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Breathlessness and restrictive lung disease: an important diabetes-related feature in patients with type 2 diabetes

Background: Diabetes mellitus is a significant comorbidity of interstitial lung disease (ILD). Objectives: The aim of this study was to investigate the incidence of restrictive lung disease (RLD) and ILD in patients with prediabetes and type 2 diabetes (T2D). Methods: Forty-eight nondiabetics, 68 pa...

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Main Authors: Kopf, Stefan (Author) , Gröner, Jan (Author) , Kender, Zoltán (Author) , Fleming, Thomas (Author) , Brune, Maik (Author) , Riedinger, Christin (Author) , Volk, Nadine (Author) , Herpel, Esther (Author) , Wielpütz, Mark Oliver (Author) , Kauczor, Hans-Ulrich (Author) , Katus, Hugo (Author) , Kreuter, Michael (Author) , Nawroth, Peter Paul (Author)
Format: Article (Journal)
Language:English
Published: June 06, 2018
In: Respiration
Year: 2018, Volume: 96, Issue: 1, Pages: 29-40
ISSN:1423-0356
DOI:10.1159/000488909
Online Access:Verlag, Volltext: http://dx.doi.org/10.1159/000488909
Verlag, Volltext: https://www.karger.com/Article/FullText/488909
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Author Notes:Stefan Kopf, Jan B. Groener, Zoltan Kender, Thomas Fleming, Maik Brune, Christin Riedinger, Nadine Volk, Esther Herpel, Dominik Pesta, Julia Szendrödi, Mark O. Wielpütz, Hans-Ulrich Kauczor, Hugo A. Katus, Michael Kreuter, Peter P. Nawroth
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Summary:Background: Diabetes mellitus is a significant comorbidity of interstitial lung disease (ILD). Objectives: The aim of this study was to investigate the incidence of restrictive lung disease (RLD) and ILD in patients with prediabetes and type 2 diabetes (T2D). Methods: Forty-eight nondiabetics, 68 patients with prediabetes, 29 newly diagnosed T2D, and 110 patients with long-term T2D were examined for metabolic control, diabetes-related complications, breathlessness, and lung function. Five participants with T2D, breathlessness, and RLD underwent multidetector computed tomography (MDCT) and a Six-Minute Walk Test (6MWT). Lung tissue from 4 patients without diabetes and from 3 patients with T2D was histologically examined for presence of pulmonary fibrosis. Results: Breathlessness in combination with RLD was significantly increased in patients with prediabetes and T2D (p < 0.01). RLD was found in 9% of patients with prediabetes, in 20% of patients with newly diagnosed T2D, and in 27% of patients with long-term T2D. Thus, patients with long-term T2D had an increased risk of RLD (OR 5.82 [95% CI 1.71-20.5], p < 0.01). RLD was significantly associated with glucose metabolism and albuminuria (p < 0.01); furthermore, presence of nephropathy increased the risk of RLD (OR 8.57 [95% CI 3.4-21.9], p < 0.01) compared to nondiabetics. MDCT revealed ILD in 4 patients, the 6MWT correlated with the extent of ILD, and histological analysis showed fibrosing ILD in patients with T2D. Conclusions: This study demonstrates increased breathlessness and a high prevalence of RLD in patients with T2D, indicating an association between diabetes and fibrosing ILD.
Item Description:Gesehen am 17.07.2018
Physical Description:Online Resource
ISSN:1423-0356
DOI:10.1159/000488909

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