OBJECTIVES: To explore whether a reduced lung function is a risk factor for developing diabetes and insulin resistance (IR), and whether such relationship contributes to the largely unexplained association between lung function and incidence of cardiovascular disease (CVD).
DESIGN: Forced vital capacity (FVC) was assessed at baseline. Incidence of diabetes and IR [according to the homeostasis model assessment (HOMA) model] was assessed in a follow-up examination after 13.9 +/- 2.6 and 9.4 +/- 3.6 years for men and women, respectively. After the follow-up examination, incidence of CVD (stroke, myocardial infarction or cardiovascular death) was monitored over 7 years.
SETTING: Populations-based cohort study.
SUBJECTS: Initially nondiabetic men (n = 1436, mean age 44.6 years) and women (n = 896, mean age 49.8 years).
RESULTS: Prevalence of IR at the follow-up examination was 34, 26, 21 and 21%, respectively, for men in the first (lowest), second, third and fourth quartile of baseline FVC (P for trend <0.0001). The corresponding values for women were 30, 29, 25 and 17%, respectively (P for trend <0.001). Adjusted for potential confounders, the odds ratio (OR) for IR (per 10% increase in FVC) was 0.91 (CI: 0.84-0.99) for men and 0.89 (CI: 0.80-0.98) for women. FVC was similarly significantly associated with the incidence of diabetes (OR = 0.90, CI: 0.81-1.00), adjusted for sex and other confounders. The incidence of CVD after the follow-up examination was significantly increased only amongst subjects with low FVC who had developed IR (RR = 1.7, CI: 1.02-2.7). CONCLUSION: Subjects with a moderately reduced FVC have an increased risk of developing IR and diabetes. This relationship seems to contribute to the largely unexplained association between reduced lung function and incidence of CVD.
PMID: 12702035
J Intern Med. 2003 May:253(5):574-81. Engstrom G, Hedblad B, Nilsson P, Wollmer P, Berglund G, Janzon L. Department of Community Medicine, University of Lund, Malmö University Hospital, Malmö, Sweden. gunnar.engstrom@smi.mas.lu.se
Comment:
Moderately reduced lung function as measured by FVC, or forced vital capacity, is related to an increased risk of developing insulin resistance and diabetes. Researchers in this study think that this may be a link between reduced lung function and cardiovascular events such as stroke, heart attack and heart failure. Since lung function declines rapidly with age, it may be an important risk factor in understanding the relationship between diabetes and cardiovascular dise
