Stefan Kopf1,2, Jan B Groener1,2, Zoltan Kender1,2, Thomas Fleming1,2, Maik Brune1, Christin Riedinger1, Nadine Volk3,4, Esther Herpel3,4, Dominik Pesta5,6, Julia Szendrödi5,6,7, Mark O Wielpütz8,9, Hans-Ulrich Kauczor8,9, Hugo A Katus10, Michael Kreuter9,11, Peter P Nawroth1,2,12. 1. Department of Endocrinology, Diabetology, and Clinical Chemistry, Internal Medicine I, University Hospital of Heidelberg, Heidelberg, Germany. 2. German Center of Diabetes Research (DZD), associated partner in the DZD, München-Neuherberg, Germany. 3. Institute of Pathology, University of Heidelberg, Heidelberg, Germany. 4. Tissue Bank, National Center for Tumor Diseases, Heidelberg, Germany. 5. Institute for Clinical Diabetology, German Diabetes Center, Düsseldorf, Germany. 6. German Center for Diabetes Research (DZD), partner in the DZD, München-Neuherberg, Germany. 7. Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany. 8. Department of Diagnostic and Interventional Radiology, Section of Pulmonary Imaging, University of Heidelberg, Heidelberg, Germany. 9. Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research, Heidelberg, Germany. 10. Department of Cardiology, Angiology, and Pneumology, Internal Medicine III, University Hospital of Heidelberg, Heidelberg, Germany. 11. Center for Interstitial and Rare Lung Diseases, Pneumology, Thoraxklinik, University of Heidelberg, Heidelberg, Germany. 12. Joint-IDC, Institute for Diabetes and Cancer at Helmholtz Zentrum Munich and University of Heidelberg, Heidelberg, Germany.
Abstract
BACKGROUND: Diabetes mellitus is a significant comorbidity of interstitial lung disease (ILD). OBJECTIVES: The aim of this study was to investigate the incidence of restrictive lung disease (RLD) and ILD in patients with prediabetes and type 2 diabetes (T2D). METHODS: Forty-eight nondiabetics, 68 patients with prediabetes, 29 newly diagnosed T2D, and 110 patients with long-term T2D were examined for metabolic control, diabetes-related complications, breathlessness, and lung function. Five participants with T2D, breathlessness, and RLD underwent multidetector computed tomography (MDCT) and a Six-Minute Walk Test (6MWT). Lung tissue from 4 patients without diabetes and from 3 patients with T2D was histologically examined for presence of pulmonary fibrosis. RESULTS: Breathlessness in combination with RLD was significantly increased in patients with prediabetes and T2D (p < 0.01). RLD was found in 9% of patients with prediabetes, in 20% of patients with newly diagnosed T2D, and in 27% of patients with long-term T2D. Thus, patients with long-term T2D had an increased risk of RLD (OR 5.82 [95% CI 1.71-20.5], p < 0.01). RLD was significantly associated with glucose metabolism and albuminuria (p < 0.01); furthermore, presence of nephropathy increased the risk of RLD (OR 8.57 [95% CI 3.4-21.9], p < 0.01) compared to nondiabetics. MDCT revealed ILD in 4 patients, the 6MWT correlated with the extent of ILD, and histological analysis showed fibrosing ILD in patients with T2D. CONCLUSIONS: This study demonstrates increased breathlessness and a high prevalence of RLD in patients with T2D, indicating an association between diabetes and fibrosing ILD.
BACKGROUND:Diabetes mellitus is a significant comorbidity of interstitial lung disease (ILD). OBJECTIVES: The aim of this study was to investigate the incidence of restrictive lung disease (RLD) and ILD in patients with prediabetes and type 2 diabetes (T2D). METHODS: Forty-eight nondiabetics, 68 patients with prediabetes, 29 newly diagnosed T2D, and 110 patients with long-term T2D were examined for metabolic control, diabetes-related complications, breathlessness, and lung function. Five participants with T2D, breathlessness, and RLD underwent multidetector computed tomography (MDCT) and a Six-Minute Walk Test (6MWT). Lung tissue from 4 patients without diabetes and from 3 patients with T2D was histologically examined for presence of pulmonary fibrosis. RESULTS:Breathlessness in combination with RLD was significantly increased in patients with prediabetes and T2D (p < 0.01). RLD was found in 9% of patients with prediabetes, in 20% of patients with newly diagnosed T2D, and in 27% of patients with long-term T2D. Thus, patients with long-term T2D had an increased risk of RLD (OR 5.82 [95% CI 1.71-20.5], p < 0.01). RLD was significantly associated with glucose metabolism and albuminuria (p < 0.01); furthermore, presence of nephropathy increased the risk of RLD (OR 8.57 [95% CI 3.4-21.9], p < 0.01) compared to nondiabetics. MDCT revealed ILD in 4 patients, the 6MWT correlated with the extent of ILD, and histological analysis showed fibrosing ILD in patients with T2D. CONCLUSIONS: This study demonstrates increased breathlessness and a high prevalence of RLD in patients with T2D, indicating an association between diabetes and fibrosing ILD.
Authors: Johann M E Jende; Zoltan Kender; Christoph Mooshage; Jan B Groener; Lucia Alvarez-Ramos; Jennifer Kollmer; Alexander Juerchott; Artur Hahn; Sabine Heiland; Peter Nawroth; Martin Bendszus; Stefan Kopf; Felix T Kurz Journal: Front Neurosci Date: 2021-03-03 Impact factor: 4.677
Authors: Thomas Skovhus Prior; Charlotte Hyldgaard; Sebastiano Emanuele Torrisi; Elisabeth Bendstrup; Michael Kreuter; Sissel Kronborg-White; Claudia Ganter Journal: Respir Res Date: 2022-03-16
Authors: Stefan Kopf; Varun Kumar; Zoltan Kender; Zhe Han; Thomas Fleming; Stephan Herzig; Peter P Nawroth Journal: Front Endocrinol (Lausanne) Date: 2021-11-25 Impact factor: 5.555
Authors: Varun Kumar; Raman Agrawal; Aparamita Pandey; Stefan Kopf; Manuel Hoeffgen; Serap Kaymak; Obul Reddy Bandapalli; Vera Gorbunova; Andrei Seluanov; Marcus A Mall; Stephan Herzig; Peter P Nawroth Journal: EMBO J Date: 2020-04-27 Impact factor: 11.598