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American Journal of Epidemiology 2005 161(6):546-556; doi:10.1093/aje/kwi076
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved

ORIGINAL CONTRIBUTIONS

Lung Function and Glucose Metabolism: An Analysis of Data from the Third National Health and Nutrition Examination Survey

Tricia M. McKeever1, Philip J. Weston2, Richard Hubbard1 and Andrew Fogarty1

1 Division of Respiratory Medicine, City Hospital, Nottingham, United Kingdom
2 Department of Diabetes, Royal Liverpool University Hospital, Liverpool, United Kingdom

Correspondence to Dr. Tricia McKeever, Division of Respiratory Medicine, Clinical Science Building, City Hospital, Hucknall Road, Nottingham NG5 1PB, United Kingdom (e-mail: Tricia.McKeever{at}Nottingham.ac.uk).

Although people with diabetes have decreased lung function, the dose-response relation between measures of glucose control and lung function in nondiabetic people is not known. The authors used data from the Third National Health and Nutrition Examination Survey (1988–1994) to investigate the relation between glucose tolerance test response and other measures of glucose homeostasis and lung function in an adult population without a clinical diagnosis of diabetes. Plasma glucose level 2 hours after oral administration of 75 g of glucose was inversely related to forced expiratory volume in 1 second (FEV1), with a difference of –144.7 ml (95% confidence interval: –231.9, –57.4) for persons in the highest quintile of postchallenge glucose compared with the lowest. Similar inverse associations with FEV1 were found for other measures of glucose autoregulation. Lung function did not appear to be related to fasting glucose level. Similar associations were seen for forced vital capacity (FVC) but not for the FEV1:FVC ratio. In the total study population, persons with previously diagnosed diabetes had an FEV1 119.1 ml (95% confidence interval: –161.5, –76.6) lower than persons without diabetes. This effect was greater in those with poorly controlled diabetes. These findings suggest that impaired glucose autoregulation is associated with impaired lung function.

glucose; hemoglobin A, glycosylated; insulin; lung; respiratory function tests


Abbreviations: CI   confidence interval; FEV1   forced expiratory volume in 1 second; FVC   forced vital capacity; NHANES III   Third National Health and Nutrition Examination Survey


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