. Wentzel
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and
| | - Joseph K. Leader
- Department of Radiology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Elliot Israel
- Division of Pulmonary and Critical Care and
- Division of Allergy and Immunology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Mario Castro
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | | | - Jason Lempel
- Department of Radiology, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Wendy C. Moore
- Section of Pulmonary, Critical Care, Allergy and Immunologic Diseases, Department of Internal Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Eugene R. Bleecker
- Division of Genetics and
- Division of Pharmacokinetics, Department of Medicine, College of Medicine, University of Arizona, Tucson, Arizona
| | - Brenda R. Phillips
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania; and
| | - David T. Mauger
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania; and
| | - Eric A. Hoffman
- Department of Biomedical Engineering
- Department of Radiology, and
- Department of Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | | | | | | | - Nizar N. Jarjour
- Division of Pulmonary Medicine and Critical Care
- Department of Medicine
| | | | - Mark L. Schiebler
- Division of Cardiothoracic Imaging, Department of Radiology, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, Wisconsin
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15
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Frizzelli A, Aiello M, Calzetta L, Bertorelli G, Chetta A. The interplay between diabetes mellitus and chronic obstructive pulmonary disease. Minerva Med 2023; 114:68-73. [PMID: 35138076 DOI: 10.23736/s0026-4806.22.07742-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) and diabetes mellitus (DM) are common and chronic disorders. COPD is characterized by persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities and it is considered currently the fourth leading cause of death worldwide. DM is a systemic disease characterized by a chronic hyperglycemia associated with inflammation and oxidative stress. The relationship between the two conditions is not completely understood and conflicting results are reported in the literature. Many studies have investigated the mechanisms through with the respiratory disease is associated with an increased risk of metabolic condition or whether the incidence risk of COPD in individuals affected by DM is higher. The link between the two chronic conditions has relevant implications in the management of patients affected by the both of them. Respiratory patients should be screened for diabetes mellitus as a frequent comorbidity of lung disease since therapeutic options should be assessed about risk-to-benefit ratios associated with the indication for the steroid use. Furthermore, the role of hyperglycemia on pulmonary function (e.g. infection or inflammatory processes) should be evaluated in DM. Finally, in presence of both diseases potential treatment interactions should be considered. In this overview we explored the common aspects of both clinical chronic illnesses and investigated the interplay between the two conditions.
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Affiliation(s)
- Annalisa Frizzelli
- Unit of Respiratory Disease and Lung Function, Department of Medicine and Surgery, University of Parma, Parma, Italy -
| | - Marina Aiello
- Unit of Respiratory Disease and Lung Function, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Luigino Calzetta
- Unit of Respiratory Disease and Lung Function, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giuseppina Bertorelli
- Unit of Respiratory Disease and Lung Function, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Alfredo Chetta
- Unit of Respiratory Disease and Lung Function, Department of Medicine and Surgery, University of Parma, Parma, Italy
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16
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Li W, Ning Y, Ma Y, Lin X, Man S, Wang B, Wang C, Yang T. Association of lung function and blood glucose level: a 10-year study in China. BMC Pulm Med 2022; 22:444. [PMID: 36434643 PMCID: PMC9700934 DOI: 10.1186/s12890-022-02208-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 10/26/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND At present, chronic respiratory diseases are a major burden in terms of morbidity and mortality and are of increasing public health concern in China. Meanwhile, the prevalence of diabetes has increased by more than 10 times over the last 40 years. While a few studies have investigated the association between chronic respiratory diseases and diabetes mellitus, the association is not clear. This study aimed to explore this association and provide evidence. METHODS In this single-center study, we enrolled participants aged ≥ 20 years undergoing at least two regular health check-ups from 2009 to 2019 at MJ Healthcare Center in Beijing. Each health check-up included physical examination, biochemical tests, a pulmonary function test, a questionnaire. A total of 11,107 adults were included, and cross-sectional and longitudinal analyses were performed. RESULTS We found that both prediabetic and diabetic adults had lower lung function than the normal population at baseline, indicating that lung function decline may start from prediabetic status. Quantitatively, with 1-mmol/L increase in fasting plasma glucose level, the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FVC% and FEV1% lowered by 25 ml, 13 ml, 0.71-1.03%, and 0.46-0.72%, respectively. However, no significant difference was found in the rates for the lung function decline among different baseline diabetes statuses. CONCLUSION People with higher blood glucose level had more severe lung function decline, with decline starting from prediabetic status, but no significant difference was noted in the rate of lung function decline based on different baseline diabetic statuses.
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Affiliation(s)
- Wei Li
- grid.415954.80000 0004 1771 3349Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2, East Yinghua Road, Chaoyang District, Beijing, 100029 China
| | - Yi Ning
- grid.11135.370000 0001 2256 9319Meinian Institute of Health, Beijing, 100191 China
| | - Yuan Ma
- grid.11135.370000 0001 2256 9319Meinian Institute of Health, Beijing, 100191 China ,grid.506261.60000 0001 0706 7839School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, 100730 China ,grid.11135.370000 0001 2256 9319Peking University Health Science Center Meinian Public Health Institute, Beijing, 100191 China
| | - Xinshan Lin
- grid.415954.80000 0004 1771 3349Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2, East Yinghua Road, Chaoyang District, Beijing, 100029 China
| | - Sailimai Man
- grid.11135.370000 0001 2256 9319Meinian Institute of Health, Beijing, 100191 China ,grid.11135.370000 0001 2256 9319Peking University Health Science Center Meinian Public Health Institute, Beijing, 100191 China ,grid.11135.370000 0001 2256 9319Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100091 China
| | - Bo Wang
- grid.11135.370000 0001 2256 9319Meinian Institute of Health, Beijing, 100191 China ,grid.11135.370000 0001 2256 9319Peking University Health Science Center Meinian Public Health Institute, Beijing, 100191 China
| | - Chen Wang
- grid.415954.80000 0004 1771 3349Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2, East Yinghua Road, Chaoyang District, Beijing, 100029 China
| | - Ting Yang
- grid.415954.80000 0004 1771 3349Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2, East Yinghua Road, Chaoyang District, Beijing, 100029 China
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17
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Peters MC, Schiebler ML, Cardet JC, Johansson MW, Sorkness R, DeBoer MD, Bleecker ER, Meyers DA, Castro M, Sumino K, Erzurum SC, Tattersall MC, Zein JG, Hastie AT, Moore W, Levy BD, Israel E, Phillips BR, Mauger DT, Wenzel SE, Fajt ML, Koliwad SK, Denlinger LC, Woodruff PG, Jarjour NN, Fahy JV. The Impact of Insulin Resistance on Loss of Lung Function and Response to Treatment in Asthma. Am J Respir Crit Care Med 2022; 206:1096-1106. [PMID: 35687105 PMCID: PMC9704842 DOI: 10.1164/rccm.202112-2745oc] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 06/09/2022] [Indexed: 02/03/2023] Open
Abstract
Rationale: The role of obesity-associated insulin resistance (IR) in airflow limitation in asthma is uncertain. Objectives: Using data in the Severe Asthma Research Program 3 (SARP-3), we evaluated relationships between homeostatic measure of IR (HOMA-IR), lung function (cross-sectional and longitudinal analyses), and treatment responses to bronchodilators and corticosteroids. Methods: HOMA-IR values were categorized as without (<3.0), moderate (3.0-5.0), or severe (>5.0). Lung function included FEV1 and FVC measured before and after treatment with inhaled albuterol and intramuscular triamcinolone acetonide and yearly for 5 years. Measurements and Main Results: Among 307 participants in SARP-3, 170 (55%) were obese and 140 (46%) had IR. Compared with patients without IR, those with IR had significantly lower values for FEV1 and FVC, and these lower values were not attributable to obesity effects. Compared with patients without IR, those with IR had lower FEV1 responses to β-adrenergic agonists and systemic corticosteroids. The annualized decline in FEV1 was significantly greater in patients with moderate IR (-41 ml/year) and severe IR (-32 ml/year,) than in patients without IR (-13 ml/year, P < 0.001 for both comparisons). Conclusions: IR is common in asthma and is associated with lower lung function, accelerated loss of lung function, and suboptimal lung function responses to bronchodilator and corticosteroid treatments. Clinical trials in patients with asthma and IR are needed to determine if improving IR might also improve lung function.
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Affiliation(s)
- Michael C. Peters
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, and
- Division of Endocrinology and Metabolism, Department of Medicine, and Diabetes Center, University of California San Francisco, San Francisco, California
| | - Mark L. Schiebler
- Division of Cardiothoracic Radiology, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Juan Carlos Cardet
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Florida
| | - Mats W. Johansson
- Morgridge Institute for Research, Madison, Wisconsin
- Department of Biomolecular Chemistry, and
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Ronald Sorkness
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Mark D. DeBoer
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Eugene R. Bleecker
- Division of Genetics, Genomics and Precision Medicine; Department of Medicine, University of Arizona, Tucson, Arizona
| | - Deborah A. Meyers
- Division of Genetics, Genomics and Precision Medicine; Department of Medicine, University of Arizona, Tucson, Arizona
| | - Mario Castro
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Kansas University Medical Center, Kansas City, Kansas
| | - Kaharu Sumino
- Division of Pulmonary Critical Care Medicine, Department of Medicine, Washington University, St. Louis, Missouri
| | | | - Matthew C. Tattersall
- Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Joe G. Zein
- Department of Pulmonary and Critical Care, Cleveland Clinic, Cleveland, Ohio
| | - Annette T. Hastie
- Department of Internal Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Wendy Moore
- Department of Internal Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Bruce D. Levy
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Elliot Israel
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Brenda R. Phillips
- Division of Statistics and Bioinformatics, Department of Public Health Sciences, Pennsylvania State University, Hershey, Pennsylvania
| | - David T. Mauger
- Division of Statistics and Bioinformatics, Department of Public Health Sciences, Pennsylvania State University, Hershey, Pennsylvania
| | - Sally E. Wenzel
- Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; and
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Merritt L. Fajt
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Suneil K. Koliwad
- Division of Endocrinology and Metabolism, Department of Medicine, and Diabetes Center, University of California San Francisco, San Francisco, California
| | - Loren C. Denlinger
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | | | - Nizar N. Jarjour
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - John V. Fahy
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, and
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18
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Allinson JP, Patel PH, Donaldson GC. Obesity, Insulin Resistance, and Asthma. Am J Respir Crit Care Med 2022; 206:1057-1058. [PMID: 35819866 PMCID: PMC9704836 DOI: 10.1164/rccm.202207-1271ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- James P Allinson
- National Heart and Lung Institute Imperial College London London, United Kingdom
- Royal Brompton Hospital London, United Kingdom
| | | | - Gavin C Donaldson
- National Heart and Lung Institute Imperial College London London, United Kingdom
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19
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Park SS, Perez Perez JL, Perez Gandara B, Agudelo CW, Rodriguez Ortega R, Ahmed H, Garcia-Arcos I, McCarthy C, Geraghty P. Mechanisms Linking COPD to Type 1 and 2 Diabetes Mellitus: Is There a Relationship between Diabetes and COPD? Medicina (B Aires) 2022; 58:medicina58081030. [PMID: 36013497 PMCID: PMC9415273 DOI: 10.3390/medicina58081030] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 01/09/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) patients frequently suffer from multiple comorbidities, resulting in poor outcomes for these patients. Diabetes is observed at a higher frequency in COPD patients than in the general population. Both type 1 and 2 diabetes mellitus are associated with pulmonary complications, and similar therapeutic strategies are proposed to treat these conditions. Epidemiological studies and disease models have increased our knowledge of these clinical associations. Several recent genome-wide association studies have identified positive genetic correlations between lung function and obesity, possibly due to alterations in genes linked to cell proliferation; embryo, skeletal, and tissue development; and regulation of gene expression. These studies suggest that genetic predisposition, in addition to weight gain, can influence lung function. Cigarette smoke exposure can also influence the differential methylation of CpG sites in genes linked to diabetes and COPD, and smoke-related single nucleotide polymorphisms are associated with resting heart rate and coronary artery disease. Despite the vast literature on clinical disease association, little direct mechanistic evidence is currently available demonstrating that either disease influences the progression of the other, but common pharmacological approaches could slow the progression of these diseases. Here, we review the clinical and scientific literature to discuss whether mechanisms beyond preexisting conditions, lifestyle, and weight gain contribute to the development of COPD associated with diabetes. Specifically, we outline environmental and genetic confounders linked with these diseases.
