Retrospective Cohort Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Oct 15, 2020; 11(10): 425-434
Published online Oct 15, 2020. doi: 10.4239/wjd.v11.i10.425
Association between restrictive pulmonary disease and type 2 diabetes in Koreans: A cross-sectional study
Do Y Lee, Seung M Nam
Do Y Lee, Seung M Nam, Department of Physical Therapy, Daegu University, Gyeongsan-si 38453, South Korea
Author contributions: Lee DY performed the experiments, interpreted the results, and wrote the manuscript; Nam SM interpreted the results, wrote and revised the manuscript, and supervised the study.
Institutional review board statement: The Korea national health and nutrition examination survey (KNHANES, 2015) is a research ethics review that corresponds to research conducted by the government for public welfare in accordance with article 2, paragraph 1 of the bioethics act and article 2, paragraph 1 of the enforcement rule of the same act. Conducted without deliberation by the committee.
Conflict-of-interest statement: All the authors have no conflicts of interest related to the manuscript.
Data sharing statement: All data have been anonymized and can be officially downloaded from the website. https://knhanes.cdc.go.kr/knhane
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Seung M Nam, PhD, Adjunct Professor, Department of Physical Therapy, Daegu University, 201, Daegudae-ro Gyeongsan-si 38453, South Korea. 20849606@hanmail.net
Received: June 25, 2020
Peer-review started: June 25, 2020
First decision: July 30, 2020
Revised: August 11, 2020
Accepted: August 31, 2020
Article in press: August 31, 2020
Published online: October 15, 2020
Abstract
BACKGROUND

Diabetes is a progressive disease that increases glucose levels in the blood. While studies have shown that patients with pulmonary disease (both obstructive and restrictive pulmonary disease) have a higher prevalence of type 2 diabetes mellitus (T2DM), there have been more studies on restrictive patterns than chronic obstructive pulmonary disease.

AIM

To assess whether restrictive and obstructive pulmonary diseases are associated with T2DM in Koreans.

METHODS

For our analysis, we used data from the Korea National Health and Nutrition Examination Survey. A total of 2830 subjects were included in this study. Spirometry results were categorized into three patterns: Normal, restrictive pulmonary disease (RPD), and obstructive pulmonary disease (OPD).

RESULTS

The factors used as diabetic indicators (i.e. homeostatic model assessment of insulin resistance, homeostatic model assessment of beta-cell function, glycated hemoglobin, and fasting insulin) were among the highest in RPD but not in OPD. Based on multivariate logistic regression analysis, subjects with RPD were found with an increased odds ratio [OR: 1.907, 95% confidence interval (CI): 1.110-3.277] for T2DM compared with subjects with normal pulmonary function, whereas in patients with OPD, the OR had not increased. Model 4, which adjusted for the variables that could affect diabetes and pulmonary disease, showed a significant increase in the T2DM OR to RPD (OR: 2.025, 95%CI: 1.264-3.244). On the other hand, no statistically significant difference was shown in OPD (OR: 0.982, 95%CI: 0.634-1.519).

CONCLUSION

RPD, not OPD, is highly associated with T2DM regardless of the risk factors of various T2DMs that can be confounds.

Keywords: Restrictive pulmonary disease, Obstructive pulmonary disease, Type 2 diabetes mellitus, Insulin resistance, Glycated hemoglobin, Koreans

Core Tip: This study was performed to assess whether restrictive and obstructive patterns of pulmonary disease and type 2 diabetes mellitus (T2DM) are associated with each other in Koreans. For our analysis, we used data from the Korea National Health and Nutrition Examination Survey. A total of 2830 subjects were included in this study. Spirometry results were categorized into three patterns: normal, restrictive, and obstructive pulmonary disease. Restrictive pulmonary disease, not obstructive disease, is highly relevant to T2DM regardless of other risk factors of various T2DMs that can be confounds.