RT Journal Article
SR Electronic
T1 Pulmonary Function and Retrobulbar Hemodynamics in Subjects With Type 2 Diabetes Mellitus
JF Respiratory Care
FD American Association for Respiratory Care
SP 602
OP 614
DO 10.4187/respcare.05129
VO 62
IS 5
A1 He Tai
A1 Ming-yue Wang
A1 Yue-ping Zhao
A1 Ling-bing Li
A1 Xiao-lin Jiang
A1 Zheng Dong
A1 Xiao-nan Lv
A1 Jing Liu
A1 Qian-yan Dong
A1 Xin-guang Liu
A1 Jin-song Kuang
YR 2017
UL http://rc.rcjournal.com/content/62/5/602.abstract
AB BACKGROUND: The primary goals of this study were to evaluate early changes in pulmonary function and retrobulbar hemodynamics and to examine the correlation between these parameters in patients with type 2 diabetes during the preclinical stages of diabetic retinopathy.METHODS: For the single-time point measurements, 63 subjects with type 2 diabetes without diabetic retinopathy (diabetes group) and 32 healthy subjects (control group) were selected to evaluate any early changes in pulmonary function and retrobulbar hemodynamics and to examine the correlation between these parameters. In the longitudinal follow-up study, 32 subjects who were newly diagnosed with type 2 diabetes were divided into 2 groups according to their resistivity index (≤0.7 and >0.7). Early changes in pulmonary function and retrobulbar hemodynamics were studied in these groups and compared with the previous values.RESULTS: For the single-time point measurements, the fasting plasma glucose, 2-h postprandial blood glucose, glycosylated hemoglobin A1c, total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels as well as the pulmonary function parameters were significantly higher in the diabetes group than in the control group. The pulmonary function parameters were negatively and significantly correlated with glycosylated hemoglobin A1c and the duration of diabetes. The retrobulbar hemodynamics were positively correlated with glycosylated hemoglobin A1c and diabetes duration; in contrast, the correlation between retrobulbar hemodynamics and glycosylated hemoglobin A1c. In the longitudinal follow-up study, the pulmonary function of the 2 groups categorized by their resistivity index levels indicated that subjects with resistivity index levels ≤0.7 showed significantly better pulmonary function, and the pulmonary function of this group showed improvement and a significantly smaller decrease. The incidence of diabetic retinopathy in the group with resistivity index levels ≤0.7 (9 of 22, 40.9%) was significantly lower than that in the group with resistivity index levels >0.7.CONCLUSIONS: Pulmonary function and retrobulbar hemodynamics changed during the preclinical stages of diabetic retinopathy. Regulating glycemia may improve retrobulbar hemodynamics in the retrobulbar arteries (ie, central retinal artery, posterior ciliary artery, and arteria ophthalmica). By detecting the retrobulbar resistivity index and the levels of glycosylated hemoglobin A1c, we could predict future changes in pulmonary function during the preclinical stages of diabetic retinopathy as well as the degree of retinopathy. (ClinicalTrials.gov registration NCT02774733.)