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Hispanics/Latinos With Type 2 Diabetes Have Functional and Symptomatic Pulmonary Impairment Mirroring Kidney Microangiopathy: Findings From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

TitleHispanics/Latinos With Type 2 Diabetes Have Functional and Symptomatic Pulmonary Impairment Mirroring Kidney Microangiopathy: Findings From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).
Publication TypePublication
Year2016
AuthorsKlein OL, Avilés-Santa L, Cai J, Collard HR, Kanaya AM, Kaplan RC, Kinney GL, Mendes E, Smith L, Talavera G, Wu D, Daviglus M
JournalDiabetes Care
Volume39
Issue11
Pagination2051-2057
Date Published2016 Nov
ISSN1935-5548
KeywordsAdolescent, Adult, Aged, albuminuria, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Forced Expiratory Volume, Hispanic Americans, Humans, Linear Models, Lung, Male, Middle Aged, Renal Insufficiency, Risk Factors, Young Adult
Abstract

OBJECTIVE: Type 2 diabetes mellitus (DM) has been associated with lung dysfunction, but this association has not been explored in Hispanics/Latinos. The relation between diabetic nephropathy and lung function and symptoms has not been explored.RESEARCH DESIGN AND METHODS: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a large, multicenter, observational study, recruited 16,415 participants aged 18-74 years (14,455 with complete data on variables of interest), between 2008 and 2011 from four U.S. communities through a two-stage area household probability design. Baseline measurements were used for analyses. Forced expiratory volume in 1 s (FEV), forced vital capacity (FVC), and dyspnea score were compared between individuals with and without DM, overall, and stratified by albuminuria. The analyses were performed separately for those with and without preexisting lung disease (chronic bronchitis, emphysema, asthma). Linear regression with sampling weights was used for all analyses.RESULTS: Among Hispanics/Latinos without lung disease, those with DM had lower mean FEV and FVC values and a higher mean dyspnea score than those without DM (mean [95% CI] FEV 3.00 [2.96-3.04] vs. 3.10 [3.09-3.11] L, P < 0.01; FVC 3.62 [3.59-3.66] vs. 3.81 [3.79-3.83] L, P < 0.001; dyspnea score 0.60 [0.49-0.71] vs. 0.41 [0.34-0.49], P < 0.001). Hispanics/Latinos with DM and macroalbuminuria showed 10% lower FVC (P < 0.001), 6% lower FEV (P < 0.001), and 2.5-fold higher dyspnea score (P = 0.04) than those without DM and with normoalbuminuria. Similar findings but with higher impairment in FVC were found in Hispanics/Latinos with lung disease.CONCLUSIONS: Hispanics/Latinos with DM have functional and symptomatic pulmonary impairment that mirror kidney microangiopathy. The progression of pulmonary impairment in adults with DM needs to be investigated further.

DOI10.2337/dc16-1170
Alternate JournalDiabetes Care
PubMed ID27612502
PubMed Central IDPMC5079610
Grant ListN01HC65236 / HL / NHLBI NIH HHS / United States
N01HC65235 / HL / NHLBI NIH HHS / United States
N01HC65234 / HL / NHLBI NIH HHS / United States
N01HC65233 / HL / NHLBI NIH HHS / United States
N01HC65237 / HL / NHLBI NIH HHS / United States
P30 DK020541 / DK / NIDDK NIH HHS / United States
MS#: 
0043
Manuscript Lead/Corresponding Author Affiliation: 
Field Center: Chicago (University of Illinois at Chicago)
ECI: 
Yes
Manuscript Status: 
Published