A Possible Association Between Suspected Restrictive Pattern as Assessed by Ordinary Pulmonary Function Test and the Metabolic Syndrome

doi:10.1378/chest.07-3003

Chest

Volume 134, Issue 4, October 2008, Pages 712-718

https://doi.org/10.1378/chest.07-3003 Get rights and content

Background

Impaired restrictive pulmonary function has been reported to be associated with insulin resistance and metabolic abnormalities. However, the possible association of restrictive pulmonary defect with metabolic syndrome (MetS) is not well understood. We examined the association in comparison with C-reactive protein (CRP), which is a predictor for MetS.

Methods

We recruited 2,396 apparently healthy adults and investigated the associations among pulmonary function, metabolic abnormality, and MetS, as defined by three different criteria. Abnormal pulmonary function was evaluated by both continuous pulmonary function variables including the percentage of predicted FVC (%PFVC) and a clinical category defined according to the American Thoracic Society/European Respiratory Society guidelines.

Results

CRP and %PFVC, but not FEV₁/FVC ratio, were significantly correlated with metabolic abnormalities even after adjustment for confounders including waist circumference. After adjustment for age, sex, and height, the odds ratios (ORs) of a restrictive pattern (RP), as defined by a reduced FVC and a normal FEV₁/FVC ratio using the lower limit of normal and RP substitutively defined by reduced FVC and an FEV₁/FVC ratio of ≥ 85% for MetS, were 1.76 to 2.52 (p < 0.05 to < 0.0001) and 1.87 to 2.28 (p < 0.05 to < 0.01), respectively. The obstructive pattern (OP) was not significantly associated with any MetS criteria. A moderate-to-severe RP, but not a high CRP level (> 3.0 mg/L), was consistently associated with the three MetS criteria (OR, 2.08 to 3.57; p < 0.05 to < 0.01), even after adjustment for confounders.

Conclusion

Impaired restrictive pulmonary function, but not OP, might be associated with metabolic disorders and MetS in a severity-dependent manner.

Section snippets

Subjects

The study was carried out in collaboration with Josai University (Sakado, Japan) and Social Insurance Omiya General Hospital (Saitama, Japan). The protocol was approved by The Ethics Committee of Josai University and Council of the Hospital, and informed consent was obtained. A total of 2,396 apparently healthy subjects (age range, 30 to 80 years) were randomly recruited from among those persons who lived in the suburbs and had undergone a complete medical checkup at the Omiya General Hospital.

Results

The clinical characteristics of the study participants are presented in Table 1. Most subjects were nonobese with relatively good cardiovascular risks profiles. The prevalence of RPLLN, RPSub, and OP were 5.4% (n = 130), 2.8% (n = 66), and 7.6% (n = 202), respectively.

Figure 1 shows the %PFVC and FEV₁/FVC ratio according to categorized NAMC. In both nonsmokers (n = 1,741) and smokers (n = 655), the %PFVC values were significantly decreased across increasing NAMC (for both, the p value for

Discussion

This study was conducted to examine the association between suspected RP, as assessed by ordinary pulmonary function tests and MetS, as well as the correlation between metabolic abnormalities and lung compliance in an apparently healthy population. Current results suggest that %PFVC, but not FEV₁/FVC ratio, may be correlated to the degree of metabolic abnormalities, such as the NAMC, even after adjustment for confounders. Consistently, the effect of smoking on %PFVC was obviously independent of

Conclusion

Impaired restrictive pulmonary function might be associated with metabolic disorders and MetS in a severity dependent manner in an apparently healthy population. Further large studies, including prospective studies along with a proper definition for RP, are needed to confirm this association and clarify the existence of a cause-effect relationship.

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The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

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Chest

Original ResearchPulmonary Function TestingA Possible Association Between Suspected Restrictive Pattern as Assessed by Ordinary Pulmonary Function Test and the Metabolic Syndrome

Background

Methods

Results

Conclusion

Section snippets

Subjects

Results

Discussion

Conclusion

Am J Med

Chest

Chest

Am J Clin Nutr

Respir Med

Lung function, insulin resistance and incidence of cardiovascular disease: a longitudinal cohort study

J Intern Med

Impaired ventilatory function and elevated insulin levels in nondiabetic males: the Normative Aging Study

Eur Respir J

Associations of measures of lung function with insulin resistance and type 2 diabetes: findings from the British Women's Heart and Health Study

Diabetologia

The association between metabolic syndrome and restrictive ventilatory dysfunction in older persons

J Gerontol A Biol Sci Med Sci

Prospective association between lung function and the incidence of diabetes: findings from the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study

Diabetes Care

Glycemic exposure is associated with reduced pulmonary function in type 2 diabetes: the Fremantle Diabetes Study

Diabetes Care

Vital capacity as a predictor of incident type 2 diabetes: the Atherosclerosis Risk in Communities study

Diabetes Care

Pulmonary dysfunction in type 1 diabetes in relation to metabolic long-term control and to incipient diabetic nephropathy

Nephron

Ventilatory pulmonary function tests in type 1 diabetes mellitus

J Assoc Physicians India

Diabetes mellitus and lung function

Med Princ Pract

Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis

Thorax

Original Research
Pulmonary Function Testing
A Possible Association Between Suspected Restrictive Pattern as Assessed by Ordinary Pulmonary Function Test and the Metabolic Syndrome