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Affiliation(s)
- Sangmi S. Park
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
| | - Jessica L. Perez Perez
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
| | - Brais Perez Gandara
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
| | - Christina W. Agudelo
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
| | - Romy Rodriguez Ortega
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
| | - Huma Ahmed
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
| | - Itsaso Garcia-Arcos
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
| | - Cormac McCarthy
- University College Dublin School of Medicine, Education and Research Centre, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland;
| | - Patrick Geraghty
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
- Correspondence: ; Tel.: +1-718-270-3141
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20
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Hsan S, Lakhdar N, Harrabi I, Zaouali M, Burney P, Denguezli M. Reduced forced vital capacity is independently associated with, aging, height and a poor socioeconomic status: a report from the Tunisian population-based BOLD study. BMC Pulm Med 2022; 22:267. [PMID: 35818049 PMCID: PMC9275164 DOI: 10.1186/s12890-022-02062-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background Reduced forced vital capacity (FVC) is a risk factor of all-cause mortality; however, the prevalence and determinants of reduced FVC are not available for the Tunisian population. This study investigated the association of reduced FVC with risk factors and health variables in an urban population of subjects aged ≥ 40 years and living in the city of Sousse in Tunisia. Methods A cross-sectional survey was performed using data from the Tunisian Burden of Obstructive Lung Disease (BOLD) study. We defined reduced FVC as a post-bronchodilator FVC below the lower limit of normal using National Health and Nutrition Examination Survey (NHANES) values and Global Lung Function Initiative 2012 equations (GLI 2012) and determined the relation between this finding and the potential risk factors (demographic and socioeconomic factors and the presence of chronic diseases), using multivariable regression analysis. Results The prevalence of reduced FVC was 26.6% (176/661) when using NHANES values for white Americans and 14.2% (94/661) using the GLI 2012 equations. Compared to people with normal FVC, those with a reduced FVC were significantly older, taller, had a lower body mass index (BMI), more respiratory symptoms and a higher prevalence of heart disease and hypertension. Multivariable analysis showed that reduced FVC was essentially driven by exposure to biomass smoke for heating, a number of schooling years lower than or equal to 6 years, a childhood history of hunger for a lack of money, aging and height. Conclusions The prevalence of reduced FVC is associated with a poor socioeconomic status aging and height.
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Affiliation(s)
- Safa Hsan
- Laboratoire de recherche: Physiologie de l'exercice et physiopathologie: de l'intégré au moleculaire, LR19ES09, Faculté de Médecine de Sousse, Université de Sousse, 4000, Sousse, Tunisia
| | - Nadia Lakhdar
- Laboratoire de recherche: Physiologie de l'exercice et physiopathologie: de l'intégré au moleculaire, LR19ES09, Faculté de Médecine de Sousse, Université de Sousse, 4000, Sousse, Tunisia
| | - Imed Harrabi
- Service d'épidémiologie, Faculté de Médecine de Sousse, Hôpital Farhat Hached, Université de Sousse, 4000, Sousse, Tunisia
| | - Monia Zaouali
- Laboratoire de recherche: Physiologie de l'exercice et physiopathologie: de l'intégré au moleculaire, LR19ES09, Faculté de Médecine de Sousse, Université de Sousse, 4000, Sousse, Tunisia
| | - Peter Burney
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Meriam Denguezli
- Laboratoire de recherche: Physiologie de l'exercice et physiopathologie: de l'intégré au moleculaire, LR19ES09, Faculté de Médecine de Sousse, Université de Sousse, 4000, Sousse, Tunisia. .,Faculté de Médecine Dentaire de Monastir, Université de Monastir, Avenue Avicenne, Monastir, Tunisia.
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21
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Miao L, Yang L, Guo LS, Shi QQ, Zhou TF, Chen Y, Zhang H, Cai H, Xu ZW, Yang SY, Lin H, Cheng Z, Zhu MY, Nan X, Huang S, Zheng YW, Targher G, Byrne CD, Li YP, Zheng MH, Chen CS. Metabolic Dysfunction-associated Fatty Liver Disease is Associated with Greater Impairment of Lung Function than Nonalcoholic Fatty Liver Disease. J Clin Transl Hepatol 2022; 10:230-237. [PMID: 35528974 PMCID: PMC9039714 DOI: 10.14218/jcth.2021.00306] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/17/2021] [Accepted: 11/08/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND AIMS We compared lung function parameters in nonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD), and examined the association between lung function parameters and fibrosis severity in MAFLD. METHODS In this cross-sectional study, we randomly recruited 2,543 middle-aged individuals from 25 communities across four cities in China during 2016 and 2020. All participants received a health check-up including measurement of anthropometric parameters, biochemical variables, liver ultrasonography, and spirometry. The severity of liver disease was assessed by the fibrosis (FIB)-4 score. RESULTS The prevalence of MAFLD was 20.4% (n=519) and that of NAFLD was 18.4% (n=469). After adjusting for age, sex, adiposity measures, smoking status, and significant alcohol intake, subjects with MAFLD had a significantly lower predicted forced vital capacity (FVC, 88.27±17.60% vs. 90.82±16.85%, p<0.05) and lower 1 s forced expiratory volume (FEV1, 79.89±17.34 vs. 83.02±16.66%, p<0.05) than those with NAFLD. MAFLD with an increased FIB-4 score was significantly associated with decreased lung function. For each 1-point increase in FIB-4, FVC was diminished by 0.507 (95% CI: -0.840, -0.173, p=0.003), and FEV1 was diminished by 0.439 (95% CI: -0.739, -0.140, p=0.004). The results remained unchanged when the statistical analyses was performed separately for men and women. CONCLUSIONS MAFLD was significantly associated with a greater impairment of lung function parameters than NAFLD.
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Affiliation(s)
- Lei Miao
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Gastroenterology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- The Interventional Pulmonary Key Laboratory of Zhejiang Province, Wenzhou, Zhejiang, China
- NAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Li Yang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- The Interventional Pulmonary Key Laboratory of Zhejiang Province, Wenzhou, Zhejiang, China
| | - Li-Sha Guo
- The Interventional Pulmonary Key Laboratory of Zhejiang Province, Wenzhou, Zhejiang, China
| | - Qiang-Qiang Shi
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- The Interventional Pulmonary Key Laboratory of Zhejiang Province, Wenzhou, Zhejiang, China
| | - Teng-Fei Zhou
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- The Interventional Pulmonary Key Laboratory of Zhejiang Province, Wenzhou, Zhejiang, China
| | - Yang Chen
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- The Interventional Pulmonary Key Laboratory of Zhejiang Province, Wenzhou, Zhejiang, China
| | - Huai Zhang
- Department of Biostatistics and Records Room, Medical Quality Management Office, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hui Cai
- Department of Respiratory Medicine, Zhong Shan Hospital Affiliated to Shanghai Fudan University, Shanghai, China
| | - Zhi-Wei Xu
- Clinical Research Service Center, People’s Hospital of Henan Provincial, Zhengzhou, Henan, China
| | - Shuan-Ying Yang
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shanxi, China
| | - Hai Lin
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Zhe Cheng
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ming-Yang Zhu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- The Interventional Pulmonary Key Laboratory of Zhejiang Province, Wenzhou, Zhejiang, China
| | - Xu Nan
- The Interventional Pulmonary Key Laboratory of Zhejiang Province, Wenzhou, Zhejiang, China
| | - Shuai Huang
- The Interventional Pulmonary Key Laboratory of Zhejiang Province, Wenzhou, Zhejiang, China
| | - Ya-Wen Zheng
- The Interventional Pulmonary Key Laboratory of Zhejiang Province, Wenzhou, Zhejiang, China
| | - Giovanni Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Christopher D Byrne
- Southampton National Institute for Health Research Biomedical Research Center, University Hospital Southampton, Southampton General Hospital, Southampton, UK
| | - Yu-Ping Li
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- The Interventional Pulmonary Key Laboratory of Zhejiang Province, Wenzhou, Zhejiang, China
| | - Ming-Hua Zheng
- NAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, Zhejiang, China
| | - Cheng-Shui Chen
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- The Interventional Pulmonary Key Laboratory of Zhejiang Province, Wenzhou, Zhejiang, China
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22
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Talpur AS, Kavanoor Sridhar K, Shabbir K, Amba-Ambaiowei EE, Hasan RM, Douedari Z, Hussain N, Bader S, Mirza S, Hafizyar F. Restrictive Pulmonary Disease in Diabetes Mellitus Type II Patients. Cureus 2022; 14:e23820. [PMID: 35530852 PMCID: PMC9067334 DOI: 10.7759/cureus.23820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 11/05/2022] Open
Abstract
Background The present study aimed to evaluate the proportion of restrictive pulmonary disease in individuals with diabetes mellitus type II patients. Methodology A cross-sectional study was performed at Liaquat University of Medical & Health Sciences between May 2020 and June 2021. All individuals aged between 40 and 65 years, irrespective of gender were included in the study. While those individuals with known obstructive lung diseases, blood disorders, or malignancy were excluded. Spirometry, total lung capacity (TLC), and carbon monoxide diffusing capacity (DLCO) measurements were conducted to obtain a pattern of restrictive disease in patients. Patients were divided into three main groups; i) prediabetes, ii) newly diagnosed cases of diabetes, iii) longstanding diabetes mellitus type II, and iv) control group. The parameters like the patients’ age, sex, medication, history of smoking, and cardiac diseases, among other demographics were recorded. The data collected was recorded on a predesigned proforma. Results The majority of the newly diagnosed cases, as well as long-standing diseases, were elderly males (p=0.014 and p<0.0001). Dyspnea was significantly correlated with longstanding diabetes mellitus type II as indicated by a higher mean score of 0.65 ± 0.10 (p=0.006). Smoking did not significantly correlate with diabetes mellitus type II. In patients with longstanding diabetes, 27 (14.4%) had a modified Medical Research Council (mMRC) score of greater than two while none of the controls had severe breathlessness. Reduced forced vital capacity (FVC) was detected in 16.0% of patients with longstanding diabetes and 12.8% in patients with newly diagnosed disease. Similar results were obtained for total lung capacity (TLC) and diffusing capacity (DLCO) (p=0.003 and p=0.02). Conclusion Diabetes mellitus type II is significantly associated with restrictive lung disease in patients as indicated by a high number of patients with longstanding diabetes in our study who were found to have restrictive lung disease and severe dyspnea. Screening for lung dysfunction could aid in optimum management of this debilitating disease.
