Pulmonary Function in Adults With Type 2 Diabetes With and Without Obesity

Charles F. Hayfron-Benjamin, Ruth Korkor Tei, Josephine Korang Osei-Tutu, Tracy Amo-Nyarko, Patience Vormatu, Joana N. Ackam, Gloria Odom Asante, Latif Musah, Anastasia N.K. Bruce, Kwaku Amponsah Obeng

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Abstract

Background: Existing reports show a bidirectional association between type 2 diabetes (T2D) and pulmonary dysfunction. Obesity, which is causally related to both T2D and pulmonary dysfunction, could play an important role in this association. However, this has not been reported. Research Question: What are the associations of measures of obesity with pulmonary function in T2D? Study Design and Methods: This was a cross-sectional study among 464 adults with T2D. Spirometry was performed according to the American Thoracic Society/European Respiratory Society guidelines. The predicted values of the spirometric indices were determined using the Global Lung Function Initiative 2012 equations. The values of FEV1/FVC and FVC were used to categorize pulmonary function patterns as normal, obstructive, restrictive, or mixed. Waist circumference (WC) was measured at the midpoint between the lower margin of the lowest palpable rib and the top of the iliac crest. Results: The mean age, diabetes duration, and female/male ratio of the participants were 55.09 ± 10.45 years, 10.00 ± 7.36 years, and 2:1, respectively. In a multiple linear regression model, WC was a significant predictor of FVC (P =.018) and FEV1/FVC ratio (P =.005), but not FEV1 (P =.472). BMI was a significant predictor of FEV1/FVC ratio (P =.031), but not FEV1 (P =.802) or FVC (P =.129). In a multivariable logistic regression model adjusted for age, sex, socioeconomic status, diabetes duration, glycated hemoglobin, statin use, and smoking pack-years, increasing z score WC was associated with higher odds of restrictive spirometry (OR, 1.32; 95% CI, 1.05-1.66; P =.019) but not airway obstruction (OR, 0.65; 95% CI, 0.42-1.03; P =.067). There were no significant associations of increasing z score BMI with restrictive spirometry (OR, 1.24; 95% CI, 0.98-1.58; P =.075) or airway obstruction (OR, 0.79; 95% CI, 0.51-1.24; P =.305). Interpretation: Increasing WC is associated with restrictive spirometry, independent of conventional diabetes and pulmonary risk factors. Future research could explore the role of the reversal of central obesity on pulmonary function in T2D.

Original languageEnglish
Article number100014
JournalCHEST Pulmonary
Volume1
Issue number3
DOIs
Publication statusPublished - Dec 2023

Keywords

  • obesity
  • obstructive airway disease
  • pulmonary dysfunction
  • restrictive lung disease
  • type 2 diabetes

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