Hispanics/Latinos with type 2 diabetes have functional and symptomatic pulmonary impairment mirroring kidney microangiopathy: Findings from the hispanic community health study/study of Latinos (HCHS/SOL)

Oana L. Klein, Larissa Aviles-Santa, Jianwen Cai, Harold R. Collard, Alka M. Kanaya, Robert C. Kaplan, Gregory L. Kinney, Eliana Mendes, Lewis Smith, Gregory Talavera, Donghong Wu, Martha Daviglus

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Abstract

OBJECTIVE Type 2 diabetes mellitus (DM) has been associated with lung dysfunction, but this association has not been explored in Hispanics/Latinos. The relation between diabetic nephropathy and lung function and symptoms has not been explored. RESEARCH DESIGN AND METHODS The Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a large, multicenter, observational study, recruited 16,415 participants aged 18-74 years (14,455 with complete data on variables of interest), between 2008 and 2011 from four U.S. communities through a two-stage area household probability design. Baseline measurements were used for analyses. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and dyspnea score were compared between individuals with and without DM, overall, and stratified by albuminuria. The analyses were performed separately for those with and without preexisting lung disease (chronic bronchitis, emphysema, asthma). Linear regression with sampling weights was used for all analyses. RESULTS Among Hispanics/Latinos without lung disease, those with DM had lower mean FEV1 and FVC values and a higher mean dyspnea score than those without DM (mean [95% CI] FEV1 3.00 [2.96-3.04] vs. 3.10 [3.09-3.11] L, P < 0.01; FVC 3.62 [3.59-3.66] vs. 3.81 [3.79-3.83] L, P < 0.001; dyspnea score 0.60 [0.49-0.71] vs. 0.41 [0.34-0.49], P < 0.001). Hispanics/Latinos with DM and macroalbuminuria showed 10% lower FVC (P < 0.001), 6% lower FEV1 (P < 0.001), and 2.5-fold higher dyspnea score (P = 0.04) than those without DM and with normoalbuminuria. Similar findings but with higher impairment in FVC were found in Hispanics/ Latinos with lung disease. CONCLUSIONS Hispanics/Latinos with DM have functional and symptomatic pulmonary impairment that mirror kidney microangiopathy. The progression of pulmonary impairment in adults with DM needs to be investigated further.

Original languageEnglish (US)
Pages (from-to)2051-2057
Number of pages7
JournalDiabetes Care
Volume39
Issue number11
DOIs
StatePublished - Nov 1 2016

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Hispanic Americans
Type 2 Diabetes Mellitus
Kidney
Lung
Health
Diabetes Mellitus
Vital Capacity
Forced Expiratory Volume
Dyspnea
Lung Diseases
Preexisting Condition Coverage
Albuminuria
Chronic Bronchitis
Emphysema
Diabetic Nephropathies
Multicenter Studies
Observational Studies
Linear Models
Asthma
Weights and Measures

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Hispanics/Latinos with type 2 diabetes have functional and symptomatic pulmonary impairment mirroring kidney microangiopathy : Findings from the hispanic community health study/study of Latinos (HCHS/SOL). / Klein, Oana L.; Aviles-Santa, Larissa; Cai, Jianwen; Collard, Harold R.; Kanaya, Alka M.; Kaplan, Robert C.; Kinney, Gregory L.; Mendes, Eliana; Smith, Lewis; Talavera, Gregory; Wu, Donghong; Daviglus, Martha.

In: Diabetes Care, Vol. 39, No. 11, 01.11.2016, p. 2051-2057.

Research output: Contribution to journalArticle

Klein, Oana L. ; Aviles-Santa, Larissa ; Cai, Jianwen ; Collard, Harold R. ; Kanaya, Alka M. ; Kaplan, Robert C. ; Kinney, Gregory L. ; Mendes, Eliana ; Smith, Lewis ; Talavera, Gregory ; Wu, Donghong ; Daviglus, Martha. / Hispanics/Latinos with type 2 diabetes have functional and symptomatic pulmonary impairment mirroring kidney microangiopathy : Findings from the hispanic community health study/study of Latinos (HCHS/SOL). In: Diabetes Care. 2016 ; Vol. 39, No. 11. pp. 2051-2057.
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abstract = "OBJECTIVE Type 2 diabetes mellitus (DM) has been associated with lung dysfunction, but this association has not been explored in Hispanics/Latinos. The relation between diabetic nephropathy and lung function and symptoms has not been explored. RESEARCH DESIGN AND METHODS The Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a large, multicenter, observational study, recruited 16,415 participants aged 18-74 years (14,455 with complete data on variables of interest), between 2008 and 2011 from four U.S. communities through a two-stage area household probability design. Baseline measurements were used for analyses. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and dyspnea score were compared between individuals with and without DM, overall, and stratified by albuminuria. The analyses were performed separately for those with and without preexisting lung disease (chronic bronchitis, emphysema, asthma). Linear regression with sampling weights was used for all analyses. RESULTS Among Hispanics/Latinos without lung disease, those with DM had lower mean FEV1 and FVC values and a higher mean dyspnea score than those without DM (mean [95{\%} CI] FEV1 3.00 [2.96-3.04] vs. 3.10 [3.09-3.11] L, P < 0.01; FVC 3.62 [3.59-3.66] vs. 3.81 [3.79-3.83] L, P < 0.001; dyspnea score 0.60 [0.49-0.71] vs. 0.41 [0.34-0.49], P < 0.001). Hispanics/Latinos with DM and macroalbuminuria showed 10{\%} lower FVC (P < 0.001), 6{\%} lower FEV1 (P < 0.001), and 2.5-fold higher dyspnea score (P = 0.04) than those without DM and with normoalbuminuria. Similar findings but with higher impairment in FVC were found in Hispanics/ Latinos with lung disease. CONCLUSIONS Hispanics/Latinos with DM have functional and symptomatic pulmonary impairment that mirror kidney microangiopathy. The progression of pulmonary impairment in adults with DM needs to be investigated further.",
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T1 - Hispanics/Latinos with type 2 diabetes have functional and symptomatic pulmonary impairment mirroring kidney microangiopathy