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23
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Daghigh F, Karimi P, Alihemmati A, Majidi Zolbin M, Ahmadiasl N. Swimming training modulates lung injury induced by ovariectomy in diabetic rats: involvement of inflammatory and fibrotic biomarkers. Arch Physiol Biochem 2022; 128:514-520. [PMID: 31821061 DOI: 10.1080/13813455.2019.1699934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
CONTEXT Previous studies have noted that the incidence of inflammatory and fibrotic diseases is higher in diabetic menopausal women. OBJECTIVE In the present study, we evaluated effects of swimming training on inflammatory and fibrotic biomarkers in the lung of ovariectomized diabetic rats. MATERIALS AND METHODS Forty female rats were assigned into four groups: sham; rats underwent surgery without ovariectomies, OVX: rats that underwent ovariectomies, OVX.Dia: ovariectomized rats with high-fat diet, OVX.Dia. Exe: ovariectomized diabetic rats with 8 weeks of swimming training. At the end of experiment, protein expressions were assessed with western blot. Lung sections were subjected to immunohistochemical and haematoxylin eosin staining. RESULTS There was a significant difference in the protein expressions between exercise and ovariectomized diabetic groups (p < .05). CONCLUSION The present study showed strong potential of swimming training on oestrogen deficient diabetic lung. These data encourage further investigation into the inclusive effects of exercise in menopausal diabetic women.
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Affiliation(s)
- Faeze Daghigh
- Department of Physiology, Tabriz Branch, Islamic Azad University, Tabriz, Iran
- Tuberculosis and Lung diseases research center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Pouran Karimi
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Alihemmati
- Department of Histology & Embryology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoumeh Majidi Zolbin
- Department of Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Ahmadiasl
- Tuberculosis and Lung diseases research center, Tabriz University of Medical Sciences, Tabriz, Iran
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Gurudatta Pawar S, K A, Santhanam J, Nellaiappa Ganesan SK, Vidya TA, Kumarasamy S, Meenakshi Sundari SN, Ramya SG. Dynamic diffusion lung capacity of carbon monoxide (DLCO) as a predictor of pulmonary microangiopathy and its association with extra pulmonary microangiopathy in patients with type II diabetes mellitus. Diabetes Metab Syndr 2022; 16:102360. [PMID: 34920193 DOI: 10.1016/j.dsx.2021.102360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 11/09/2021] [Accepted: 12/02/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIM Lung as a target end organ for microvascular disease often remains underdiagnosed. This study aims to assess occurrence of pulmonary microangiopathy among Type 2 diabetes mellitus (T2DM) using dynamic diffusion lung capacity of carbon monoxide (DLCO). METHODS A total of 120 participants aged >18 years were enrolled in this study. Group 1 comprised T2DM with microangiopathy (n = 40), group 2 include T2DM without microangiopathy (n = 40), group 3 were healthy controls (n = 40). Individuals with underlying lung disease, smoking history, heart failure, urinary tract infection, macrovascular complications of diabetes, microalbuminuria due to other causes were excluded from the study. Using electronic spirometry, Forced Expiratory Volume in first second (FEV1), Forced Vital Capacity (FVC) was measured and FEV1/FVC ratio calculated. DLCO (%predicted) using single breath method was measured in sitting position followed by supine position and delta DLCO was calculated. DLCO measured was compared between the three groups. RESULTS DLCO (median [IQR]) in sitting (78 [70-82.75]) and supine position (70 [62-84]) among group one was significantly decreased when compared to other two groups (p value < 0.001, p value < 0.001 respectively). Delta DLCO (median, [IQR]) among patients with diabetic microangiopathy (-6 [-8 to -2]) was significant on comparison with group two (4[2,6]) and control group (5[4,6]) (p < 0.001). Negative delta DLCO reflecting pulmonary microangiopathy was significantly associated with extrapulmonary microangiopathy (p value = 0.027). CONCLUSION Postural variation in DLCO is a useful non-invasive test for identifying pulmonary microangiopathy among T2DM patients. Presence of pulmonary microangiopathy has significant association with diabetic nephropathy and retinopathy.
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Affiliation(s)
- Sridatta Gurudatta Pawar
- Department of General Medicine, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India
| | - Arun K
- Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India.
| | - Jennie Santhanam
- Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India
| | - S K Nellaiappa Ganesan
- Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India
| | - T A Vidya
- Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India
| | - Subramaniyan Kumarasamy
- Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India
| | - S N Meenakshi Sundari
- Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India
| | - S G Ramya
- Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India
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Kotlyarov S, Bulgakov A. Lipid Metabolism Disorders in the Comorbid Course of Nonalcoholic Fatty Liver Disease and Chronic Obstructive Pulmonary Disease. Cells 2021; 10:2978. [PMID: 34831201 PMCID: PMC8616072 DOI: 10.3390/cells10112978] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/25/2021] [Accepted: 10/30/2021] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is currently among the most common liver diseases. Unfavorable data on the epidemiology of metabolic syndrome and obesity have increased the attention of clinicians and researchers to the problem of NAFLD. The research results allow us to emphasize the systemicity and multifactoriality of the pathogenesis of liver parenchyma lesion. At the same time, many aspects of its classification, etiology, and pathogenesis remain controversial. Local and systemic metabolic disorders are also a part of the pathogenesis of chronic obstructive pulmonary disease and can influence its course. The present article analyzes the metabolic pathways mediating the links of impaired lipid metabolism in NAFLD and chronic obstructive pulmonary disease (COPD). Free fatty acids, cholesterol, and ceramides are involved in key metabolic and inflammatory pathways underlying the pathogenesis of both diseases. Moreover, inflammation and lipid metabolism demonstrate close links in the comorbid course of NAFLD and COPD.
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Affiliation(s)
- Stanislav Kotlyarov
- Department of Nursing, Ryazan State Medical University, 390026 Ryazan, Russia;
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Lee WH, Wu DW, Chen YC, Liu YH, Liao WS, Chen SC, Hung CH, Kuo CH, Su HM. Association of Pulmonary Function Decline over Time with Longitudinal Change of Glycated Hemoglobin in Participants without Diabetes Mellitus. J Pers Med 2021; 11:jpm11100994. [PMID: 34683134 PMCID: PMC8537814 DOI: 10.3390/jpm11100994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 09/20/2021] [Accepted: 09/29/2021] [Indexed: 01/13/2023] Open
Abstract
Pulmonary damage and function impairment were frequently noted in patients with diabetes mellitus (DM). However, the relationship between lung function and glycemic status in non-DM subjects was not well-known. Here, we evaluated the association of longitudinal changes of lung function parameters with longitudinal changes of glycated hemoglobin (HbA1c) in non-DM participants. The study enrolled participants without prior type 2 DM, hypertension, and chronic obstructive pulmonary disease (COPD) from the Taiwan Biobank database. Laboratory profiles and pulmonary function parameters, including forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), were examined at baseline and follow-up. Finally, 7055 participants were selected in this study. During a mean 3.9-year follow-up, FVC and FEV1 were significantly decreased over time (both p < 0.001). In the multivariable analysis, the baseline (unstandardized coefficient β = −0.032, p < 0.001) and longitudinal change (unstandardized coefficient β = −0.025, p = 0.026) of FVC were negatively associated with the baseline and longitudinal change of HbA1c, respectively. Additionally, the longitudinal change of FVC was negatively associated with the risk of newly diagnosed type 2 DM (p = 0.018). During a mean 3.9-year follow-up, our present study, including participants without type 2 DM, hypertension, and COPD, demonstrated that the baseline and longitudinal change of FVC were negatively and respectively correlated with the baseline and longitudinal change of HbA1c. Furthermore, compared to those without new-onset DM, participants with new-onset DM had a more pronounced decline of FVC over time.
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Affiliation(s)
- Wen-Hsien Lee
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan; (W.-H.L.); (D.-W.W.); (Y.-C.C.); (Y.-H.L.); (W.-S.L.); (S.-C.C.); (C.-H.H.); (C.-H.K.)
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
| | - Da-Wei Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan; (W.-H.L.); (D.-W.W.); (Y.-C.C.); (Y.-H.L.); (W.-S.L.); (S.-C.C.); (C.-H.H.); (C.-H.K.)
- Research Center for Environmental Medicine, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
| | - Ying-Chih Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan; (W.-H.L.); (D.-W.W.); (Y.-C.C.); (Y.-H.L.); (W.-S.L.); (S.-C.C.); (C.-H.H.); (C.-H.K.)
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
| | - Yi-Hsueh Liu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan; (W.-H.L.); (D.-W.W.); (Y.-C.C.); (Y.-H.L.); (W.-S.L.); (S.-C.C.); (C.-H.H.); (C.-H.K.)
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
| | - Wei-Sheng Liao
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan; (W.-H.L.); (D.-W.W.); (Y.-C.C.); (Y.-H.L.); (W.-S.L.); (S.-C.C.); (C.-H.H.); (C.-H.K.)
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan; (W.-H.L.); (D.-W.W.); (Y.-C.C.); (Y.-H.L.); (W.-S.L.); (S.-C.C.); (C.-H.H.); (C.-H.K.)
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
| | - Chih-Hsing Hung
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan; (W.-H.L.); (D.-W.W.); (Y.-C.C.); (Y.-H.L.); (W.-S.L.); (S.-C.C.); (C.-H.H.); (C.-H.K.)
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
| | - Chao-Hung Kuo
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan; (W.-H.L.); (D.-W.W.); (Y.-C.C.); (Y.-H.L.); (W.-S.L.); (S.-C.C.); (C.-H.H.); (C.-H.K.)
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
| | - Ho-Ming Su
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan; (W.-H.L.); (D.-W.W.); (Y.-C.C.); (Y.-H.L.); (W.-S.L.); (S.-C.C.); (C.-H.H.); (C.-H.K.)
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, 482 Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
- Correspondence: ; Tel.: +886-7-8036783-3441; Fax: +886-7-8063346
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Otani T, Yamaguchi K, Nakao S, Sakamoto S, Horimasu Y, Masuda T, Miyamoto S, Nakashima T, Iwamoto H, Fujitaka K, Hamada H, Hattori N. Association between glucose intolerance and chemotherapy-induced lung injury in patients with lung cancer and interstitial lung disease. Cancer Chemother Pharmacol 2021; 88:857-865. [PMID: 34350479 DOI: 10.1007/s00280-021-04341-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/31/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Cytotoxic chemotherapy-induced lung injury is a fatal complication in patients with lung cancer and interstitial lung disease (ILD). We aimed to evaluate the association between hyperglycemia and this form of lung injury in patients with lung cancer concomitant with ILD. METHODS From 1147 patients with advanced lung cancer, we retrospectively enrolled 98 patients with ILD whose hemoglobin A1c (HbA1c) levels were measured, and investigated the association between HbA1c levels and cytotoxic chemotherapy-induced lung injury. In 73 patients whose serum samples were retained, we measured serum levels of advanced glycation end products (AGE) and assessed the association of AGE levels with HbA1c levels and cytotoxic chemotherapy-induced lung injury. RESULTS The incidence of cytotoxic chemotherapy-induced lung injury was significantly higher in patients with HbA1c levels ≥ 5.8% than in those with HbA1c levels < 5.8%, but not in those with HbA1c levels ≥ 6.5% than in those with HbA1c levels < 6.5%. The multivariate logistic regression model revealed that HbA1c level ≥ 5.8% was a significant risk factor for this complication [odds ratio 3.178 (95% confidence interval 1.057-9.556), P = 0.040]. In addition, serum AGE levels were significantly higher in patients with HbA1c levels ≥ 5.8% than in those with HbA1c levels < 5.8% [median (interquartile range); 0.129 (0.023-0.290) and 0.474 (0.213-1.109) μg/mL, P = 0.001]. CONCLUSION Glucose intolerance (e.g., HbA1c level ≥ 5.8%) may be a risk factor of cytotoxic chemotherapy-induced lung injury, which might be associated with elevated AGE production due to hyperglycemia.
