The discrepant effect of blood glucose on the risk of early and late lung injury: a national cohort study

Abstract Background The association between glycemic control and short-, and long-term lung health remains controversial. This study aimed to investigate the relationship between glucose control and overall lung health in a national cohort. Methods The analysis included 5610 subjects from NHANES 200...

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Main Authors: Lu Wang, Yicheng Zhou, Xiaojuan Jiao, Qin Zhang, Kun Feng, Yunfeng Shen
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-024-03376-0
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author Lu Wang
Yicheng Zhou
Xiaojuan Jiao
Qin Zhang
Kun Feng
Yunfeng Shen
author_facet Lu Wang
Yicheng Zhou
Xiaojuan Jiao
Qin Zhang
Kun Feng
Yunfeng Shen
author_sort Lu Wang
collection DOAJ
description Abstract Background The association between glycemic control and short-, and long-term lung health remains controversial. This study aimed to investigate the relationship between glucose control and overall lung health in a national cohort. Methods The analysis included 5610 subjects from NHANES 2007–2012. We assessed the correlation of glycemic status with respiratory symptoms (cough, sputum, wheeze, and exertional dyspnea), lung function (forced expiratory volume in 1-s (FEV1), forced vital capacity (FVC)), and obstructive or restrictive lung disease (RLD). Furthermore, we determined all-cause mortality in patients with restrictive lung disease by linking data to the National Mortality Index records up to December 31, 2019. Results The study involved the examination of respiratory symptoms, pulmonary function tests, and mortality analyses encompassing 3714, 3916, and 173 subjects, respectively. Multifactorial regression analyses revealed that a 1% increase in blood glucose was associated with a reduction in effect sizes (β) for FVC and FEV1 by -1.66% (-2.47%, -0.86%) and -1.94% (-2.65%, -1.23%), respectively. This increase also exhibited correlations with an elevated risk of exertional dyspnoea, restrictive ventilation dysfunction, and all-cause mortality, presenting odds ratios (ORs) of 1.19 (1.06, 1.33), 1.22 (1.10, 1.36), and 1.61 (1.29, 2.01), respectively. Regarding glycemic control, patients with improved control demonstrated stronger associations with early lung damage, significantly correlating with reduced FVC (β -10.90%, [-14.45%, -7.36%]) and FEV1 (β -9.38%, [-12.90%, -5.87%]). Moreover, they experienced a notably higher risk of exertional dyspnoea (adjusted OR 2.09, [1.35- 3.24]), while the diabetic group with poorer glycemic control showed more significant connections with advanced lung damage. This group exhibited significant associations with an increased risk of restrictive ventilatory dysfunction (adjusted OR, 2.56, [1.70–3.86]) and all-cause mortality (hazard ratios [HRs] 2.65, [1.05–6.67]), all compared to the reference group with normal glycemic metabolism. Conclusions Elevated blood glucose exhibited an inverse correlation with both long-term and short-term lung health. A negative L-shaped relationship was observed between glycemic control and early lung injury, along with a linearly negative association concerning late-stage lung damage. Given the cross-sectional nature of this study, a longitudinal investigation is needed to validate our findings.
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spelling doaj-art-8c3dfd3cfb594855b82868d364309b7f2025-08-20T02:31:40ZengBMCBMC Pulmonary Medicine1471-24662024-12-0124111110.1186/s12890-024-03376-0The discrepant effect of blood glucose on the risk of early and late lung injury: a national cohort studyLu Wang0Yicheng Zhou1Xiaojuan Jiao2Qin Zhang3Kun Feng4Yunfeng Shen5Department of Endocrinology and Metabolism, Nanchang University Second Affiliated HospitalDepartment of Endocrinology and Metabolism, The Eighth Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Endocrinology and Metabolism, Nanchang University Second Affiliated HospitalDepartment of Endocrinology and Metabolism, Nanchang University Second Affiliated HospitalPingshan District People’s Hospital of ShenzhenDepartment of Endocrinology and Metabolism, The Eighth Affiliated Hospital, Sun Yat-Sen UniversityAbstract Background The association between glycemic control and short-, and long-term lung health remains controversial. This study aimed to investigate the relationship between glucose control and overall lung health in a national cohort. Methods The analysis included 5610 subjects from NHANES 2007–2012. We assessed the correlation of glycemic status with respiratory symptoms (cough, sputum, wheeze, and exertional dyspnea), lung function (forced expiratory volume in 1-s (FEV1), forced vital capacity (FVC)), and obstructive or restrictive lung disease (RLD). Furthermore, we determined all-cause mortality in patients with restrictive lung disease by linking data to the National Mortality Index records up to December 31, 2019. Results The study involved the examination of respiratory symptoms, pulmonary function tests, and mortality analyses encompassing 3714, 3916, and 173 subjects, respectively. Multifactorial regression analyses revealed that a 1% increase in blood glucose was associated with a reduction in effect sizes (β) for FVC and FEV1 by -1.66% (-2.47%, -0.86%) and -1.94% (-2.65%, -1.23%), respectively. This increase also exhibited correlations with an elevated risk of exertional dyspnoea, restrictive ventilation dysfunction, and all-cause mortality, presenting odds ratios (ORs) of 1.19 (1.06, 1.33), 1.22 (1.10, 1.36), and 1.61 (1.29, 2.01), respectively. Regarding glycemic control, patients with improved control demonstrated stronger associations with early lung damage, significantly correlating with reduced FVC (β -10.90%, [-14.45%, -7.36%]) and FEV1 (β -9.38%, [-12.90%, -5.87%]). Moreover, they experienced a notably higher risk of exertional dyspnoea (adjusted OR 2.09, [1.35- 3.24]), while the diabetic group with poorer glycemic control showed more significant connections with advanced lung damage. This group exhibited significant associations with an increased risk of restrictive ventilatory dysfunction (adjusted OR, 2.56, [1.70–3.86]) and all-cause mortality (hazard ratios [HRs] 2.65, [1.05–6.67]), all compared to the reference group with normal glycemic metabolism. Conclusions Elevated blood glucose exhibited an inverse correlation with both long-term and short-term lung health. A negative L-shaped relationship was observed between glycemic control and early lung injury, along with a linearly negative association concerning late-stage lung damage. Given the cross-sectional nature of this study, a longitudinal investigation is needed to validate our findings.https://doi.org/10.1186/s12890-024-03376-0Glycemic controlPulmonary functionLung healthRespiratory symptomsRestrictive lung function impairmentObstructive lung function impairment
spellingShingle Lu Wang
Yicheng Zhou
Xiaojuan Jiao
Qin Zhang
Kun Feng
Yunfeng Shen
The discrepant effect of blood glucose on the risk of early and late lung injury: a national cohort study
BMC Pulmonary Medicine
Glycemic control
Pulmonary function
Lung health
Respiratory symptoms
Restrictive lung function impairment
Obstructive lung function impairment
title The discrepant effect of blood glucose on the risk of early and late lung injury: a national cohort study
title_full The discrepant effect of blood glucose on the risk of early and late lung injury: a national cohort study
title_fullStr The discrepant effect of blood glucose on the risk of early and late lung injury: a national cohort study
title_full_unstemmed The discrepant effect of blood glucose on the risk of early and late lung injury: a national cohort study
title_short The discrepant effect of blood glucose on the risk of early and late lung injury: a national cohort study
title_sort discrepant effect of blood glucose on the risk of early and late lung injury a national cohort study
topic Glycemic control
Pulmonary function
Lung health
Respiratory symptoms
Restrictive lung function impairment
Obstructive lung function impairment
url https://doi.org/10.1186/s12890-024-03376-0
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