Low Vital Capacity Independently Predicts Type 2 Diabetes

The FVC(forced vital capacity ) -diabetes link could suggest explanations for other phenomena, like the elevated risk of heart disease associated with low vital capacity.” Lower vital capacity independently predicts the development of type 2 diabetes, according to a report in the June Diabetes Care.

Dr. Frederick L. Brancati from Johns Hopkins University, Baltimore, Maryland said that, "Diabetes and lung function are connected and we don’t know why yet, but this is new and deserves attention."

Dr. Brancati and colleagues used data from the Atherosclerosis Risk in Communities (ARIC) study to test their hypothesis that lower lung function, as indicated by lower vital capacity, is associated with features of insulin resistance and is an independent predictor of new onset type 2 diabetes.

Lower forced vital capacity (FVC) (% predicted) was associated with higher fasting glucose, insulin, and triglycerides, higher systolic blood pressure, and lower HDL cholesterol among men and women in the database, the authors report.

During 9 years of follow-up, there was an inverse relationship between FVC (% predicted) and the incidence of type 2 diabetes, the report indicates. The age- and race-adjusted incidence in the lowest FVC (% predicted) group (28.3 cases per 1000 person-years) was more than twice that in the highest FVC (% predicted) group for both men and women.

Adjustment for the presence of metabolic syndrome or for fasting glucose, insulin resistance, and systolic blood pressure slightly attenuated the association between vital capacity and incident type 2 diabetes, the researchers note, but the association was stronger among men and women who did not smoke.

FVC was significantly more likely to be lower among individuals who were African American, older, and less educated; those who smoked more cigarettes; those who were less physically active; those with higher body-mass index, waist circumference, and waist-to-hip ratio; those with metabolic syndrome; and those with higher white blood cell counts and fibrinogen levels, the results indicate.

"The main implication of our study is that lower vital capacity of the lung deserves attention as an emerging, novel risk factor for type 2 diabetes," the authors conclude. "Even if it turns out not to lie within a causal pathway to diabetes, FVC might still be a useful risk predictor, and the FVC-diabetes link could suggest explanations for other phenomena, like the elevated risk of heart disease associated with low vital capacity."

"We’re looking at rate of decline of FVC in adults with already established diabetes, on the hunch that there could be a cycle," Dr. Brancati said. "We’re also collaborating with sleep experts to study sleep related breathing disturbances in relation to insulin resistance. Finally, we’re investigating a ‘fetal origins’ angle, using data from a cohort study of mothers and offspring that started in the 1950s."
Diabetes Care 2005;28:1472-1479.