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
ARTICLE HIGHLIGHTS
Research background

Previously, the association between type 2 diabetes mellitus (T2DM) and pulmonary disease was confirmed. Some studies found that T2DM is related to obstructive pulmonary disease (OPD), and others have shown that it is related to restrictive pulmonary disease (RPD).

Research motivation

T2DM and RPD are highly connected with T2DM, but research on causality between them is insufficient. Therefore, it is important to study this.

Research objectives

To find out the association between T2DM and pulmonary disease and to reveal its causal relationship.

Research methods

Korea National Health and Nutrition Examination Survey (KNHANES) is a survey research program conducted by the Korean Centers for Diseases Control and Prevention to assess the health and nutritional status of adults and children in Korea and to track changes over time. The survey combines interviews, physical examinations, and laboratory tests. KNHANES interview includes demographic, socioeconomic, dietary, and health-related questions. The examination component consists of medical, dental, and physiological measurements as well as laboratory tests administered by medical personnel, and all data are made anonymous and can be officially downloaded from the website. The KNHANES data are the official national disclosure data conducted annually. The data in this study are complex sampling design, using logistic regression analysis that is most appropriate to view the association between the variables recommended by the Korean Centers for Diseases Control.

Research results

Compared to OPD, the ratio of T2DM and its risk factors in restrictive RPD was very high. In addition, the analysis of pulmonary disease by fasting glucose level showed no significant difference in impaired fasting glucose group, and in T2DM, the probability of RPD occurring was 1.907 times higher than that of OPD. Also, the results of this study have significant association between RPD and T2DM, whereas impaired fasting glucose was weak or not present.

Research conclusions

RPD is highly relevant to T2DM regardless of risk factors. To summarize, this study suggests that RPD is not a cause of T2DM but rather a consequence of T2DM.

Research perspectives

In the future, a longitudinal study should identify changes in pulmonary function of impaired fasting glucose as it progresses.