Abstract
Aims
Diabetes is linked with decreases in lung elasticity and in capacity to transfer carbon
monoxide. Systemic inflammation, a common concern with diabetes, may contribute to
airflow obstruction. We examined the association of self-reported diabetes with self-reported
respiratory diseases (RDs) among 53,146 adults from the C8 Health Project.
Methods
Participants were categorized into three groups: Type 1 (T1D, n = 781), Type 2 (T2D,
n = 4277), or no diabetes (n = 48,088). ORs (95% CIs) for the association of diabetes
with four RDs were computed: emphysema, chronic obstructive pulmonary disease (COPD),
chronic bronchitis (CB), and asthma. Covariates controlled for were age, sex, estimated
glomerular filtration rate, C-reactive protein, smoking history, BMI, and perfluorooctonaoic
acid (C8).
Results
RDs were present in 26%, 21% and 13% of persons with T1D, T2D, and no diabetes, respectively.
In multivariable analyses, persons with T1D were 62% more likely to have any RD (OR:
1.62, CI: (1.36–1.93)), while those with T2D were 1.3 times as likely (OR: 1.26, CI:
1.15–1.37)). Compared to those without diabetes, in those with T1D and T2D diabetes
respectively, ORs (CIs) for COPD were 1.89 (1.38–2.57), 1.45 (1.23–1.71), asthma:
1.51 (1.21–1.87), 1.38 (1.24–1.53), CB: 1.96 (1.57–2.45), 1.35 (1.20–1.52) and emphysema:
1.25 (0.85–1.82), 1.31 (1.10–1.56). Population attributable risks for any RDs associated
with a history of smoking were 19%, 30%, and 26% for those with Type 1, Type 2, and
no diabetes respectively.
Conclusions
Diabetes, more so in T1D, appears to increase RD risk. Smoking is an important risk
factor, but not as informative in Type 1 diabetes.
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Article info
Publication history
Published online: May 23, 2018
Accepted:
May 17,
2018
Received in revised form:
May 9,
2018
Received:
October 13,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.