Sagun Gul, Gedik Canan, Ekiz Esra, Karagoz Engin, Takir Mumtaz, Oguz Aytekin
Department of Internal Medicine, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey.
Department of Respiratory Disease, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey.
BMC Pulm Med. 2015 Nov 6;15:139. doi: 10.1186/s12890-015-0125-9.
Impaired lung function and insulin resistance have been associated and thereby have also been indicated to be powerful predictors of cardiovascular mortality. Therefore, the co-existence of insulin resistance and impaired lung function accompanied with cardiovascular risk factors should induce cardiovascular mortality even in patients without known respiratory disease in a cumulative pattern. It could be useful to determine the lung function of patients with insulin resistance in order to decrease cardiovascular mortality by means of taking measures that minimize the risk of decline in lung function. However, no prior studies have been done on association between insulin resistance and lung function in adults in Turkey. We aimed to determine if insulin resistance plays a detrimental role in lung function in outpatients admitted to internal medicine clinics in adults from Turkey.
A total of 171 outpatients (mean ± SD) age: 43.1 ± 11.9) years) admitted to internal medicine clinics were included in this single-center cross-sectional study, and were divided into patients with (n = 63, mean ± SD) age: 43.2 ± 12.5) years, 83.5 % female) or without (n = 108, mean ± SD) age: 43.0 ± 11.6) years, 93.5 % female) insulin resistance. All patients were non-smokers. Data on gender, age, anthropometrics, blood pressure, blood biochemistry, metabolic syndrome (MetS), and lung function tests were collected in each patient. Correlates of insulin resistance were determined via logistic regression analysis.
Insulin resistance was present in 36.8 % of patients. Logistic regression analysis revealed an increase in the likelihood of having insulin resistance of 1.07 times with every 1-point increase in waist circumference, 1.01 times with every 1-point increase in triglycerides, 0.93 times with every 1-point decrease in HDL (high density lipoprotein) cholesterol, and 0.86 times with every 1-point decrease in percentage of FEV1/FVC pre (FEV1%pre: Forced expiratory volume in the first second of expiration for predicted values; FVC%pre.: Forced vital capacity for predicted values).
Insulin resistance should also be considered amongst the contributing factors for decline in lung function.
肺功能受损与胰岛素抵抗有关，因此也被认为是心血管疾病死亡率的有力预测指标。所以，胰岛素抵抗和肺功能受损与心血管危险因素并存，即使在无已知呼吸系统疾病的患者中，也可能以累积的方式导致心血管疾病死亡率升高。确定胰岛素抵抗患者的肺功能，以便通过采取措施降低肺功能下降风险来降低心血管疾病死亡率，可能会有所帮助。然而，此前土耳其尚未有关于成年人胰岛素抵抗与肺功能之间关联的研究。我们旨在确定胰岛素抵抗在土耳其成年内科门诊患者的肺功能中是否起有害作用。
本单中心横断面研究纳入了171名内科门诊患者（平均年龄±标准差：43.1±11.9岁），并将其分为有胰岛素抵抗组（n = 63，平均年龄±标准差：43.2±12.5岁，女性占83.5%）和无胰岛素抵抗组（n = 108，平均年龄±标准差：43.0±11.6岁，女性占93.5%）。所有患者均不吸烟。收集了每位患者的性别、年龄、人体测量学数据、血压、血液生化、代谢综合征（MetS）和肺功能测试数据。通过逻辑回归分析确定胰岛素抵抗的相关因素。
36.8%的患者存在胰岛素抵抗。逻辑回归分析显示，腰围每增加1个单位，胰岛素抵抗发生可能性增加1.07倍；甘油三酯每增加1个单位，增加1.01倍；高密度脂蛋白（HDL）胆固醇每降低1个单位，降低0.93倍；第一秒用力呼气容积占预计值百分比（FEV1%pre：第一秒用力呼气容积占预计值；FVC%pre：用力肺活量占预计值）每降低1个单位，降低0.86倍。
胰岛素抵抗也应被视为肺功能下降的促成因素之一。