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Affiliation(s)
- Toshihito Otani
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Kakuhiro Yamaguchi
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Satoshi Nakao
- Department of Internal Medicine, Mitsugi General Hospital, 124, Ichi, Mitsugi-cho, Onomichi, Hiroshima, 722-0393, Japan
| | - Shinjiro Sakamoto
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yasushi Horimasu
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Takeshi Masuda
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Shintaro Miyamoto
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Taku Nakashima
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Hiroshi Iwamoto
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Kazunori Fujitaka
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Hironobu Hamada
- Department of Physical Analysis and Therapeutic Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Noboru Hattori
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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Wielscher M, Amaral AFS, van der Plaat D, Wain LV, Sebert S, Mosen-Ansorena D, Auvinen J, Herzig KH, Dehghan A, Jarvis DL, Jarvelin MR. Genetic correlation and causal relationships between cardio-metabolic traits and lung function impairment. Genome Med 2021; 13:104. [PMID: 34154662 PMCID: PMC8215837 DOI: 10.1186/s13073-021-00914-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Associations of low lung function with features of poor cardio-metabolic health have been reported. It is, however, unclear whether these co-morbidities reflect causal associations, shared genetic heritability or are confounded by environmental factors. METHODS We performed three analyses: (1) cardio-metabolic health to lung function association tests in Northern Finland Birth cohort 1966, (2) cross-trait linkage disequilibrium score regression (LDSC) to compare genetic backgrounds and (3) Mendelian randomisation (MR) analysis to assess the causal effect of cardio-metabolic traits and disease on lung function, and vice versa (bidirectional MR). Genetic associations were obtained from the UK Biobank data or published large-scale genome-wide association studies (N > 82,000). RESULTS We observed a negative genetic correlation between lung function and cardio-metabolic traits and diseases. In Mendelian Randomisation analysis (MR), we found associations between type 2 diabetes (T2D) instruments and forced vital capacity (FVC) as well as FEV1/FVC. Body mass index (BMI) instruments were associated to all lung function traits and C-reactive protein (CRP) instruments to FVC. These genetic associations provide evidence for a causal effect of cardio-metabolic traits on lung function. Multivariable MR suggested independence of these causal effects from other tested cardio-metabolic traits and diseases. Analysis of lung function specific SNPs revealed a potential causal effect of FEV1/FVC on blood pressure. CONCLUSIONS The present study overcomes many limitations of observational studies by using Mendelian Randomisation. We provide evidence for an independent causal effect of T2D, CRP and BMI on lung function with some of the T2D effect on lung function being attributed to inflammatory mechanisms. Furthermore, this analysis suggests a potential causal effect of FEV1/FVC on blood pressure. Our detailed analysis of the interplay between cardio-metabolic traits and impaired lung function provides the opportunity to improve the quality of existing intervention strategies.
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Affiliation(s)
- Matthias Wielscher
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Andre F S Amaral
- National Heart and Lung Institute (NHLI), Imperial College London, Emmanuel Kaye Building, London, SW3 6LR, UK
| | - Diana van der Plaat
- National Heart and Lung Institute (NHLI), Imperial College London, Emmanuel Kaye Building, London, SW3 6LR, UK
| | - Louise V Wain
- Genetic Epidemiology Group, Department of Health Sciences, George Davies Centre, University of Leicester, University Rd, Leicester, LE1 7RH, UK
- National Institute for Health Research, Leicester Respiratory Biomedical Research Centre, Glenfield Hospital, University Rd, Leicester, LE1 7RH, UK
| | - Sylvain Sebert
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O.Box 8000, FI-90014, Oulu, Finland
- Biocenter of Oulu, University of Oulu, Aapistie 5, FI-90014, Oulu, Finland
| | - David Mosen-Ansorena
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Juha Auvinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O.Box 8000, FI-90014, Oulu, Finland
- Biocenter of Oulu, University of Oulu, Aapistie 5, FI-90014, Oulu, Finland
| | - Karl-Heinz Herzig
- Biocenter of Oulu, University of Oulu, Aapistie 5, FI-90014, Oulu, Finland
- Research Unit of Biomedicine, Medical Research Center (MRC), University of Oulu, University Hospital, P.O. Box 8000, Oulu, Finland
- Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, 41 Jackowskiego St, 60-512, Poznan, Poland
| | - Abbas Dehghan
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Debbie L Jarvis
- National Heart and Lung Institute (NHLI), Imperial College London, Emmanuel Kaye Building, London, SW3 6LR, UK.
| | - Marjo-Riitta Jarvelin
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK.
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O.Box 8000, FI-90014, Oulu, Finland.
- Biocenter of Oulu, University of Oulu, Aapistie 5, FI-90014, Oulu, Finland.
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Kingston Lane, London, UB8 3PH, UK.
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Bai L, Zhang L, Pan T, Wang W, Wang D, Turner C, Zhou X, He H. Idiopathic pulmonary fibrosis and diabetes mellitus: a meta-analysis and systematic review. Respir Res 2021; 22:175. [PMID: 34103046 PMCID: PMC8188656 DOI: 10.1186/s12931-021-01760-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/26/2021] [Indexed: 11/25/2022] Open
Abstract
Background Idiopathic pulmonary fibrosis (IPF) is a chronic diffuse interstitial lung disease, of which the etiology has been poorly understood. Several studies have focused on the relationship between IPF and diabetes mellitus (DM) in the past years but have failed to reach a consensus. This meta-analysis aimed to examine the association between diabetes to IPF. Methods We accumulated studies investigating the association between DM and IPF from databases including Medline, Cochrane Library, Embase, Web of Science, and China National Knowledge Infrastructure. RevMan 5.3 and the Newcastle–Ottawa Scale (NOS) were utilized to analyze the data and assess the quality of the included studies. The value of odds ratio (OR) with 95% confidence interval (CI) was used as the measure to estimate the risk of DM in IPF. Heterogeneity was assessed by I2 statistics. We also performed subgroup analysis, meta-regression, and Egger’s test for bias analysis. Results Nine case–control studies with 5096 IPF patients and 19,095 control subjects were included in the present meta-analysis, which indicated a positive correlation between DM and IPF (OR 1.65, 95% CI 1.30–2.10; P < 0.0001). Meta-regression and subgroup analysis negated the influence of covariates like cigarette smoking, age and gender, but the heterogeneity existed and could not be fully explained. Conclusion IPF and DM may be associated, but the causal relationship remains indeterminate till now. Further rigorously designed studies are required to confirm the present findings and investigate the possible mechanisms behind the effect of DM on IPF.
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Affiliation(s)
- Le Bai
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China
| | - Li Zhang
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China
| | - Tingyu Pan
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China
| | - Wei Wang
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.,Department of GCP Research Center, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Dian Wang
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.,Department of GCP Research Center, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Cassidy Turner
- Arizona Metabolomics Laboratory, College of Health Solutions, Arizona State University, Scottsdale, AZ, USA
| | - Xianmei Zhou
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China. .,Department of Respiratory Medicine, Jiangsu Province Hospital of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, Jiangsu Province, People's Republic of China.
| | - Hailang He
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China. .,Department of Respiratory Medicine, Jiangsu Province Hospital of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, Jiangsu Province, People's Republic of China.
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Jin S, Hu W. Severity of COVID-19 and Treatment Strategy for Patient With Diabetes. Front Endocrinol (Lausanne) 2021; 12:602735. [PMID: 33995267 PMCID: PMC8121170 DOI: 10.3389/fendo.2021.602735] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 04/13/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), which was named by the World Health Organization (WHO) in February 2020, has quickly spread to more than 200 countries around the world and was declared as a global pandemic in March 2020. The severity of the disease makes it more prone to severe symptoms and higher mortality rates in patients, especially those who are with comorbidities, including high blood pressure, cardiovascular disease, obesity, and diabetes, increases the concern over the consequences of this pandemic. However, initial reports do not clearly describe whether diabetes itself or associated comorbidities or treatment strategies contribute to the severe prognosis of COVID-19 infections. Various clinical trials are being conducted on glucose-lowering agents but to date, there is no standard treatment protocol approved for COVID-19 cases with pre-existing diabetes. This review is aimed to decipher the potential risk factors of COVID-19 involved from existing evidence. Identification of a novel therapeutic strategy could be beneficial for combating SARS-CoV-2, which might be dreadful to debilitating people who have diabetes.
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Affiliation(s)
- Shi Jin
- Department of Endocrinology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Weina Hu
- Department of Cardiology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
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McNeill JN, Lau ES, Zern EK, Nayor M, Malhotra R, Liu EE, Bhat RR, Brooks LC, Farrell R, Sbarbaro JA, Schoenike MW, Medoff BD, Lewis GD, Ho JE. Association of obesity-related inflammatory pathways with lung function and exercise capacity. Respir Med 2021; 183:106434. [PMID: 33964816 DOI: 10.1016/j.rmed.2021.106434] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Obesity has multifactorial effects on lung function and exercise capacity. The contributions of obesity-related inflammatory pathways to alterations in lung function remain unclear. RESEARCH QUESTION To examine the association of obesity-related inflammatory pathways with pulmonary function, exercise capacity, and pulmonary-specific contributors to exercise intolerance. METHOD We examined 695 patients who underwent cardiopulmonary exercise testing (CPET) with invasive hemodynamic monitoring at Massachusetts General Hospital between December 2006-June 2017. We investigated the association of adiponectin, leptin, resistin, IL-6, CRP, and insulin resistance (HOMA-IR) with pulmonary function and exercise parameters using multivariable linear regression. RESULTS Obesity-related inflammatory pathways were associated with worse lung function. Specifically, higher CRP, IL-6, and HOMA-IR were associated with lower percent predicted FEV1 and FVC with a preserved FEV1/FVC ratio suggesting a restrictive physiology pattern (P ≤ 0.001 for all). For example, a 1-SD higher natural-logged CRP level was associated with a nearly 5% lower percent predicted FEV1 and FVC (beta -4.8, s.e. 0.9 for FEV1; beta -4.9, s.e. 0.8 for FVC; P < 0.0001 for both). Obesity-related inflammatory pathways were associated with worse pulmonary vascular distensibility (adiponectin, IL-6, and CRP, P < 0.05 for all), as well as lower pulmonary artery compliance (IL-6 and CRP, P ≤ 0.01 for both). INTERPRETATION Our findings highlight the importance of obesity-related inflammatory pathways including inflammation and insulin resistance on pulmonary spirometry and pulmonary vascular function. Specifically, systemic inflammation as ascertained by CRP, IL-6 and insulin resistance are associated with restrictive pulmonary physiology independent of BMI. In addition, inflammatory markers were associated with lower exercise capacity and pulmonary vascular dysfunction.
