Reduced pulmonary function and its associations in type 2 diabetes: the Fremantle Diabetes Study

To determine whether diabetes is associated with reduced lung function, we studied 421 Angle-Celt/European subjects, representing 20.5% of all patient s with type 2 diabetes identified in an urban Australian catchment area of 120 097 people. In addition to collection of detailed demographic and diabe tes-specific data, spirometry was performed and forced vital capacity (FVC) , forced expiratory volume in 1 s (FEV1), vital capacity (VC) and peak expi ratory flow (PEF) measured. When expressed as a percentage of those predict ed (%pred) for age, sex and height, the means of all spirometric measures w ere reduced by greater than or equal to 9.5%. After controlling for smoking , age and gender in a linear regression model, HbA(1c) was not associated w ith any measure of lung function (P>0.13) but diabetes duration was signifi cantly associated with FEV1(%pred) and PEF%pred (P less than or equal to 0. 04) and had borderline associations with FVC%pred and VC%pred (P less than or equal to 0.064). In separate analyses controlling for smoking alone, age , body mass index (BMI), coronary heart disease (CHD) and retinopathy were independently and inversely associated with FVC%pred, FEV1%pred and VC%pred (P < 0.05). In sub-group analyses, these three spirometric measures were a ssociated with BMI, CHD and diabetes duration in males, and age and BMI in females. Pulmonary function is reduced in type 2 diabetes. Diabetes duratio n seems a more important influence than glycaemic control, but obesity and vascular disease may also contribute. (C) 2000 Elsevier Science Ireland Lid . All rights reserved.