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Original Research: PULMONARY FUNCTION IN DIABETES |

Pulmonary Function in Diabetes: A Metaanalysis

Bram van den Borst, MD; Harry R. Gosker, PhD; Maurice P. Zeegers, PhD; Annemie M. W. J. Schols, PhD
Author and Funding Information

From the NUTRIM School for Nutrition, Toxicology and Metabolism, Department of Respiratory Medicine (Drs van den Borst, Gosker, and Schols), and the Department of Complex Genetics, Cluster of Genetics and Cell Biology (Dr Zeegers), Maastricht University Medical Centre, Maastricht, The Netherlands; and the Unit of Genetic Epidemiology (Dr Zeegers), Department of Public Health, Epidemiology and Biostatistics, School of Medicine, University of Birmingham, Birmingham, England.

Correspondence to: Bram van den Borst, MD, Maastricht University Medical Centre, Department of Respiratory Medicine, PO Box 616, 6200 MD Maastricht, The Netherlands; e-mail: b.vdborst@pul.unimaas.nl


Funding/Support: This study was performed within the framework of Top Institute Pharma project T1-201. The research of Dr Gosker is supported by a grant from the Netherlands Asthma Foundation [NAF 3.4.05.038]. Dr Zeegers is sponsored by Cancer Research UK [A7098, A6135, A6835, A5738], Birmingham Children’s Hospital Research Foundation, England [102f], and the Institute for the Stimulation of Innovation by Science and Technology, Belgium [070699].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(2):393-406. doi:10.1378/chest.09-2622
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Background:  Research into the association between diabetes and pulmonary function has resulted in inconsistent outcomes among studies. We performed a metaanalysis to clarify this association.

Methods:  From a systematic search of the literature, we included 40 studies describing pulmonary function data of 3,182 patients with diabetes and 27,080 control subjects. Associations were summarized pooling the mean difference (MD) (standard error) between patients with diabetes and control subjects of all studies for key lung function parameters.

Results:  For all studies, the pooled MD for FEV1, FVC, and diffusion of the lungs for carbon monoxide were −5.1 (95% CI, −6.4 to −3.7; P < .001), −6.3 (95% CI, −8.0 to −4.7; P < .001), and −7.2 (95% CI, −10.0 to −4.4; P < .001) % predicted, respectively, and for FEV1/FVC 0.1% (95% CI, −0.8 to 1.0; P = .78). Metaregression analyses showed that between-study heterogeneity was not explained by BMI, smoking, diabetes duration, or glycated hemoglobin (all P > .05).

Conclusions:  Diabetes is associated with a modest, albeit statistically significant, impaired pulmonary function in a restrictive pattern. Since our results apply to the diabetic subpopulation free from overt pulmonary disease, it would next be interesting to investigate the potential clinical implications in those patients with diabetes who carry a pulmonary diagnosis, such as COPD or asthma.

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