| Diabetes is a result of absolute or relative insulin secretion less than or different degrees of insulin resistance, resulting in hyperglycemia as the main features of the metabolic diseases. With the change of social life,obesity and the aging of the population , diabetes is increasing year by year in China ,In 1980 from 0.67% to 3.21% in 1996, increased by nearly 5-fold in 15 years. Has now reached 40 million, ranking second in the world, of which 95% is typeⅡdiabetes.The world suffer from diabetes more than 100 million 50 million, expected number of patients to reach 300 million in 2025, more than 7596 patients from developing countries, most patients with diabetes will be India, China and the United States, and more inclined to younger age at onset. Therefore, diabetes has become a major world health problem.Sustained increase in blood sugar can lead to systemic multi-system organ of metabolic abnormalities, dysfunction and structural changes, including the heart, central nervous system, peripheral nerves, blood vessels and kidneys and so on. In recent years, experimental studies have shown that Lung is one of the target organs of diabetic damage.Lung is rich in connective tissue and vascular systems, domestic and foreign scholars have found that alveolar epithelial cells, as well as pulmonary capillary endothelial cell basement membrane thickening and extracellular matrix proliferation in patients with typeⅡdiabetes.In the past years, the shortness of breath, chest tightness and other symptoms of patients with typeⅡdiabetes in clinical practice are often considered to be obesity, coronary heart disease; whereas Lung function damage caused by diabetes is often overlooked.In recent years, With the in-depth study of diabetes and its complications ,changes in lung function in patients with diabetes have been growing concerns by respiratory and endocrine doctors.Some studies on Pulmonary ventilatory function,small airway function and diffusing capacity of patients with typeⅡdiabetes were carried out by domestic and foreign scholars ,but the various reports are inconsistent.some scholars reported that the longer course of disease in patients with typeⅡdiabetes, the more obvious damage to lung function.But there are also scholars reported that typeⅡdiabetes-induced lung injury had no correlation with the course of disease.Therefore, changes in lung function in patients with typeⅡdiabetes and its influencing factors needs to be further studied. From January 2007 to December 2007, 100 cases of hospital-typeⅡdiabetes (2TDM) patients and 40 healthy volunteers were randomly selected from general hospital of Da-qing oil field. Parameters of Lung function of normal subjects and patients with type 2 diabetes were detected. Index is listed as follows:the total lung capacity (TLC), forced vital capacity (FVC), 1 seconds forced expiratory volume (FEV1), maximal midexpiratory flow (MMEF25, MMEF50), diffusing capacity of the lung for carbon monoxide(DLCO), DLCO corrected by alveolar volume (DLCO / VA) and arterial oxygen partial pressure (PaO2), carbon dioxide partial pressure (PaCO2) and oxygen saturation (SaO2) ;and parameters of Lung function of patients with type 2 diabetes with TLC, FVC, FEV1, MMEF25, MMEF50, DLCO and DLCO / VA as the dependent variable, fasting plasma glucose (FPG), 2-hr plasma glucose (PG2h), insulin sensitivity index(ISI), fasting c-peptide(FCP), 2-hr postprandial c-peptide(PCP), Glycosylated hemoglobin (HbA1C), body mass index(BMI) and diabetic duration as independent variables to carry out multi-factor linear regression analysis,To further explore Changes of Lung function in patients with typeⅡdiabetes(2TDM) and its relationship with FPG, PG2h, FCP, PCP, HbA1C, diabetic duration, BMI and ISI, so as to provide experimental data for theory of preventing and treating lung injury, changes of pulmonary function of patients with Type 2 diabetes in clinic. The following results were obtained by contrastive studies of general information,pulmonary ventilatory function,diffusing capacity and arterial blood gas analysis in healthy control group and typeⅡdiabetes group;by comparative analysis of different time course ,different level of blood sugar control and different degree of insulin resistance of Pulmonary function test results in typeⅡdiabetes group;and by multi-factor linear regression analysis of parameters of Lung function in patients with typeⅡdiabetes(2TDM) with relationship of FPG, PG2h, FCP, PCP, HbA1C, diabetic duration, BMI and ISI :1. Body Mass Index (BMI): compared with the control group(21.15±2.70 kg / m2 ),BMI was significantly higher in 2TDM group(25.46±2.77 kg/ m2), the difference had the high remarkable (P <0. 01).2. Compared with the control group, TLC, FVC (L), FEV1 (L), MMEF50 were lower in 2TDM group. the difference had the high remarkable (P <0.01); compared with the control group, MMEF25 was lower in 2TDM group,the difference was significant (P <0.05). In diffusing capacity and arterial blood gas analysis, DLCO, DLCO / VA, PaO2 and SaO2 in 2TDM Group lower than the control group, there were significant differences in the two groups(P <0.01).3. Different time course of Pulmonary function test results in typeⅡdiabetes group: compared with≤5 years of the duration of illness: TLC, FEV1, MMEF25, MMEF50 and DLCO / VA in 5-10 years of the duration of illness, there were no significant difference in the two groups (P> 0.05); and compared with≤5 years of the duration of illness: TLC, FEV1, MMEF25, MMEF50 and DLCO / VA were lower over 10 years, the difference had the high remarkable (P <0.01).4. Different level of blood sugar control of Pulmonary function test results in typeⅡdiabetes group: compared with FPG <8mmol / L, or compared with PG2h <10 mmol / L: TLC, FEV1, MMEF50 and DLCO / VA in FPG≥8mmol / L or PG2h≥10mmol / L were significantly lower, the difference had the high remarkable (P <0.01); MMEF25 also reduced, the difference was significant (P <0.05).5. Different degree of insulin resistance of Pulmonary function test results in typeⅡdiabetes group : compared with HOMA-IR(homeostasis model assessment-insulin resistance)≥2: TLC, FEV1, MMEF50 and DLCO / VA were significantly lower in HOMA-IR <2, the difference had the high remarkable (P <0.01); MMEF25 also reduced, the difference was significant (P <0.05).6. TLC, FVC, FEV1, MMEF50 in typeⅡdiabetes group had no significant correlation with FPG,PG2h,FCP,PCP,HbA1C,BMI,ISI,diabetic duration (P> 0. 05); However, DLCO, DLCO / VA with the FPG, PG2h, FCP, PCP, HbA1C, BMI, diabetic duration were negatively correlated (P < 0. 05); MMEF25 with FCP, PCP was highly significant negative correlation (P <0. 01), and with FPG, PG2h, HbA1C, BMI, diabetic duration was negatively correlated (P <0. 05); MMEF25, DLCO, DLCO / VA with the ISI were significant positive correlations (P <0. 05).Conclusion1. Lung function damage in patients with typeⅡdiabetes mainly presented as restrictive ventilatory functional disturbance , small airway dysfunction and abnormal diffusing capacity.2. Different time course ,different level of blood sugar control and different degree of insulin resistance in typeⅡdiabetes group play an important role in changes of TLC,FEV1,MMEF50,MMEF25和DLCO/VA.3. FPG, PG2h, FCP, PCP, HbA1C, BMI, diabetic duration, ISI are closely related with small airway dysfunction and abnormalities of diffusive function in typeⅡdiabetes group. Controlling blood glucose , ameliorating insulin resistance ,enhancing insulin sensitivity, controlling weight of patients with typeⅡdiabetes ,the diagnosis and correct treatment as early as possible, are the importment factors for the prevention and cure of lung function injury of patients with typeⅡdiabetes. |
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