Shah Swati H, Sonawane Pranali, Nahar Pradeep, Vaidya Savita, Salvi Sundeep
Department of Physiology, B. J. Medical College and Sassoon General Hospitals, Pune, Maharashtra, India.
Lung India. 2013 Apr;30(2):108-12. doi: 10.4103/0970-2113.110417.
Pulmonary complications of diabetes mellitus (DM) have been poorly characterized. Some authors have reported normal pulmonary functions and even concluded that spirometry is not at all necessary in diabetic patients. Some studies have shown abnormal respiratory parameters in patients of DM. Moreover, the duration of DM and glycemic control have varied impact on the pulmonary functions.
The study was undertaken to analyze the pulmonary function parameters in diabetic patients and compare them with age and gender matched healthy subjects. We correlated forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) in diabetic patients with duration of the disease and glycosylated hemoglobin (HbA1c).
Pulmonary function tests (PFTs) were recorded in 60 type 2 diabetic male patients and 60 normal healthy male controls aged 40-60 years by using Helios 702 spirometer. The PFTs recorded were - FVC, FEV1, FEV1/FVC, FEF25, FEF50, FEF75, FEF25-75, FEF0.2-1.2, and peak expiratory flow rate (PEFR). HbA1c of all the patients was estimated by ion exchange resin method, which is a very standard method of estimation. PFTs of diabetic patients and controls were compared by applying Student's unpaired t test. Associations between FVC and FEV1 and HbA1c and duration of illness in diabetic patients were analyzed by applying Pearson's coefficient.
The PFTs were significantly decreased in diabetic patients compared with the healthy controls except FEV1/FVC. There was no correlation found between FVC and FEV1 and duration of illness as well as HbA1c.
DM being a systemic disease, which also affects lungs causing restrictive type of ventilatory changes probably because of glycosylation of connective tissues, reduced pulmonary elastic recoil and inflammatory changes in lungs. We found glycemic levels and duration of disease are probably not the major determinants of lung pathology, which requires further research.
糖尿病（DM）的肺部并发症一直未得到充分描述。一些作者报告糖尿病患者肺功能正常，甚至得出结论认为糖尿病患者根本不需要进行肺活量测定。一些研究显示糖尿病患者存在呼吸参数异常。此外，糖尿病病程和血糖控制对肺功能有不同影响。
本研究旨在分析糖尿病患者的肺功能参数，并将其与年龄和性别匹配的健康受试者进行比较。我们将糖尿病患者的用力肺活量（FVC）和第1秒用力呼气量（FEV1）与疾病病程和糖化血红蛋白（HbA1c）进行关联分析。
使用Helios 702肺活量计记录60例40 - 60岁2型糖尿病男性患者和60例正常健康男性对照的肺功能测试（PFTs）。记录的PFTs参数包括 - FVC、FEV1、FEV1/FVC、FEF25、FEF50、FEF75、FEF25 - 75、FEF0.2 - 1.2以及呼气峰值流速（PEFR）。所有患者的HbA1c通过离子交换树脂法进行测定，这是一种非常标准的测定方法。应用学生氏非配对t检验比较糖尿病患者和对照组的PFTs。应用Pearson系数分析糖尿病患者中FVC和FEV1与HbA1c及病程之间的关联。
与健康对照组相比，糖尿病患者的PFTs显著降低，但FEV1/FVC除外。未发现FVC和FEV1与病程以及HbA1c之间存在相关性。
糖尿病作为一种全身性疾病，也会影响肺部，可能由于结缔组织糖基化、肺弹性回缩力降低和肺部炎症改变导致限制性通气变化。我们发现血糖水平和疾病病程可能不是肺部病理的主要决定因素，这需要进一步研究。
