Carolina López-Cano1, Albert Lecube1,2, Marta García-Ramírez2,3, Xavier Muñoz4,5, Enric Sánchez1, Asunción Seminario5,6, Marta Hernández1, Andreea Ciudin3, Liliana Gutiérrez1, Cristina Hernández2,3, Rafael Simó2,3. 1. Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida, Universitat de Lleida, 25198 Lleida, Catalonia, Spain. 2. Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, 28029 Madrid, Spain. 3. Endocrinology and Nutrition Department, Hospital Universitari Vall d'Hebron, Diabetes and Metabolism Research Unit, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, 08035 Barcelona, Catalonia, Spain. 4. Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, 08035 Barcelona, Catalonia, Spain. 5. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, 28029 Madrid, Spain. 6. Respiratory Department, Hospital Universitari Arnau de Vilanova-Santa María, Institut de Recerca Biomèdica de Lleida, Universitat de Lleida, 25198 Lleida, Catalonia, Spain.
Abstract
Context: Lung impairment is a new target for late diabetic complications. Biomarkers that could help identify patients requiring functional respiratory tests have not been reported. Objective: Our aim was to examine whether serum surfactant protein D (SP-D) and A (SP-A) could be useful biomarkers of lung damage in obese patients with type 2 diabetes (T2D) without known lung disease. Design and Setting: A case-control study conducted in an ambulatory obesity unit. Patients: Forty-nine obese patients with T2D and 98 subjects without diabetes matched by age, sex, body mass index, and waist circumference were included. Interventions: Serum SP-D and SP-A levels were measured using enzyme-linked immunosorbent assay. Forced spirometry and static pulmonary volume were assessed. Results: Patients with T2D exhibited higher serum SP-D concentrations than control subjects (P = 0.006). No differences in serum SP-A concentrations were observed. There was an inverse association between forced expiratory volume in 1 second (FEV1) and serum SP-D (r = -0.265; P = 0.029), as well as a significant positive relationship between SP-D concentration and residual volume (r = 0.293; P = 0.043). From receiver operating characteristic analysis, the best SP-D cutoff to identify a FEV1 <80% of predicted was 132.3 ng/mL (area under the curve, 0.725; sensitivity, 77.7%; specificity, 69.4%). Stepwise multivariate regression analysis showed that serum SP-D concentration ≥132.3 ng/mL was independently associated with a FEV1 <80% of predicted (R2 = 0.406). Only the existence of T2D contributed independently to serum SD-P variance among all subjects (R2 = 0.138). Conclusions: Serum SP-D concentration can be a useful biomarker for detecting lung impairment in obese patients with T2D.
Context: Lung impairment is a new target for late diabetic complications. Biomarkers that could help identify patients requiring functional respiratory tests have not been reported. Objective: Our aim was to examine whether serum surfactant protein D (SP-D) and A (SP-A) could be useful biomarkers of lung damage in obesepatients with type 2 diabetes (T2D) without known lung disease. Design and Setting: A case-control study conducted in an ambulatory obesity unit. Patients: Forty-nine obesepatients with T2D and 98 subjects without diabetes matched by age, sex, body mass index, and waist circumference were included. Interventions: Serum SP-D and SP-A levels were measured using enzyme-linked immunosorbent assay. Forced spirometry and static pulmonary volume were assessed. Results:Patients with T2D exhibited higher serum SP-D concentrations than control subjects (P = 0.006). No differences in serum SP-A concentrations were observed. There was an inverse association between forced expiratory volume in 1 second (FEV1) and serum SP-D (r = -0.265; P = 0.029), as well as a significant positive relationship between SP-D concentration and residual volume (r = 0.293; P = 0.043). From receiver operating characteristic analysis, the best SP-D cutoff to identify a FEV1 <80% of predicted was 132.3 ng/mL (area under the curve, 0.725; sensitivity, 77.7%; specificity, 69.4%). Stepwise multivariate regression analysis showed that serum SP-D concentration ≥132.3 ng/mL was independently associated with a FEV1 <80% of predicted (R2 = 0.406). Only the existence of T2D contributed independently to serum SD-P variance among all subjects (R2 = 0.138). Conclusions: Serum SP-D concentration can be a useful biomarker for detecting lung impairment in obesepatients with T2D.
Authors: Alexander Zoufaly; Marko Poglitsch; Judith H Aberle; Wolfgang Hoepler; Tamara Seitz; Marianna Traugott; Alexander Grieb; Erich Pawelka; Hermann Laferl; Christoph Wenisch; Stephanie Neuhold; Doris Haider; Karin Stiasny; Andreas Bergthaler; Elisabeth Puchhammer-Stoeckl; Ali Mirazimi; Nuria Montserrat; Haibo Zhang; Arthur S Slutsky; Josef M Penninger Journal: Lancet Respir Med Date: 2020-09-24 Impact factor: 30.700