A 10% increase in forced vital capacity was associated with a lower incidence of diabetes (OR 0.90; 95% CI 0.81-1.00) and insulin resistance, contributing to cardiovascular disease risk.
Cohort (n=2,332)
Does reduced lung function increase the risk of developing insulin resistance, diabetes, and cardiovascular disease in initially nondiabetic adults?
Moderately reduced forced vital capacity is associated with an increased risk of developing insulin resistance and diabetes, which in turn mediates an increased risk of cardiovascular disease.
Effect estimate: OR 0.90 (95% CI 0.81-1.00)
OBJECTIVES: To explore whether a reduced lung function is a risk factor for developing diabetes and insulin resistance (IR), and whether such relationship contributes to the largely unexplained association between lung function and incidence of cardiovascular disease (CVD). DESIGN: Forced vital capacity (FVC) was assessed at baseline. Incidence of diabetes and IR according to the homeostasis model assessment (HOMA) model was assessed in a follow-up examination after 13.9 +/- 2.6 and 9.4 +/- 3.6 years for men and women, respectively. After the follow-up examination, incidence of CVD (stroke, myocardial infarction or cardiovascular death) was monitored over 7 years. SETTING: Populations-based cohort study. SUBJECTS: Initially nondiabetic men (n = 1436, mean age 44.6 years) and women (n = 896, mean age 49.8 years). RESULTS: Prevalence of IR at the follow-up examination was 34, 26, 21 and 21%, respectively, for men in the first (lowest), second, third and fourth quartile of baseline FVC (P for trend <0.0001). The corresponding values for women were 30, 29, 25 and 17%, respectively (P for trend <0.001). Adjusted for potential confounders, the odds ratio (OR) for IR (per 10% increase in FVC) was 0.91 (CI: 0.84-0.99) for men and 0.89 (CI: 0.80-0.98) for women. FVC was similarly significantly associated with the incidence of diabetes (OR = 0.90, CI: 0.81-1.00), adjusted for sex and other confounders. The incidence of CVD after the follow-up examination was significantly increased only amongst subjects with low FVC who had developed IR (RR = 1.7, CI: 1.02-2.7). CONCLUSION: Subjects with a moderately reduced FVC have an increased risk of developing IR and diabetes. This relationship seems to contribute to the largely unexplained association between reduced lung function and incidence of CVD.
Engström et al. (Thu,) conducted a cohort in Insulin resistance and diabetes (n=2,332). Forced vital capacity (FVC) was evaluated on Incidence of diabetes (OR 0.90, 95% CI 0.81-1.00). A 10% increase in forced vital capacity was associated with a lower incidence of diabetes (OR 0.90; 95% CI 0.81-1.00) and insulin resistance, contributing to cardiovascular disease risk.