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Affiliation(s)
- Jenna N McNeill
- From the Cardiovascular Research Center, Division of Massachusetts General Hospital, Boston, MA, USA; Pulmonary and Critical Care, Division of Massachusetts General Hospital, Boston, MA, USA
| | - Emily S Lau
- From the Cardiovascular Research Center, Division of Massachusetts General Hospital, Boston, MA, USA; Cardiology Division of Massachusetts General Hospital, Boston, MA, USA
| | - Emily K Zern
- From the Cardiovascular Research Center, Division of Massachusetts General Hospital, Boston, MA, USA; Cardiology Division of Massachusetts General Hospital, Boston, MA, USA
| | - Matthew Nayor
- Cardiology Division of Massachusetts General Hospital, Boston, MA, USA
| | - Rajeev Malhotra
- Cardiology Division of Massachusetts General Hospital, Boston, MA, USA
| | - Elizabeth E Liu
- From the Cardiovascular Research Center, Division of Massachusetts General Hospital, Boston, MA, USA
| | - Rohan R Bhat
- Cardiology Division of Massachusetts General Hospital, Boston, MA, USA
| | - Liana C Brooks
- Cardiology Division of Massachusetts General Hospital, Boston, MA, USA
| | - Robyn Farrell
- Cardiology Division of Massachusetts General Hospital, Boston, MA, USA
| | - John A Sbarbaro
- Cardiology Division of Massachusetts General Hospital, Boston, MA, USA
| | - Mark W Schoenike
- Cardiology Division of Massachusetts General Hospital, Boston, MA, USA
| | - Benjamin D Medoff
- Pulmonary and Critical Care, Division of Massachusetts General Hospital, Boston, MA, USA
| | - Gregory D Lewis
- Cardiology Division of Massachusetts General Hospital, Boston, MA, USA
| | - Jennifer E Ho
- From the Cardiovascular Research Center, Division of Massachusetts General Hospital, Boston, MA, USA; Cardiology Division of Massachusetts General Hospital, Boston, MA, USA.
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Kim SH, Kim HS, Min HK, Lee SW. Association between insulin resistance and lung function trajectory over 4 years in South Korea: community-based prospective cohort. BMC Pulm Med 2021; 21:110. [PMID: 33794844 PMCID: PMC8017677 DOI: 10.1186/s12890-021-01478-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 03/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Hyperglycemic conditions are associated with respiratory dysfunction. Although several studies have reported that insulin resistance (IR) is related to decreased lung function, the association between IR and change in lung function has been rarely studied. This study aimed to investigate the potential association of IR on annual change in lung function using a community-based prospective cohort in Korea. Methods We selected 4827 Korean participants whose serial lung functions were assessed over 4 years using 1:3 propensity score matching. Exposure was baseline IR estimated with homeostatic model assessment (HOMA-IR), and outcomes were annual changes in lung function determined by calculating the regression coefficient using least-square linear regression analysis. Results In the multivariate linear regression, per one unit increased log transformed HOMA-IR was associated with decline in FEV1%-predicted (β: − 0.23, 95% CI: − 0.36 to − 0.11) and FVC %-predicted (β: − 0.20, 95% CI: − 0.33 to − 0.08), respectively. In the generalized additive model plot, HOMA-IR showed a negative linear association with annual changes in FEV1%-predicted and FVC %-predicted. The suggested threshold of HOMA-IR for decline in lung function was 1.0 unit for annual change in FEV1%-predicted and 2.2 unit for annual change in FVC %-predicted. Age showed statistically significant effect modification on the relationship between HOMA-IR and annual change in FEV1%-predicted. Increased HOMA-IR was associated with the decreased annual change in FEV1%-predicted, particularly in older people. Conclusions In South Korea, increased HOMA-IR was associated with decline in lung function. Since IR was related to decline in FEV1%-predicted, particularly in older people, tailored approaches are needed in these populations. The potential pulmonary hazard of IR needs to be confirmed in future studies. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01478-7.
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Affiliation(s)
- Sang Hyuk Kim
- Medical Corps 2nd of Armored Brigade, Republic of Korea Army, Paju, Korea
| | - Hyun Sam Kim
- Division of Nephrology, Department of Internal Medicine, Eulji Medical Center, 68, Hangeulbiseok-ro, Nowon-gu, Seoul, 01735, Korea
| | - Hyang Ki Min
- Division of Nephrology, Department of Internal Medicine, Eulji Medical Center, 68, Hangeulbiseok-ro, Nowon-gu, Seoul, 01735, Korea
| | - Sung Woo Lee
- Division of Nephrology, Department of Internal Medicine, Eulji Medical Center, 68, Hangeulbiseok-ro, Nowon-gu, Seoul, 01735, Korea.
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33
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Albarrati A, Taher M, Nazer R. Effect of inspiratory muscle training on respiratory muscle strength and functional capacity in patients with type 2 diabetes mellitus: A randomized clinical trial. J Diabetes 2021; 13:292-298. [PMID: 33471439 DOI: 10.1111/1753-0407.13106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/12/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is usually associated with respiratory manifestations including inspiratory muscle weakness which affects exercise capacity. The present study aimed to determine the effect of inspiratory muscle training (IMT) on inspiratory muscle strength and exercise capacity in patients with Type 2 diabetes mellitus (T2DM). METHODS This was a randomized controlled trial in patients with type 2 diabetes mellitus with no previous cardiopulmonary or neuromuscular diseases. Patients had no back pain. Patients were randomized into interventional or placebo groups. Sniff nasal inspiratory pressure (SNIP), maximum inspiratory pressure (MIP), and six-minute walking test (6MWT) were measured at baseline and 8 weeks post incremental inspiratory muscle training. RESULTS At baseline, interventional and placebo groups were similar in age, body mass index, sex inspiratory muscle strength, and exercise capacity. After 8 weeks of incremental inspiratory muscle training at 40% of MIP, the interventional group had a significant increase in the SNIP (mean difference: 18.5 ± 5.30 cm H2O vs 2.8 ± 4.8 cm H2O) and MIP (mean difference: 19.4 ± 4.3 Vs 5.4 ± 3.6 cm H2O) compared to the placebo group, respectively. The interventional group showed improvement in the 6MWT (mean difference: 70 ± 29 m vs 34 ± 24 m) compared to the placebo group, P < .05. CONCLUSION Incremental inspiratory muscle training increased the diaphragm strength in patients with T2DM and improved exercise capacity.
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Affiliation(s)
- Ali Albarrati
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed Taher
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Faculty of Physical Therapy, Cairo University, Egypt
| | - Rakan Nazer
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Prentice BJ, Jaffe A, Hameed S, Verge CF, Waters S, Widger J. Cystic fibrosis-related diabetes and lung disease: an update. Eur Respir Rev 2021; 30:30/159/200293. [PMID: 33597125 PMCID: PMC9488640 DOI: 10.1183/16000617.0293-2020] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022] Open
Abstract
The development of cystic fibrosis-related diabetes (CFRD) often leads to poorer outcomes in patients with cystic fibrosis including increases in pulmonary exacerbations, poorer lung function and early mortality. This review highlights the many factors contributing to the clinical decline seen in patients diagnosed with CFRD, highlighting the important role of nutrition, the direct effect of hyperglycaemia on the lungs, the immunomodulatory effects of high glucose levels and the potential role of genetic modifiers in CFRD.
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Affiliation(s)
- Bernadette J Prentice
- Dept of Respiratory Medicine, Sydney Children's Hospital, Randwick, Australia
- School of Women's and Children's Health, University of New South Wales, Sydney, Randwick, Australia
| | - Adam Jaffe
- Dept of Respiratory Medicine, Sydney Children's Hospital, Randwick, Australia
- School of Women's and Children's Health, University of New South Wales, Sydney, Randwick, Australia
| | - Shihab Hameed
- School of Women's and Children's Health, University of New South Wales, Sydney, Randwick, Australia
- Faculty of Medicine, University of Sydney, Sydney, Australia
- Dept of Endocrinology, Sydney Children's Hospital, Randwick, Australia
| | - Charles F Verge
- School of Women's and Children's Health, University of New South Wales, Sydney, Randwick, Australia
- Dept of Endocrinology, Sydney Children's Hospital, Randwick, Australia
| | - Shafagh Waters
- School of Women's and Children's Health, University of New South Wales, Sydney, Randwick, Australia
- MiCF Research Centre, Sydney, Australia
| | - John Widger
- Dept of Respiratory Medicine, Sydney Children's Hospital, Randwick, Australia
- School of Women's and Children's Health, University of New South Wales, Sydney, Randwick, Australia
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Ferreccio C, Huidobro A, Cortés S, Bambs C, Toro P, Van De Wyngard V, Acevedo J, Paredes F, Venegas P, Verdejo H, Oyarzún-González X, Cook P, Castro PF, Foerster C, Vargas C, Koshiol J, Araya JC, Cruz F, Corvalán AH, Quest AF, Kogan MJ, Lavandero S. Cohort Profile: The Maule Cohort (MAUCO). Int J Epidemiol 2021; 49:760-761i. [PMID: 32176288 DOI: 10.1093/ije/dyaa003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 01/09/2020] [Indexed: 12/29/2022] Open
Affiliation(s)
- Catterina Ferreccio
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrea Huidobro
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Facultad de Medicina, School of Medicine, Universidad Católica del Maule, Talca, Chile
| | - Sandra Cortés
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Centro de Desarrollo Urbano Sustentable, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Bambs
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Toro
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Vanessa Van De Wyngard
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Johanna Acevedo
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Departamento de Epidemiología, Ministerio de Salud, Santiago, Chile
| | - Fabio Paredes
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pía Venegas
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Hugo Verdejo
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ximena Oyarzún-González
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Paz Cook
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo F Castro
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Foerster
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Instituto de Ciencias Agronómicas y Veterinarias, Universidad de O'Higgins, Rancagua, Chile
| | - Claudio Vargas
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Facultad de Ciencias, Departamento de Matemáticas y Ciencias de la computación, Universidad de Santiago de Chile, Santiago, Chile
| | - Jill Koshiol
- Division of Cancer Epidemiology and Genetics, Infections and Immunoepidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Juan Carlos Araya
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Departamento de Patología, Facultad de Medicina, Universidad de la Frontera, Temuco, Chile
| | - Francisco Cruz
- Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandro H Corvalán
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrew F Quest
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Marcelo J Kogan
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Departamento de Química, Farmacología y Toxicología, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago, Chile
| | - Sergio Lavandero
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Departamento de Química, Farmacología y Toxicología, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago, Chile.,Departamento de Química, Farmacología y Toxicología, Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Viswanathan V, Puvvula A, Jamthikar AD, Saba L, Johri AM, Kotsis V, Khanna NN, Dhanjil SK, Majhail M, Misra DP, Agarwal V, Kitas GD, Sharma AM, Kolluri R, Naidu S, Suri JS. Bidirectional link between diabetes mellitus and coronavirus disease 2019 leading to cardiovascular disease: A narrative review. World J Diabetes 2021; 12:215-237. [PMID: 33758644 PMCID: PMC7958478 DOI: 10.4239/wjd.v12.i3.215] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/20/2020] [Accepted: 02/11/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a global pandemic where several comorbidities have been shown to have a significant effect on mortality. Patients with diabetes mellitus (DM) have a higher mortality rate than non-DM patients if they get COVID-19. Recent studies have indicated that patients with a history of diabetes can increase the risk of severe acute respiratory syndrome coronavirus 2 infection. Additionally, patients without any history of diabetes can acquire new-onset DM when infected with COVID-19. Thus, there is a need to explore the bidirectional link between these two conditions, confirming the vicious loop between "DM/COVID-19". This narrative review presents (1) the bidirectional association between the DM and COVID-19, (2) the manifestations of the DM/COVID-19 loop leading to cardiovascular disease, (3) an understanding of primary and secondary factors that influence mortality due to the DM/COVID-19 loop, (4) the role of vitamin-D in DM patients during COVID-19, and finally, (5) the monitoring tools for tracking atherosclerosis burden in DM patients during COVID-19 and "COVID-triggered DM" patients. We conclude that the bidirectional nature of DM/COVID-19 causes acceleration towards cardiovascular events. Due to this alarming condition, early monitoring of atherosclerotic burden is required in "Diabetes patients during COVID-19" or "new-onset Diabetes triggered by COVID-19 in Non-Diabetes patients".
