PMID- 27795984 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220129 IS - 2372-952X (Print) IS - 2372-952X (Electronic) IS - 2372-952X (Linking) VI - 3 IP - 4 DP - 2016 TI - Pulmonary Predictors of Incident Diabetes in Smokers. PG - 739-747 AB - BACKGROUND: Diabetes mellitus and its complications are a large and increasing burden for health care worldwide. Reduced pulmonary function has been observed in diabetes (both type 1 and type 2), and this reduction is thought to occur prior to diagnosis. Other measures of pulmonary health are associated with diabetes, including lower exercise tolerance, greater dyspnea, lower quality of life (as measured by the St. George's Respiratory Questionaire [SGRQ]) and susceptibility to lung infection and these measures may also predate diabetes diagnosis. METHODS: We examined 7080 participants in the COPD Genetic Epidemiology (COPDGene) study who did not report diabetes at their baseline visit and who provided health status updates during 4.2 years of longitudinal follow-up (LFU). We used Cox proportional hazards modeling, censoring participants at final LFU contact, reported mortality or report of incident diabetes to model predictors of diabetes. These models were constructed using known risk factors as well as proposed markers related to pulmonary health, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV(1)/FVC, respiratory exacerbations (RE), 6-minute walk distance (6MWD), pulmonary associated quality of life (as measured by the SGRQ), corticosteroid use, chronic bronchitis and dyspnea. RESULTS: Over 21,519 person years of follow-up, 392 of 7080 participants reported incident diabetes which was associated with expected predictors; increased body mass index (BMI), high blood pressure, high cholesterol and current smoking status. Age, gender and accumulated smoking exposure were not associated with incident diabetes. Additionally, preserved ratio with impaired spirometry (PRISm) pattern pulmonary function, reduced 6MWD and any report of serious pulmonary events were associated with incident diabetes. CONCLUSIONS: This cluster of pulmonary indicators may aid clinicians in identifying and treating patients with pre- or undiagnosed diabetes. FAU - Kinney, Gregory L AU - Kinney GL AD - Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus. FAU - Baker, Emma H AU - Baker EH AD - St. George's, University of London, United Kingdom. FAU - Klein, Oana L AU - Klein OL AD - Department of Medicine, University of California-San Francisco. FAU - Black-Shinn, Jennifer L AU - Black-Shinn JL AD - Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus. FAU - Wan, Emily S AU - Wan ES AD - Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts. FAU - Make, Barry AU - Make B AD - National Jewish Health and University of Colorado-Denver. FAU - Regan, Elizabeth AU - Regan E AD - National Jewish Health and University of Colorado-Denver. FAU - Bowler, Russell P AU - Bowler RP AD - National Jewish Health and University of Colorado-Denver. FAU - Lutz, Sharon M AU - Lutz SM AD - Department of Biostatistics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus. FAU - Young, Kendra A AU - Young KA AD - Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus. FAU - Duca, Lindsey M AU - Duca LM AD - Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus. FAU - Washko, George R AU - Washko GR AD - Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. FAU - Silverman, Edwin K AU - Silverman EK AD - Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts. FAU - Crapo, James D AU - Crapo JD AD - National Jewish Health and University of Colorado-Denver. FAU - Hokanson, John E AU - Hokanson JE AD - Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus. LA - eng GR - R01 HL089897/HL/NHLBI NIH HHS/United States GR - K01 HL125858/HL/NHLBI NIH HHS/United States GR - T32 ES007142/ES/NIEHS NIH HHS/United States GR - U01 HL089897/HL/NHLBI NIH HHS/United States GR - R01 HL089856/HL/NHLBI NIH HHS/United States GR - U01 HL089856/HL/NHLBI NIH HHS/United States GR - MR/K012770/1/MRC_/Medical Research Council/United Kingdom PT - Journal Article PL - United States TA - Chronic Obstr Pulm Dis JT - Chronic obstructive pulmonary diseases (Miami, Fla.) JID - 101635411 PMC - PMC5084840 MID - NIHMS819236 OTO - NOTNLM OT - COPD OT - chronic obstructive pulmonary disease OT - diabetes OT - pulmonary predictors COIS- Declaration of Interest Gregory L. Kinney, Oana L. Klein, Jennifer L. Black-Shinn, Emily S. Wan, Sharon M. Lutz, Elizabeth Regan, Russell P. Bowler, Kendra A. Young, Lindsey M. Duca, George R. Washko, James D. Crapo and John E. Hokanson have no conflicts to disclose. Emma H. Baker is joint holder of an MRC industry collaboration award with Astra Zeneca and principal investigator at St. George's for CRN portfolio adopted studies for Sirocco (Astra Zeneca), Ideal (GlaxoSmithKline), Asthma survey (Boehringer Ingelheim) and Arietta (Roche). Barry Make has participated in research studies and/or served on medical advisory boards for AstraZeneca, Boehringer-Ingelheim, CSL Bering, GlaxoSmithKline, Forest, Novartis, Spiration, and Sunovion. In the past three years, Edwin K. Silverman received honoraria and consulting fees from Merck, grant support and consulting fees from GlaxoSmithKline and honoraria and travel support from Novartis. EDAT- 2016/11/01 06:00 MHDA- 2016/11/01 06:01 PMCR- 2016/08/09 CRDT- 2016/11/01 06:00 PHST- 2016/11/01 06:00 [pubmed] PHST- 2016/11/01 06:01 [medline] PHST- 2016/11/01 06:00 [entrez] PHST- 2016/08/09 00:00 [pmc-release] AID - 10.15326/jcopdf.3.4.2016.0137 [doi] PST - ppublish SO - Chronic Obstr Pulm Dis. 2016;3(4):739-747. doi: 10.15326/jcopdf.3.4.2016.0137.