T2 - Findings from the hispanic community health study/study of Latinos (HCHS/SOL)

AU - Klein, Oana L.

AU - Aviles-Santa, Larissa

AU - Cai, Jianwen

AU - Collard, Harold R.

AU - Kanaya, Alka M.

AU - Kaplan, Robert C.

AU - Kinney, Gregory L.

AU - Mendes, Eliana

AU - Smith, Lewis

AU - Talavera, Gregory

AU - Wu, Donghong

AU - Daviglus, Martha

PY - 2016/11/1

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N2 - OBJECTIVE Type 2 diabetes mellitus (DM) has been associated with lung dysfunction, but this association has not been explored in Hispanics/Latinos. The relation between diabetic nephropathy and lung function and symptoms has not been explored. RESEARCH DESIGN AND METHODS The Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a large, multicenter, observational study, recruited 16,415 participants aged 18-74 years (14,455 with complete data on variables of interest), between 2008 and 2011 from four U.S. communities through a two-stage area household probability design. Baseline measurements were used for analyses. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and dyspnea score were compared between individuals with and without DM, overall, and stratified by albuminuria. The analyses were performed separately for those with and without preexisting lung disease (chronic bronchitis, emphysema, asthma). Linear regression with sampling weights was used for all analyses. RESULTS Among Hispanics/Latinos without lung disease, those with DM had lower mean FEV1 and FVC values and a higher mean dyspnea score than those without DM (mean [95% CI] FEV1 3.00 [2.96-3.04] vs. 3.10 [3.09-3.11] L, P < 0.01; FVC 3.62 [3.59-3.66] vs. 3.81 [3.79-3.83] L, P < 0.001; dyspnea score 0.60 [0.49-0.71] vs. 0.41 [0.34-0.49], P < 0.001). Hispanics/Latinos with DM and macroalbuminuria showed 10% lower FVC (P < 0.001), 6% lower FEV1 (P < 0.001), and 2.5-fold higher dyspnea score (P = 0.04) than those without DM and with normoalbuminuria. Similar findings but with higher impairment in FVC were found in Hispanics/ Latinos with lung disease. CONCLUSIONS Hispanics/Latinos with DM have functional and symptomatic pulmonary impairment that mirror kidney microangiopathy. The progression of pulmonary impairment in adults with DM needs to be investigated further.

AB - OBJECTIVE Type 2 diabetes mellitus (DM) has been associated with lung dysfunction, but this association has not been explored in Hispanics/Latinos. The relation between diabetic nephropathy and lung function and symptoms has not been explored. RESEARCH DESIGN AND METHODS The Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a large, multicenter, observational study, recruited 16,415 participants aged 18-74 years (14,455 with complete data on variables of interest), between 2008 and 2011 from four U.S. communities through a two-stage area household probability design. Baseline measurements were used for analyses. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and dyspnea score were compared between individuals with and without DM, overall, and stratified by albuminuria. The analyses were performed separately for those with and without preexisting lung disease (chronic bronchitis, emphysema, asthma). Linear regression with sampling weights was used for all analyses. RESULTS Among Hispanics/Latinos without lung disease, those with DM had lower mean FEV1 and FVC values and a higher mean dyspnea score than those without DM (mean [95% CI] FEV1 3.00 [2.96-3.04] vs. 3.10 [3.09-3.11] L, P < 0.01; FVC 3.62 [3.59-3.66] vs. 3.81 [3.79-3.83] L, P < 0.001; dyspnea score 0.60 [0.49-0.71] vs. 0.41 [0.34-0.49], P < 0.001). Hispanics/Latinos with DM and macroalbuminuria showed 10% lower FVC (P < 0.001), 6% lower FEV1 (P < 0.001), and 2.5-fold higher dyspnea score (P = 0.04) than those without DM and with normoalbuminuria. Similar findings but with higher impairment in FVC were found in Hispanics/ Latinos with lung disease. CONCLUSIONS Hispanics/Latinos with DM have functional and symptomatic pulmonary impairment that mirror kidney microangiopathy. The progression of pulmonary impairment in adults with DM needs to be investigated further.

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