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Affiliation(s)
- Vijay Viswanathan
- M Viswanathan Hospital for Diabetes, M Viswanathan Diabetes Research Centre, Chennai 600013, India
| | - Anudeep Puvvula
- Annu’s Hospitals for Skin and Diabetes, Nellore 524101, Andhra Pradesh, India
| | - Ankush D Jamthikar
- Department of Electronics and Communications, Visvesvaraya National Institute of Technology, Nagpur 440010, Maharashtra, India
| | - Luca Saba
- Department of Radiology, University of Cagliari, Monserrato 09045, Cagliari, Italy
| | - Amer M Johri
- Department of Medicine, Division of Cardiology, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Vasilios Kotsis
- 3rd Department of Internal Medicine, Hypertension Center, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki 541-24, Greece
| | - Narendra N Khanna
- Department of Cardiology, Indraprastha APOLLO Hospitals, New Delhi 110020, India
| | - Surinder K Dhanjil
- Stroke Diagnosis and Monitoring Division, AtheroPoint™ LLC, CA 95661, United States
| | - Misha Majhail
- Stroke Diagnosis and Monitoring Division, AtheroPoint™, Roseville, CA 95661, United States
| | - Durga Prasanna Misra
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
| | - Vikas Agarwal
- Departments of Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
| | - George D Kitas
- Academic Affairs, Dudley Group NHS Foundation Trust, Dudley DY1 2HQ, United Kingdom
- Arthritis Research UK Epidemiology Unit, Manchester University, Manchester M13 9PL, United Kingdom
| | - Aditya M Sharma
- Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA 22908, United States
| | - Raghu Kolluri
- OhioHealth Heart and Vascular, Ohio, OH 43082, United States
| | - Subbaram Naidu
- Electrical Engineering Department, University of Minnesota, Duluth, MN 55812, United States
| | - Jasjit S Suri
- Stroke Diagnosis and Monitoring Division, AtheroPoint™, Roseville, CA 95661, United States
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Schipke J, Jütte D, Brandenberger C, Autilio C, Perez-Gil J, Bernhard W, Ochs M, Mühlfeld C. Dietary Carbohydrates and Fat Induce Distinct Surfactant Alterations in Mice. Am J Respir Cell Mol Biol 2021; 64:379-390. [PMID: 33351709 DOI: 10.1165/rcmb.2020-0335oc] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/22/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity and type 2 diabetes are nutrition-related conditions associated with lung function impairment and pulmonary diseases; however, the underlying pathomechanisms are incompletely understood. Pulmonary surfactant is essential for lung function, and surfactant synthesis by AT2 (alveolar epithelial type 2) cells relies on nutrient uptake. We hypothesized that dietary amounts of carbohydrates or fat affect surfactant homeostasis and composition. Feeding mice a starch-rich diet (StD), sucrose-rich diet (SuD), or fat-rich diet (FaD) for 30 weeks resulted in hypercholesterolemia and hyperinsulinemia compared with a fiber-rich control diet. In SuD and FaD groups, lung mechanic measurements revealed viscoelastic changes during inspiration, indicating surfactant alterations, and interfacial adsorption of isolated surfactant at the air-liquid interface was decreased under FaD. The composition of characteristic phospholipid species was modified, including a shift from dipalmitoyl-phosphatidylcholine (PC16:0/16:0) to palmitoyl-palmitoleoyl-phosphatidylcholine (PC16:0/16:1) in response to carbohydrates and decreased myristic acid-containing phosphatidylcholine species (PC14:0/14:0; PC16:0/14:0) on excess fat intake, as well as higher palmitoyl-oleoyl-phosphatidylglycerol (PG16:0/18:1) and palmitoyl-linoleoyl-phosphatidylglycerol (PG16:0/18:2) fractions in StD, SuD, and FaD groups than in the control diet. Moreover, mRNA expression levels of surfactant synthesis-related proteins within AT2 cells were altered. Under the StD regimen, AT2 cells showed prominent lipid accumulations and smaller lamellar bodies. Thus, in an established mouse model, distinct diet-related surfactant alterations were subtle, yet detectable, and may become challenging under conditions of reduced respiratory capacity. Dietary fat was the only macronutrient significantly affecting surfactant function. This warrants future studies examining alimentary effects on lung surfactant, with special regard to pulmonary complications in obesity and type 2 diabetes.
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Affiliation(s)
- Julia Schipke
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease-Hannover, German Center for Lung Research, Hannover, Germany
- Cluster of Excellence Regenerative Biology to Reconstructive Therapy, Hannover, Germany
| | - Dagmar Jütte
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Christina Brandenberger
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease-Hannover, German Center for Lung Research, Hannover, Germany
- Cluster of Excellence Regenerative Biology to Reconstructive Therapy, Hannover, Germany
| | - Chiara Autilio
- Department of Biochemistry and Molecular Biology, Biology and Research Institute-Hospital, Complutense University, Madrid, Spain
| | - Jesus Perez-Gil
- Department of Biochemistry and Molecular Biology, Biology and Research Institute-Hospital, Complutense University, Madrid, Spain
| | - Wolfgang Bernhard
- Department of Neonatology, Eberhard-Karls University, Tübingen, Germany
| | - Matthias Ochs
- Institute of Functional Anatomy, Charité University of Medicine-Berlin, Berlin, Germany; and
- German Center for Lung Research, Berlin, Germany
| | - Christian Mühlfeld
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease-Hannover, German Center for Lung Research, Hannover, Germany
- Cluster of Excellence Regenerative Biology to Reconstructive Therapy, Hannover, Germany
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Kim SH, Kim HS, Min HK, Lee SW. Obstructive spirometry pattern and the risk of chronic kidney disease: analysis from the community-based prospective Ansan-Ansung cohort in Korea. BMJ Open 2021; 11:e043432. [PMID: 33649059 PMCID: PMC8098974 DOI: 10.1136/bmjopen-2020-043432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE There have been limited studies on the relationship between obstructive spirometry pattern and the development of chronic kidney disease (CKD). We investigated the association between obstructive spirometry pattern and incident CKD development in a large-scale prospective cohort study. METHODS We reviewed the data of 7960 non-CKD adults aged 40-69 years who participated in the Ansung-Ansan cohort, a prospective community-based cohort study. Prebronchodilation results for the ratio of forced expiratory volume per 1 s (FEV1) to forced vital capacity (FVC) were used as the primary exposure. The primary outcome was incident CKD, defined as the first event of an estimated glomerular filtration rate <60 mL/min/1.73 m2. HRs and 95% CIs were calculated using multivariate Cox proportional hazard regression analysis. RESULTS Over a mean follow-up period of 11.7 years, incident CKD developed in 511 subjects (6.4%). An increase of 0.1 in FEV1/FVC was associated with a decreased risk of incident CKD (HR 0.76, 95% CI 0.68 to 0.84, p<0.001). Compared with the fourth quartile, the HR (95 % CI) of the first quartile of FEV1/FVC ratio was 1.81 (1.39 to 2.36, p<0.001). In the restricted cubic spline curve, the renal hazard associated with a decreased FEV1/FVC ratio was evident at FEV1/FVC values <0.80, showing a U-shaped relationship. In subgroup analysis, the renal hazard associated with a decreased FEV1/FVC ratio was particularly evident in people without metabolic syndrome (p for interaction=0.018). CONCLUSION Decreased FEV1/FVC ratio was independently associated with an increased risk of incident CKD development, particularly in people without metabolic syndrome. Future studies need to be conducted to confirm these results.
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Affiliation(s)
- Sang Hyuk Kim
- Medical Service Corps of 2nd Armored Brigade, Republic of Korea Army, Paju, South Korea
| | - Hyeon Sam Kim
- Department of Internal Medicine, Nowon Eulji Medical center, Eulji University, Seoul, South Korea
| | - Hyang Ki Min
- Department of Internal Medicine, Nowon Eulji Medical center, Eulji University, Seoul, South Korea
| | - Sung Woo Lee
- Department of Internal Medicine, Nowon Eulji Medical center, Eulji University, Seoul, South Korea
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Hammad AM, Al-Qerem W, Alassi A, Hyassat D. Effect of Type 2 Diabetes Mellitus and Diabetic Medication on Pulmonary Function. CURRENT RESPIRATORY MEDICINE REVIEWS 2021. [DOI: 10.2174/1573398x17666210121141412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Type 2 diabetes mellitus (T2DM) is a chronic condition with an impairing
effect on multiple organs. Numerous respiratory disorders have been observed in patients with
T2DM. However, the effect of T2DM on pulmonary function is inconclusive.
Aims:
In this study, we investigated the effect of T2DM on respiratory function and the correlation
of glycemic control, diabetes duration and insulin intake.
Methods:
1500 patients were recruited for this study; 560 having T2DM for at least a year were included
in the final data, in addition to 540 healthy volunteers. Forced expiratory volume in one second
(FEV1), forced vital capacity (FVC), forced expiratory flow at 25-75% (FEF 25-75%), as
well as FEV1/FVC ratio values were measured.
Results:
A two-sample t-test showed that z-scores produced by Al-Qerem et al.’s equations for
FEV1, FVC, and FEF 25-75% were significantly lower for the T2DM group than the control group
(p < 0.01). FEV1/FVC ratio in the T2DM group was significantly higher (p < 0.01). Multiple linear
regression analysis found that glycemic control represented by HbA1c as well as disease duration
were negatively associated with the pulmonary function (p < 0.01). However, insulin intake was
found to have no significant correlation with pulmonary function.
Conclusion:
T2DM was linked to reduced pulmonary function and was consistent with a restrictive
ventilation pattern. HbA1c, as well as disease duration, were found to be independent risk factors
for reduced pulmonary function.
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Affiliation(s)
- Alaa M. Hammad
- Department of Pharmacy, College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Walid Al-Qerem
- Department of Pharmacy, College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Ameen Alassi
- Department of Pharmacy, College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Dana Hyassat
- National Center for Diabetes, Endocrinology and Genetics, Jordan University, Amman, Jordan
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He S, Yang J, Li X, Gu H, Su Q, Qin L. Visceral adiposity index is associated with lung function impairment: a population-based study. Respir Res 2021; 22:2. [PMID: 33407481 PMCID: PMC7789783 DOI: 10.1186/s12931-020-01599-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/10/2020] [Indexed: 02/07/2023] Open
Abstract
Background The effects of visceral adiposity on decreased lung function have drawn much attention. Recently, the visceral adiposity index (VAI) has been proposed as a visceral fat distribution and dysfunction marker. However, the relationship between the VAI and lung function has not been investigated. The objective of the study was to analyze the association between the VAI and lung function and evaluate the potential of VAI as a predictor of lung function. Methods We collected data from a population-based study of 1786 subjects aged 40 years or older. All subjects completed a questionnaire and underwent anthropometric measurements and laboratory tests. Linear and logistic regression models were developed to assess the association between the VAI and lung function. Results The VAI was inversely related to FVC%predicted in men and negatively associated with both FVC%predicted and FEV1%predicted in women. In the linear regression analysis, the decrease in FVC%predicted associated with each 10% increase in the VAI was 1.127% in men and 1.943% in women; the decrease in FEV1%predicted associated with each 10%increase in the VAI was 0.663% in men and 1.738% in women. Further regression analysis revealed that the VAI was positively correlated with FVC and FEV1 impairment in women. Conclusions We were the first to show a clear correlation between the VAI and lung function impairment in the Chinese population. The VAI could be a simple and reliable approach in daily practice, and individuals, especially women with a high VAI, should receive additional screening and preventive interventions for respiratory disease.
