Division of Allergy, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Health Promotion Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Endocrinol Metab (Seoul). 2021 Dec;36(6):1254-1267. doi: 10.3803/EnM.2021.1249. Epub 2021 Dec 13.
We analyzed hemoglobin A1c (HbA1c) levels and various lung function test results in healthy individuals after a 6-year follow-up period to explore the influence of lung function changes on glycemic control.
Subjects whose HbA1c levels did not qualify as diabetes mellitus (DM) and who had at least two consecutive lung function tests were selected among the people who visited a health promotion center. Lung function parameters, including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV/FVC ratio, and forced expiratory flow 25% to 75% (FEF25%-75%), were divided into four groups based on their baseline quantiles. To evaluate future DM onset risk in relation to lung function changes, the correlation between baseline HbA1c levels and changes in lung function parameters after a 6-year follow-up period was analyzed.
Overall, 17,568 individuals were included; 0.9% of the subjects were diagnosed with DM. The individuals included in the quartile with FEV1/FVC ratio values of 78% to 82% had lower risk of DM than those in the quartile with FEV1/FVC ratio values of ≥86% after adjusting for age, sex, and body mass index (P=0.04). Baseline percent predicted FEV1, FVC, FEV1/FVC ratio, and FEF25%-75%, and differences in the FEV1/FVC ratio or FEF25%-75%, showed negative linear correlations with baseline HbA1c levels.
Healthy subjects with FEV1/FVC ratio values between 78% and 82% had 40% lower risk for future DM. Smaller differences and lower baseline FEV1/FVC ratio or FEF25%-75% values were associated with higher baseline HbA1c levels. These findings suggest that airflow limitation affects systemic glucose control and that the FEV1/FVC ratio could be one of the factors predicting future DM risk in healthy individuals.
我们对经过 6 年随访的健康个体的糖化血红蛋白（HbA1c）水平和各种肺功能检测结果进行了分析，旨在探讨肺功能变化对血糖控制的影响。
从参加健康体检中心体检的人群中，选取 HbA1c 水平不符合糖尿病（DM）标准且至少有两次连续肺功能检查的个体，根据其基线四分位数将肺功能参数（包括第 1 秒用力呼气容积[FEV1]、用力肺活量[FVC]、FEV1/FVC 比值和 25%~75%用力呼气流量[FEF25%-75%]）分为 4 组。为评估肺功能变化与未来 DM 发病风险的关系，分析了基线 HbA1c 水平与 6 年随访期间肺功能参数变化的相关性。
共纳入 17568 例个体，其中 0.9%的个体被诊断为 DM。校正年龄、性别和体重指数（BMI）后，与 FEV1/FVC 比值≥86%的四分位组相比，FEV1/FVC 比值为 78%~82%的四分位组的 DM 发病风险较低（P=0.04）。基线预测 FEV1%、FVC%、FEV1/FVC 比值和 FEF25%-75%以及 FEV1/FVC 比值或 FEF25%-75%的差值与基线 HbA1c 水平呈负线性相关。
FEV1/FVC 比值为 78%~82%的健康个体未来发生 DM 的风险降低 40%。较小的差值和较低的 FEV1/FVC 比值或 FEF25%-75%与较高的基线 HbA1c 水平相关。这些发现提示气流受限可能影响全身血糖控制，且 FEV1/FVC 比值可能是预测健康个体未来 DM 风险的因素之一。
