Pulmonary Predictors of Incident Diabetes in Smokers.
| Autor: | Kinney GL; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus., Baker EH; St. George's, University of London, United Kingdom., Klein OL; Department of Medicine, University of California-San Francisco., Black-Shinn JL; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus., Wan ES; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts., Make B; National Jewish Health and University of Colorado-Denver., Regan E; National Jewish Health and University of Colorado-Denver., Bowler RP; National Jewish Health and University of Colorado-Denver., Lutz SM; Department of Biostatistics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus., Young KA; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus., Duca LM; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus., Washko GR; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts., Silverman EK; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts., Crapo JD; National Jewish Health and University of Colorado-Denver., Hokanson JE; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus. |
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| Jazyk: | angličtina |
| Zdroj: | Chronic obstructive pulmonary diseases (Miami, Fla.) [Chronic Obstr Pulm Dis] 2016; Vol. 3 (4), pp. 739-747. |
| DOI: | 10.15326/jcopdf.3.4.2016.0137 |
| Abstrakt: | Background: Diabetes mellitus and its complications are a large and increasing burden for health care worldwide. Reduced pulmonary function has been observed in diabetes (both type 1 and type 2), and this reduction is thought to occur prior to diagnosis. Other measures of pulmonary health are associated with diabetes, including lower exercise tolerance, greater dyspnea, lower quality of life (as measured by the St. George's Respiratory Questionaire [SGRQ]) and susceptibility to lung infection and these measures may also predate diabetes diagnosis. Methods: We examined 7080 participants in the COPD Genetic Epidemiology (COPDGene) study who did not report diabetes at their baseline visit and who provided health status updates during 4.2 years of longitudinal follow-up (LFU). We used Cox proportional hazards modeling, censoring participants at final LFU contact, reported mortality or report of incident diabetes to model predictors of diabetes. These models were constructed using known risk factors as well as proposed markers related to pulmonary health, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV Results: Over 21,519 person years of follow-up, 392 of 7080 participants reported incident diabetes which was associated with expected predictors; increased body mass index (BMI), high blood pressure, high cholesterol and current smoking status. Age, gender and accumulated smoking exposure were not associated with incident diabetes. Additionally, preserved ratio with impaired spirometry (PRISm) pattern pulmonary function, reduced 6MWD and any report of serious pulmonary events were associated with incident diabetes. Conclusions: This cluster of pulmonary indicators may aid clinicians in identifying and treating patients with pre- or undiagnosed diabetes. Competing Interests: Declaration of Interest Gregory L. Kinney, Oana L. Klein, Jennifer L. Black-Shinn, Emily S. Wan, Sharon M. Lutz, Elizabeth Regan, Russell P. Bowler, Kendra A. Young, Lindsey M. Duca, George R. Washko, James D. Crapo and John E. Hokanson have no conflicts to disclose. Emma H. Baker is joint holder of an MRC industry collaboration award with Astra Zeneca and principal investigator at St. George’s for CRN portfolio adopted studies for Sirocco (Astra Zeneca), Ideal (GlaxoSmithKline), Asthma survey (Boehringer Ingelheim) and Arietta (Roche). Barry Make has participated in research studies and/or served on medical advisory boards for AstraZeneca, Boehringer-Ingelheim, CSL Bering, GlaxoSmithKline, Forest, Novartis, Spiration, and Sunovion. In the past three years, Edwin K. Silverman received honoraria and consulting fees from Merck, grant support and consulting fees from GlaxoSmithKline and honoraria and travel support from Novartis. |
| Databáze: | MEDLINE |
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