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

OBJECTIVE - To determine whether impaired pulmonary function is a significant predictor of the incidence of diabetes. RESEARCH DESIGN AND METHODS - Using data from the National Health and Nutrition Examination Survey Epidemiologic Follow-Up Study, a cohort study of a representative sample of U.S. adults, we examined the prospective associations between pulmonary function and incidence of diabetes. Our analyses included 4,830 U.S. men and women aged 25-74 years who had a baseline interview and examination (including spirometry) from 1971 through 1975 and were followed through 1992-1993. Incident diabetes (n = 443) was based on self- or proxy reports, hospitalization, or death certificates. RESULTS - After multiple adjustment, forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), percentage of predicted FEV1, and percentage of predicted FVC were significantly and inversely associated with the incidence of diabetes, but the ratio of FEV1 to FVC was not. Obstructive lung disease (defined by the Global Initiative for Chronic Obstructive Lung Disease classification) was not significantly associated with the incidence of diabetes, but restrictive lung disease was (hazard ratio = 1.45, 95% CI 1.04-2.03). The association did not differ significantly by smoking status. CONCLUSIONS - Although several prospective studies have found that impaired pulmonary function may increase the risk for developing diabetes, additional research is needed to better understand these relationships and their possible implications.