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Influence of Hyperglycemia to the Severity of Pulmonary Fibrosis*

Jiro Usuki, MD; Tatsuji Enomoto, MD; Arata Azuma, MD; Kuniko Matsuda, BS; Akinori Aoyama, PhD; Shoji Kudoh, MD
Chest. 2001;120(1_suppl):S71. doi:10.1378/chest.120.1_suppl.S71
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Several investigators1 have reported the frequent association of diabetes mellitus (DM) and idiopathic interstitial pneumonia (IIP). One hundred four cases of IIP in our hospital were studied retrospectively. Glucose tolerance could be reviewed in 37 cases. Twelve cases (32.4%) of IIP met the criteria for DM. As the prevalence of DM is reported at approximately 9.4% of those > 40 years old in Japan, it appeared that IIP patients tended to have accompanying DM. However, the correlation between IIP and DM is still unclear. We focused on advanced glycation end products (AGEs), the late-stage products of Maillard reaction, because AGEs have been shown to play an important role in fibrotic changes in many organs, including kidneys2 and arteries3 in patients with DM. Immunoreactivity for AGEs has been demonstrated in lung tissues from patients with pulmonary fibrosis.4 Serum AGEs level (/creatinine) of patients with IIP in our hospital was higher than that of normal volunteers. To investigate the role of AGEs in the pathogenesis of pulmonary fibrosis, we used bleomycin-induced pulmonary fibrosis in mice with or without hyperglycemia.

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