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Lung function, insulin resistance and incidence of cardiovascular disease: a longitudinal cohort study.

Engström, Gunnar LU ; Hedblad, Bo LU ; Nilsson, P; Wollmer, Per LU ; Berglund, Göran LU and Janzon, Lars LU (2003) In Journal of Internal Medicine1989-01-01+01:00 253(5). p.574-581
Abstract
Objectives. To explore whether a reduced lung function is a risk factor for developing diabetes and insulin resistance (IR), and whether such relationship contributes to the largely unexplained association between lung function and incidence of cardiovascular disease (CVD).



Design. Forced vital capacity (FVC) was assessed at baseline. Incidence of diabetes and IR [according to the homeostasis model assessment (HOMA) model] was assessed in a follow-up examination after 13.9 ± 2.6 and 9.4 ± 3.6 years for men and women, respectively. After the follow-up examination, incidence of CVD (stroke, myocardial infarction or cardiovascular death) was monitored over 7 years.



Setting. Populations-based cohort... (More)
Objectives. To explore whether a reduced lung function is a risk factor for developing diabetes and insulin resistance (IR), and whether such relationship contributes to the largely unexplained association between lung function and incidence of cardiovascular disease (CVD).



Design. Forced vital capacity (FVC) was assessed at baseline. Incidence of diabetes and IR [according to the homeostasis model assessment (HOMA) model] was assessed in a follow-up examination after 13.9 ± 2.6 and 9.4 ± 3.6 years for men and women, respectively. After the follow-up examination, incidence of CVD (stroke, myocardial infarction or cardiovascular death) was monitored over 7 years.



Setting. Populations-based cohort study.



Subjects. Initially nondiabetic men (n = 1436, mean age 44.6 years) and women (n = 896, mean age 49.8 years).



Results. Prevalence of IR at the follow-up examination was 34, 26, 21 and 21%, respectively, for men in the first (lowest), second, third and fourth quartile of baseline FVC (P for trend <0.0001). The corresponding values for women were 30, 29, 25 and 17%, respectively (P for trend <0.001). Adjusted for potential confounders, the odds ratio (OR) for IR (per 10% increase in FVC) was 0.91 (CI: 0.84-0.99) for men and 0.89 (CI: 0.80-0.98) for women. FVC was similarly significantly associated with the incidence of diabetes (OR = 0.90, CI: 0.81-1.00), adjusted for sex and other confounders.



The incidence of CVD after the follow-up examination was significantly increased only amongst subjects with low FVC who had developed IR (RR = 1.7, CI: 1.02-2.7).



Conclusion. Subjects with a moderately reduced FVC have an increased risk of developing IR and diabetes. This relationship seems to contribute to the largely unexplained association between reduced lung function and incidence of CVD. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Internal Medicine1989-01-01+01:00
volume
253
issue
5
pages
574 - 581
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • pmid:12702035
  • wos:000182323100010
  • scopus:0037734258
ISSN
1365-2796
DOI
language
English
LU publication?
yes
id
d6441afe-d1bf-4157-9eb9-82760c44a898 (old id 113299)
date added to LUP
2007-07-18 14:33:10
date last changed
2018-05-29 11:51:43
@article{d6441afe-d1bf-4157-9eb9-82760c44a898,
  abstract     = {Objectives. To explore whether a reduced lung function is a risk factor for developing diabetes and insulin resistance (IR), and whether such relationship contributes to the largely unexplained association between lung function and incidence of cardiovascular disease (CVD).<br/><br>
<br/><br>
Design. Forced vital capacity (FVC) was assessed at baseline. Incidence of diabetes and IR [according to the homeostasis model assessment (HOMA) model] was assessed in a follow-up examination after 13.9 ± 2.6 and 9.4 ± 3.6 years for men and women, respectively. After the follow-up examination, incidence of CVD (stroke, myocardial infarction or cardiovascular death) was monitored over 7 years.<br/><br>
<br/><br>
Setting. Populations-based cohort study.<br/><br>
<br/><br>
Subjects. Initially nondiabetic men (n = 1436, mean age 44.6 years) and women (n = 896, mean age 49.8 years).<br/><br>
<br/><br>
Results. Prevalence of IR at the follow-up examination was 34, 26, 21 and 21%, respectively, for men in the first (lowest), second, third and fourth quartile of baseline FVC (P for trend &lt;0.0001). The corresponding values for women were 30, 29, 25 and 17%, respectively (P for trend &lt;0.001). Adjusted for potential confounders, the odds ratio (OR) for IR (per 10% increase in FVC) was 0.91 (CI: 0.84-0.99) for men and 0.89 (CI: 0.80-0.98) for women. FVC was similarly significantly associated with the incidence of diabetes (OR = 0.90, CI: 0.81-1.00), adjusted for sex and other confounders.<br/><br>
<br/><br>
The incidence of CVD after the follow-up examination was significantly increased only amongst subjects with low FVC who had developed IR (RR = 1.7, CI: 1.02-2.7).<br/><br>
<br/><br>
Conclusion. Subjects with a moderately reduced FVC have an increased risk of developing IR and diabetes. This relationship seems to contribute to the largely unexplained association between reduced lung function and incidence of CVD.},
  author       = {Engström, Gunnar and Hedblad, Bo and Nilsson, P and Wollmer, Per and Berglund, Göran and Janzon, Lars},
  issn         = {1365-2796},
  language     = {eng},
  number       = {5},
  pages        = {574--581},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Journal of Internal Medicine1989-01-01+01:00},
  title        = {Lung function, insulin resistance and incidence of cardiovascular disease: a longitudinal cohort study.},
  url          = {http://dx.doi.org/},
  volume       = {253},
  year         = {2003},
}