Jackson Heart Study, Jackson State University, 350 West Woodrow Wilson Avenue, Suite 701, Jackson, MS 39213, USA.
Lung. 2011 Aug;189(4):311-21. doi: 10.1007/s00408-011-9296-1. Epub 2011 May 13.
The objectives of this study were to test the hypothesis that diabetes and impaired glucose tolerance (IGT), diabetes control and diabetes duration, and metabolic biomarkers in adults with normal glucose tolerance (NGT) are inversely associated with spirometry-measured lung function. We conducted a cross-sectional observational cohort study that included nonsmoking African American adults (n = 2,945; mean age = 52.5 ± 12.6 years; 69.2% female), who were free of cardiovascular disease, from the Jackson Heart Study. The interventions were diabetes, metabolic biomarkers and lung function. We measured the associations of glycemia with forced expiratory volume (FEV) in 1 s, FEV in 6 s, and vital capacity. Multivariable adjusted mean lung function values were lower among adults with diabetes and IGT (in women only, but not after adjustment for waist circumference) than adults with NGT. Among adults with diabetes, no associations were observed between lung function and diabetes control or duration. In women with NGT, lower lung function was consistently associated with higher glucose levels and less consistently with higher insulin levels and insulin resistance. Lower lung function was consistently associated with higher insulin levels and insulin resistance and less consistently associated with insulin and hemoglobin A1c in men with NGT. Overall, our findings generally support the hypothesis that diabetes, IGT, and increased levels of metabolic biomarkers in individuals with NGT are inversely associated with lung function in African Americans, independent of adiposity.
在血糖正常的成年人(NGT)中,糖尿病和糖耐量受损(IGT)、糖尿病控制和糖尿病持续时间,以及代谢生物标志物与肺功能测量值(如用力呼气量(FEV)1 秒、FEV6 秒和肺活量)呈负相关。我们进行了一项横断面观察性队列研究,纳入了无心血管疾病的非裔美国成年人(n=2945;平均年龄 52.5±12.6 岁;69.2%为女性),他们来自杰克逊心脏研究。干预措施包括糖尿病、代谢生物标志物和肺功能。我们测量了血糖与 1 秒用力呼气量(FEV1)、6 秒用力呼气量(FEV6)和肺活量之间的关联。多变量调整后的平均肺功能值在糖尿病和 IGT 患者中较低(仅在女性中较低,但在调整腰围后则没有),而在 NGT 患者中则较高。在糖尿病患者中,肺功能与糖尿病控制或持续时间之间无相关性。在 NGT 的女性中,较低的肺功能与较高的血糖水平始终相关,而与较高的胰岛素水平和胰岛素抵抗的相关性则不太一致。在 NGT 的男性中,较低的肺功能与较高的胰岛素水平和胰岛素抵抗始终相关,与胰岛素和血红蛋白 A1c 的相关性则不太一致。总体而言,我们的发现普遍支持以下假设:在非裔美国人中,NGT 个体的糖尿病、IGT 以及代谢生物标志物水平的升高与肺功能呈负相关,与肥胖无关。