Metabolic Factors Modulating the Connection Between Diabetes and Pulmonary Alterations
Authors' conclusion
Lower FEV1 and FVC in diabetes are linked to insulin resistance, impaired clearance, and higher insulin doses, all of which result in higher insulinemia and likely represent underlying pathogenic mechanisms.
Study context
- Population
- Participants of the German Diabetes Study (GDS) with T1D, T2D or normal glucose tolerance; Mendelian randomization (MR) using MAGIC (HOMA-IR, n = 37,037) and UK Household Longitudinal Study (pulmonary function, n = 321,047)spirometry measurements
- Participants
- 426 / 482 / 244
- Exposure
- T1D vs T2D vs normal glucose tolerance
- Type 1 diabetesn = 426
- Type 2 diabetesn = 482
- Control (CON)n = 244reference
- Outcome
- Associations of metabolic measures with FEV1 and FVC
Methodological detailsBotnia clamps, generalized linear models adjusted for confounders, Mendelian randomization in independent cohorts
- Botnia clamps
- Generalized linear models adjusted for confounders
- Mendelian randomization in independent cohorts
Main finding
As reported in the abstract
Higher M value associated with higher FEV1 and forced vital capacity (FVC)
all β > 0.18
P < 0.0001
Higher insulin clearance associated with higher FEV1 and FVC
all β = 0.05
P < 0.050
T2D had lower FEV1 and FVC vs T1D and CON, associated with M value
all β > 0.17
P < 0.050
MR: causal association between HOMA-IR and lower FEV1
β = −0.13
P = 0.0018
Observational data: associations, not effects.
Further findings
FEV1 and daily insulin doses in T1D
- FEV1 associated with daily insulin doses in T1D
- β = −0.21, P = 0.0006
FEV1 by diabetes (sub)type
- T2D
- β = −0.19, P = 0.0052
- Severe insulin resistant
- β = −0.27, P = 0.039
- Mild age-related diabetes
- β = −0.23, P = 0.0033
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →