Background: The dose-response relationship between glycemic status and lung function has not been thoroughly investigated. We hypothesized that there are continuous and inverse associations between glycemic measures and lung function tests and examined the hypothesis in Japanese adults.
Methods: We cross-sectionally investigated associations of hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) with forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) in 3161 adults who participated in a health screening from 2008 to 2011. The study participants included both diabetic and non-diabetic adults. Multiple linear regression analyses were performed to examine the associations.
Results: Inverse associations were observed in both sexes, which were attenuated in women after adjustment for multiple variables. A 1% absolute increase in HbA1c was associated with a -52-mL (95% confidence interval [CI] -111 to 8 mL) difference in FVC and a -25-mL (95% CI -75 to 25 mL) difference in FEV1 in women, and a -128-mL (95% CI -163 to -94 mL) difference in FVC and a -73-mL (95% CI -101 to -44 mL) difference in FEV1 in men. A 10-mg/dL increase in FPG was associated with a -11-mL (95% CI -29 to 8 mL) difference in FVC and a -8-mL (95% CI -24 to 7 mL) difference in FEV1 in women, and a -32-mL (95% CI -44 to -21 mL) difference in FVC and a -19-mL (95% CI -28 to -9 mL) difference in FEV1 in men.
Conclusions: Inverse associations between glycemic measures and lung function were observed. Men seem more susceptible to the alteration in FVC and FEV1 than women.
【背景】: 糖代謝の状態と肺機能の負の関連は報告されているが、その用量依存関係については未だ十分調査がされていない。今回の研究では、これに連続的な負の関連があることを仮説とし日本人健診集団においてそれを検証した。
【方法】: この横断研究は2008年から2011年に東京都済生会中央病院にて健診を受診した3,161人の日本人成人を対象として行われた。糖代謝状態の指標としてヘモグロビンA1c (HbA1c)と空腹時血糖値(FPG)を、肺機能検検査として努力性肺活量(FVC)と1秒量(FEV1)を用い、これらの関連を調べるため多変量線形回帰分析を行った。
【結果】: 男女ともに糖代謝の状態と肺機能は負の関連を認めたが、多変量調整後、女性では関連は減弱した。HbA1cの1％の上昇は、女性ではFVCの-52ml (95％信頼区間：-111 to 8) の変化とFEV1の-25ml (95％信頼区間：-75 to 25) の変化と関連し、男性ではFVCの-128ml (95％信頼区間：-163 to -94) の変化とFEV1の-73ml (95％信頼区間：-101 to -44) の変化と関連した。FPGの10mg/dlの上昇は、女性ではFVCの-11ml (95％信頼区間：-29 to 8) の変化とFEV1の-8ml (95％信頼区間：-24 to 7) の変化と関連し、男性ではFVCの-32ml (95％信頼区間：-44 to -21) の変化とFEV1の-19ml (95％信頼区間：-28 to -9) の変化と関連した。
【結論: 】糖代謝の状態と肺機能の連続的な負の関連が観察された。糖代謝による肺機能の変化は男性の方がより大きいと考えられた。