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Affiliation(s)
- Sunyue He
- Department of Endocrinology, Xinhua Hospital Chongming Branch, School of Medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, China
| | - Jie Yang
- Department of Endocrinology, Xinhua Hospital Chongming Branch, School of Medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, China
| | - Xiaoyong Li
- Department of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Hongxia Gu
- Department of Endocrinology, Xinhua Hospital Chongming Branch, School of Medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, China
| | - Qing Su
- Department of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Li Qin
- Department of Endocrinology, Xinhua Hospital Chongming Branch, School of Medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, China. .,Department of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
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Zhu J, Zhao H, Chen D, Tse LA, Kinra S, Li Y. Genetic Correlation and Bidirectional Causal Association Between Type 2 Diabetes and Pulmonary Function. Front Endocrinol (Lausanne) 2021; 12:777487. [PMID: 34899610 PMCID: PMC8655865 DOI: 10.3389/fendo.2021.777487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/29/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Observational studies have shown possible bidirectional association between type 2 diabetes (T2D) and pulmonary function, but the causality is not well defined. The purpose of this study is to investigate genetic correlation and causal relationship of T2D and glycemic traits with pulmonary function. METHODS By leveraging summary statistics from large-scale genome-wide association studies, linkage disequilibrium score regression was first implemented to quantify genetic correlations between T2D, glycemic traits, and several spirometry indices. Then both univariable and multivariable Mendelian randomization analyses along with multiple pleiotropy-robust methods were performed in two directions to assess the causal nature of these relationships. RESULTS Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) showed significant genetic correlations with T2D and fasting insulin levels and suggestive genetic correlations with fasting glucose and hemoglobin A1c. In Mendelian randomization analyses, genetically predicted higher FEV1 (OR = 0.77; 95% CI = 0.63, 0.94) and FVC (OR = 0.82; 95% CI = 0.68, 0.99) were significantly associated with lower risk of T2D. Conversely, genetic predisposition to higher risk of T2D exhibited strong association with reduced FEV1 (beta = -0.062; 95% CI = -0.100, -0.024) and FEV1 (beta = -0.088; 95% CI = -0.126, -0.050) and increased FEV1/FVC ratio (beta = 0.045; 95% CI = 0.012, 0.078). We also found a suggestive causal effect of fasting glucose on pulmonary function and of pulmonary function on fasting insulin and proinsulin. CONCLUSIONS The present study provided supportive evidence for genetic correlation and bidirectional causal association between T2D and pulmonary function. Further studies are warranted to clarify possible mechanisms related to lung dysfunction and T2D, thus offering a new strategy for the management of the two comorbid diseases.
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Affiliation(s)
- Jiahao Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Huanling Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Dingwan Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Lap Ah Tse
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Yingjun Li
- Department of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical College, Hangzhou, China
- *Correspondence: Yingjun Li,
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Kopf S, Kumar V, Kender Z, Han Z, Fleming T, Herzig S, Nawroth PP. Diabetic Pneumopathy-A New Diabetes-Associated Complication: Mechanisms, Consequences and Treatment Considerations. Front Endocrinol (Lausanne) 2021; 12:765201. [PMID: 34899603 PMCID: PMC8655305 DOI: 10.3389/fendo.2021.765201] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/22/2021] [Indexed: 01/04/2023] Open
Abstract
Patients with diabetes are over-represented among the total cases reported with "idiopathic" pulmonary fibrosis (IPF). This raises the question, whether this is an association only or whether diabetes itself can cause pulmonary fibrosis. Recent studies in mouse models of type 1 and type 2 diabetes demonstrated that diabetes causes pulmonary fibrosis. Both types of diabetes trigger a cascade, starting with increased DNA damage, an impaired DNA repair, and leading to persistent DNA damage signaling. This response, in turn, induces senescence, a senescence-associated-secretory phenotype (SASP), marked by the release of pro-inflammatory cytokines and growth factors, finally resulting in fibrosis. Restoring DNA repair drives fibrosis into remission, thus proving causality. These data can be translated clinically to patients with type 2 diabetes, characterized by long-term diabetes and albuminuria. Hence there are several arguments, to substitute the term "idiopathic" pulmonary fibrosis (IPF) in patients with diabetes (and exclusion of other causes of lung diseases) by the term "diabetes-induced pulmonary fibrosis" (DiPF). However, future studies are required to establish this term and to study whether patients with diabetes respond to the established therapies similar to non-diabetic patients.
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Affiliation(s)
- Stefan Kopf
- Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Varun Kumar
- Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- European Molecular Biology Laboratory, Advanced Light Microscopy Facility, Heidelberg, Germany
| | - Zoltan Kender
- Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Zhe Han
- Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Fleming
- Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Stephan Herzig
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Institute for Diabetes and Cancer, Helmholtz Center Munich, Munich-Neuherberg, Germany
- Joint Heidelberg-Institute for Diabetes and Cancer (IDC) Translational Diabetes Programme, Helmholtz-Zentrum, Munich, Germany
| | - Peter P. Nawroth
- Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Joint Heidelberg-Institute for Diabetes and Cancer (IDC) Translational Diabetes Programme, Helmholtz-Zentrum, Munich, Germany
- *Correspondence: Peter P. Nawroth,
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Díez-Manglano J, Asìn Samper U. Pulmonary function tests in type 2 diabetes: a meta-analysis. ERJ Open Res 2021; 7:00371-2020. [PMID: 33569495 PMCID: PMC7861023 DOI: 10.1183/23120541.00371-2020] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/30/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The aim of this study was to determine the association between type 2 diabetes (T2D) and pulmonary function tests. METHODS After conducting an exhaustive literature search, we performed a meta-analysis. We employed the inverse variance method with a random-effects model to calculate the effect estimate as the mean difference (MD) and 95% confidence interval (CI). We calculated the heterogeneity with the I2 statistic and performed a meta-regression analysis by sex, body mass index (BMI), smoking and geographical region. We also conducted a sensitivity analysis according to the studies' publication date, size of the T2D group and the study quality, excluding the study with the greatest weight in the effect. RESULTS The meta-analysis included 66 studies (one longitudinal, two case-control and 63 cross-sectional), with 11 134 patients with T2D and 48 377 control participants. The pooled MD (95% CI) for the predicted percentage of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), forced expiratory flow at 25-75% of FVC, peak expiratory flow, and diffusing capacity of the lung for carbon monoxide were -7.15 (95% CI -8.27, -6.03; p<0.001), -9.21 (95% CI -11.15, -7.26; p<0.001), -9.89 (95% CI -14.42, -5.36; p<0.001), -9.79 (95% CI -13.42, -6.15; p<0.001) and -7.13 (95% CI -10.62, -3.64; p<0.001), respectively. There was no difference in the ratio of FEV1/FVC (95% CI -0.27; -1.63, 1.08; p=0.69). In all cases, there was considerable heterogeneity. The meta-regression analysis showed that between studies heterogeneity was not explained by patient sex, BMI, smoking or geographical region. The findings were consistent in the sensitivity analysis. CONCLUSIONS T2D is associated with impaired pulmonary function, independently of sex, smoking, BMI and geographical region. Longitudinal studies are needed to investigate outcomes for patients with T2D and impaired pulmonary function.
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Affiliation(s)
| | - Uxua Asìn Samper
- Dept of Internal Medicine, University Hospital Miguel Servet, Zaragoza, Spain
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Yesufu JO, Oluwasile OD, Oluranti OI, Fasanmade AA, Soladoye AO. Cardiopulmonary health indices and diabetes risk scores in undergraduate students of a private university in Nigeria. BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2020. [DOI: 10.1186/s43088-019-0032-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Abstract
Background
Cardiopulmonary health and its relationship with diabetes mellitus are very important but particularly underexplored in young undergraduate students of private Universities in Nigeria. This observational study investigated the effect of diabetic risk on cardiopulmonary health indices among healthy, consenting undergraduate students of a private university in Nigeria by a convenient sampling method. Cardiopulmonary health indices were assessed by anthropometry; cardiorespiratory fitness was determined by maximum oxygen uptake levels (VO2 max), blood pressure and heart rates were measured using the Bruce treadmill protocol; oxygen saturation was determined by pulse oximetry, pulmonary function was assessed by spirometry; diabetes mellitus was risk determined by fasting blood glucose levels and the FINDRISC (Finish Diabetes Risk Score questionnaire which is a validated tool, for determining Diabetes risk; heart health awareness was determined by a modification of the healthy heart questionnaire (HHQ-GP-1) which is a standardized tool for heart health awareness and practices.
Results
Results showed that the prevalence of diabetes risk was 38.8% in the sample population. The healthy heart questionnaire revealed that participants had poor diet (76%) or did little or no exercise (60%) and were also ignorant of what a normal blood pressure should be (72%). There was no significant difference between blood pressure (systolic and diastolic) and heart rates after physical exercise of those at diabetes risk and those not at risk (p > 0.05). Fasting blood glucose levels between those at diabetes risk and those not at risk was significantly different (p < 0.01). The cardiorespiratory fitness (VO2 max) of those not at diabetic risk was not significantly higher than of those at risk (p > 0.385). Respiratory functions (vital capacity, forced vital capacity, and forced expiratory volume) of those not at diabetic risk were higher than those at risk, showing that diabetes may impair lung function. Though this was not statistically significant (p > 0.05), the result obtained cannot be disregarded.
Conclusion
Universities and higher institutions of learning should incorporate regular health promotion and education programs that focus more on healthy lifestyles, physical exercise, and proper diet.
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Inspiratory Muscle Training on Glucose Control in Diabetes: A Randomized Clinical Trial. Int J Sport Nutr Exerc Metab 2020; 31:21-31. [PMID: 33248438 DOI: 10.1123/ijsnem.2020-0175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 08/27/2020] [Accepted: 09/03/2020] [Indexed: 11/18/2022]
Abstract
This study evaluated the effects of inspiratory muscle training (IMT) in glucose control and respiratory muscle function in patients with diabetes. It was a randomized clinical trial conducted at the Physiopathology Laboratory of the Hospital de Clínicas de Porto Alegre. Patients with Type 2 diabetes were randomly assigned to IMT or placebo-IMT (P-IMT), performed at 30% and 2% of maximal inspiratory pressure, respectively, every day for 12 weeks. The main outcome measures were HbA1c, glycemia, and respiratory muscle function. Thirty patients were included: 73.3% women, 59.6 ± 10.7 years old, HbA1c 8.7 ± 0.9% (71.6 ± 9.8 mmol/mol), and glycemia 181.8 ± 57.8 mg/dl (10.5 ± 3.2 mmol/L). At the end of the training, HbA1c was 8.2 ±0.3% (66.1 ± 3.3 mmol/mol) and 8.7 ± 0.3% (71.6 ± 3.3 mmol/mol) for the IMT and P-IMT groups, respectively (p = .8). Fasting glycemia decreased in both groups with no difference after training although it was lower in IMT at 8 weeks: 170.0 ± 11.4 mg/dl(9.4 ± 0.6 mmol/L) and 184.4 ± 15.0 mg/dl (10.2 ± 0.8 mmol/L) for IMT and P-IMT, respectively (p < .05). Respiratory endurance time improved in the IMT group (baseline = 325.9 ± 51.1 s and 305.0 ± 37.8 s; after 12 weeks = 441.1 ± 61.7 s and 250.7 ± 39.0 s for the IMT and P-IMT groups, respectively; p < .05). Considering that glucose control did not improve, IMT should not be used as an alternative to other types of exercise in diabetes. Higher exercise intensities or longer training periods might produce better results. The clinical trials identifier is NCT03191435.
