Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China.
Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China.
Nutr Metab Cardiovasc Dis. 2024 Oct;34(10):2378-2385. doi: 10.1016/j.numecd.2024.05.004. Epub 2024 May 10.
BACKGROUND AND AIMS: To investigate causal relationships of lung function with risks microvascular diseases among participants with diabetes, type 2 diabetes mellitus (T2DM) and type 1 diabetes mellitus (T1DM), respectively, in prospective and Mendelian randomization (MR) study. METHODS AND RESULTS: 14,617 participants with diabetes and without microvascular diseases at baseline from the UK Biobank were included in the prospective analysis. Of these, 13,421 had T2DM and 1196 had T1DM. The linear MR analyses were conducted in the UK Biobank with 6838 cases of microvascular diseases and 10,755 controls. Lung function measurements included forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). The study outcome was microvascular diseases, a composite outcome including chronic kidney diseases, retinopathy and peripheral neuropathy. During a median follow-up of 12.1 years, 2668 new-onset microvascular diseases were recorded. FVC (%predicted) was inversely associated with the risk of new-onset microvascular diseases in participants with diabetes (Per SD increment, adjusted HR = 0.86; 95%CI:0.83-0.89), T2DM (Per SD increment, adjusted HR = 0.86; 95%CI:0.82-0.90) and T1DM (Per SD increment, adjusted HR = 0.87; 95%CI: 0.79-0.97), respectively. Similar results were found for FEV1 (%predicted). In MR analyses, genetically predicted FVC (adjusted RR = 0.55, 95%CI:0.39-0.77) and FEV1 (adjusted RR = 0.48, 95%CI:0.28-0.83) were both inversely associated with microvascular diseases in participants with T1DM. No significant association was found in those with T2DM. Similar findings were found for each component of microvascular diseases. CONCLUSION: There was a causal inverse association between lung function and risks of microvascular diseases in participants with T1DM, but not in those with T2DM.
背景与目的：在前瞻性和孟德尔随机化（MR）研究中，分别研究了肺功能与糖尿病、2 型糖尿病（T2DM）和 1 型糖尿病（T1DM）患者微血管疾病风险之间的因果关系。
方法和结果：纳入英国生物库中无微血管疾病的 14617 名糖尿病患者进行前瞻性分析。其中 13421 名患有 T2DM，1196 名患有 T1DM。在英国生物库中进行了线性 MR 分析，包括 6838 例微血管疾病病例和 10755 例对照。肺功能测量包括用力肺活量（FVC）和 1 秒用力呼气量（FEV1）。研究结局为微血管疾病，一种包括慢性肾脏病、视网膜病变和周围神经病变的复合结局。在中位随访 12.1 年后，记录到 2668 例新发微血管疾病。在糖尿病患者（每 SD 增量，调整 HR = 0.86；95%CI：0.83-0.89）、T2DM 患者（每 SD 增量，调整 HR = 0.86；95%CI：0.82-0.90）和 T1DM 患者（每 SD 增量，调整 HR = 0.87；95%CI：0.79-0.97）中，FVC（%预测值）与新发微血管疾病风险呈负相关。对于 FEV1（%预测值）也得到了相似的结果。在 MR 分析中，遗传预测的 FVC（调整 RR = 0.55，95%CI：0.39-0.77）和 FEV1（调整 RR = 0.48，95%CI：0.28-0.83）均与 T1DM 患者的微血管疾病呈负相关。在 T2DM 患者中未发现显著相关性。在微血管疾病的每个组成部分中也得到了相似的发现。
结论：在 T1DM 患者中，肺功能与微血管疾病风险之间存在因果负相关，但在 T2DM 患者中则不然。
Front Endocrinol (Lausanne). 2024
Front Endocrinol (Lausanne). 2024
Front Endocrinol (Lausanne). 2024
Skin Res Technol. 2024-7
Front Endocrinol (Lausanne). 2021
PLOS Glob Public Health. 2025-7-23
Zotero 插件