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Omori H, Higashi N, Nawa T, Fukui T, Kaise T, Suzuki T. Associated Factors and Comorbidities of Airflow Limitation in Subjects Undergoing Comprehensive Health Examination in Japan - Survey of Chronic Obstructive Pulmonary Disease Patients Epidemiology in Japan (SCOPE- J). Int J Chron Obstruct Pulmon Dis 2020; 15:3039-3050. [PMID: 33262583 PMCID: PMC7696619 DOI: 10.2147/copd.s272588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/06/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To identify associated factors of having at least one of the airflow limitation, chronic cough/phlegm, and currently treated respiratory diseases in health examinees, and to describe the characteristics of each subgroup classified by comorbidities. Subjects and Methods This was an observational cross-sectional survey carried out in multiple regions of Japan. Subjects aged 40 years older, undergoing comprehensive health examination, were recruited. Airflow limitation was defined as having forced expiratory volume in 1 s/forced vital capacity lower than 70%. Associated factors of having at least one of the airflow limitation, chronic cough/phlegm, and currently treated respiratory diseases were examined by logistic regression analysis. Subgroup classification by comorbidity patterns was conducted by hierarchical cluster analysis. Results In a total of 22,293 subjects, 1520 (6.8%) had at least one of the airflow limitation, chronic cough/phlegm, and currently treated respiratory diseases. With this objective variable, the following explanatory variables were significantly associated: older age, higher total score in the chronic obstructive pulmonary disease assessment test (CAT) and coexistence of lung cancer (common in ever-smokers and never-smokers), higher pack-years, lower body mass index, higher C-reactive protein, without coexistence of diabetes mellitus (specific in ever-smokers), male sex, coexistence of anxiety, and sleep disorder (specific in never-smokers). Among the 1520 subjects, 1512 subjects with smoking history data were classified by comorbidity patterns into subgroups of "no comorbidities," "mixed comorbidities," "inflammatory comorbidities," "overweight," "underweight," and "chronic kidney disease." "Inflammatory comorbidities" were specific in ever-smokers, and "underweight" was specific in never-smokers. Conclusion Several factors were identified as associated factors of having at least one of airflow limitation, chronic cough/phlegm, and currently treated respiratory diseases and they were different between ever-smokers and never-smokers. Different comorbidity patterns were observed by smoking history. These findings could provide information to assist the management of subjects with COPD or at risk for COPD in the general population.
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Affiliation(s)
- Hisamitsu Omori
- Department of Biomedical Laboratory Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Noritaka Higashi
- Department of Respiratory Medicine, Japanese Red Cross Kumamoto Health Care Center, Kumamoto, Japan
| | | | - Toshiki Fukui
- Center for Preventive Medical Treatment, Olive Takamatsu Medical Clinic, Takamatsu, Japan
| | - Toshihiko Kaise
- Japan Development Division, GlaxoSmithKline K.K., Tokyo, Japan
| | - Takeo Suzuki
- Japan Development Division, GlaxoSmithKline K.K., Tokyo, Japan
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Lee J, Kwon D, Lee Y, Jung I, Hyun D, Lee H, Ahn YS. Hypertension Is Associated with Increased Risk of Diabetic Lung. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207513. [PMID: 33076466 PMCID: PMC7602540 DOI: 10.3390/ijerph17207513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 02/07/2023]
Abstract
Lung function is often impaired in diabetic patients, especially in a restrictive pattern, which has recently been described as the diabetic lung. Since hypertension (HTN) is common in diabetic patients, our study investigated whether HTN acts as an aggravating factor in diabetic lung. Within the cross-sectional study from the 6th Korean National Health and Nutrition Examination Survey (KNHANES), fasting plasma glucose (FPG), blood pressure (BP), pulmonary function, and laboratory data were examined in 4644 subjects aged between 40 and 79 years. A multivariate regression model was used to investigate the relationship between BP, FPG, and pulmonary function. Lung function was significantly reduced in the HTN (p = 0.001), impaired fasting glucose (IFG) (p < 0.001), and diabetes mellitus (DM) (p < 0.001) groups. Next, a multivariate logistic regression model was used to derive the odds ratio (OR) of reduced lung function based on the presence of IFG, DM, and HTN. The OR of reduced forced vital capacity (FVCp < 80%) was 3.30 (p < 0.001) in the HTN-DM group and 2.30 (p < 0.001) in the normal BP-DM group, when compared with the normal BP-normal FPG group. The combination of HTN and DM had the strongest negative effect on FVC. The results presented in this study indicate that diabetes and hypertension have a synergistic association with impaired lung function.
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Affiliation(s)
- Jihyun Lee
- Department of Medicine, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju 26426, Korea; (J.L.); (D.K.); (Y.L.); (I.J.)
| | - Donghwan Kwon
- Department of Medicine, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju 26426, Korea; (J.L.); (D.K.); (Y.L.); (I.J.)
| | - Youngjang Lee
- Department of Medicine, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju 26426, Korea; (J.L.); (D.K.); (Y.L.); (I.J.)
| | - Inchan Jung
- Department of Medicine, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju 26426, Korea; (J.L.); (D.K.); (Y.L.); (I.J.)
| | - Daesung Hyun
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju 26426, Korea; (D.H.); (H.L.)
| | - Hunju Lee
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju 26426, Korea; (D.H.); (H.L.)
| | - Yeon-Soon Ahn
- Department of Preventive Medicine and Genomic Cohort Institute, Yonsei Wonju College of Medicine, Yonsei University, Wonju 26426, Korea
- Correspondence: ; Tel.: +82-33-741-0347
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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. [PMID: 32431104 PMCID: PMC7643603 DOI: 10.4093/dmj.2019.0109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/01/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND We sought to explore whether reduced pulmonary function is an independent risk factor for incident diabetes in Koreans. METHODS We conducted a prospective cohort study of pulmonary function as a risk factor for incident diabetes using 10-year follow-up data from 3,864 middle-aged adults from the Ansung cohort study in Korea. The incidence of diabetes was assessed using both oral glucose tolerance tests and glycosylated hemoglobin levels. RESULTS During 37,118 person-years of follow-up, 583 participants developed diabetes (incidence rate: 15.7 per 1,000 person-years). The mean follow-up period was 8.0±3.7 years. Forced vital capacity (FVC; % predicted) and forced expiratory volume in 1 second (FEV1; % predicted) were significantly correlated with incident diabetes in a graded manner after adjustment for sex, age, smoking, exercise, and metabolic parameters. The adjusted hazard ratio (HR) and confidence interval (CI) for diabetes were 1.408 (1.106 to 1.792) and 1.469 (1.137 to 1.897) in the first quartiles of FVC and FEV1, respectively, when compared with the highest quartile. Furthermore, the FVC of the lowest first and second quartiles showed a significantly higher 10-year panel homeostasis model assessment of insulin resistance index, with differences of 0.095 (95% CI, 0.010 to 0.018; P=0.028) and 0.127 (95% CI, 0.044 to 0.210; P=0.003), respectively, when compared to the highest quartiles. CONCLUSION FVC and FEV1 are independent risk factors for developing diabetes in Koreans. Pulmonary factors are possible risk factors for insulin resistance and diabetes.
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Affiliation(s)
- Hoon Sung Choi
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Sung Woo Lee
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Jin Taek Kim
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Hong Kyu Lee
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
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Bidirectional relationship between diabetes and pulmonary function: a systematic review and meta-analysis. DIABETES & METABOLISM 2020; 47:101186. [PMID: 32889114 DOI: 10.1016/j.diabet.2020.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 07/25/2020] [Accepted: 08/01/2020] [Indexed: 01/29/2023]
Abstract
AIM Evidence of the lungs being a target organ of diabetes-related pathophysiology is increasing, and decreased pulmonary function increases the risk of diabetes after adjusting for demographic and metabolic factors. This systematic review and meta-analysis evaluates the bidirectional relationship between diabetes and pulmonary function. METHODS MEDLINE, Embase, The Cochrane Library and Web of Science databases were searched, and all studies describing this bidirectional relationship were identified. Two reviewers independently extracted study characteristics and assessed the risk of bias. RESULTS A total of 93 studies were included in the meta-analysis. The pooled weighted mean difference (WMD) between diabetes patients and non-diabetic participants for forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were -5.65% and -5.91%, respectively, of predicted values. Diabetes-related microvascular complications and poor glycaemic control were associated with poorer pulmonary function in those with diabetes. In addition, diabetes was associated with a restrictive spirometry pattern (RSP) in both cross-sectional studies [odds ratio (OR): 2.88, 95% confidence interval (CI): 2.18-3.81, I2 = 0.0%] and prospective cohort studies [hazard ratio (HR): 1.57, 95% CI: 1.04-2.36]. In five longitudinal studies, the conclusions were inconsistent as to whether or not diabetes accelerates pulmonary function decline. However, every 10% decrease in baseline predicted FVC value was associated with a 13% higher risk of incident diabetes (HR: 1.13, 95% CI: 1.09-1.17, I2 = 0.0%). CONCLUSION There is a bidirectional relationship between diabetes and pulmonary function. However, further investigations into whether dynamic changes in glycaemic levels before and shortly after diabetes onset mediate the deleterious effects on pulmonary function, or vice versa, are now required.
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Wouters EFM, Reynaert NL. Skin autofluorescence: early sign of lung function deterioration? ERJ Open Res 2020; 6:00368-2020. [PMID: 32714966 PMCID: PMC7369460 DOI: 10.1183/23120541.00368-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 11/17/2022] Open
Abstract
Advanced glycation end products (AGEs) comprise a heterogeneous group of stable end-products of the non-enzymatic glycation reactions described by Maillard in 1912, in which reduced sugars irreparably modify proteins, lipids and DNA. This is a slow physiological process and accumulation of AGEs is part of normal ageing. Under conditions of hyperglycaemia and oxidative stress, a much faster and more substantial generation of AGEs is induced. The myriad of pathogenic signals AGEs can induce and the fact that enhanced AGE accumulation accompanies a broad spectrum of age-associated chronic inflammatory diseases [1] form the basis of the Maillard theory of ageing [2]. The relationship between SAF and FEV1, DLCO and X5, independent of COPD or diabetes. Will individuals with raised SAF and subclinical lung function alterations develop disease? What mechanisms underlie parenchymal alterations indicated by SAF?https://bit.ly/2YTtdkL
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Affiliation(s)
- Emiel F M Wouters
- Dept of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands.,Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Niki L Reynaert
- Dept of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
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