PMID- 34920193 OWN - NLM STAT- MEDLINE DCOM- 20220331 LR - 20220401 IS - 1878-0334 (Electronic) IS - 1871-4021 (Linking) VI - 16 IP - 1 DP - 2022 Jan TI - Dynamic diffusion lung capacity of carbon monoxide (DLCO) as a predictor of pulmonary microangiopathy and its association with extra pulmonary microangiopathy in patients with type II diabetes mellitus. PG - 102360 LID - S1871-4021(21)00380-5 [pii] LID - 10.1016/j.dsx.2021.102360 [doi] AB - BACKGROUND AND AIM: Lung as a target end organ for microvascular disease often remains underdiagnosed. This study aims to assess occurrence of pulmonary microangiopathy among Type 2 diabetes mellitus (T2DM) using dynamic diffusion lung capacity of carbon monoxide (DLCO). METHODS: A total of 120 participants aged >18 years were enrolled in this study. Group 1 comprised T2DM with microangiopathy (n = 40), group 2 include T2DM without microangiopathy (n = 40), group 3 were healthy controls (n = 40). Individuals with underlying lung disease, smoking history, heart failure, urinary tract infection, macrovascular complications of diabetes, microalbuminuria due to other causes were excluded from the study. Using electronic spirometry, Forced Expiratory Volume in first second (FEV1), Forced Vital Capacity (FVC) was measured and FEV1/FVC ratio calculated. DLCO (%predicted) using single breath method was measured in sitting position followed by supine position and delta DLCO was calculated. DLCO measured was compared between the three groups. RESULTS: DLCO (median [IQR]) in sitting (78 [70-82.75]) and supine position (70 [62-84]) among group one was significantly decreased when compared to other two groups (p value < 0.001, p value < 0.001 respectively). Delta DLCO (median, [IQR]) among patients with diabetic microangiopathy (-6 [-8 to -2]) was significant on comparison with group two (4[2,6]) and control group (5[4,6]) (p < 0.001). Negative delta DLCO reflecting pulmonary microangiopathy was significantly associated with extrapulmonary microangiopathy (p value = 0.027). CONCLUSION: Postural variation in DLCO is a useful non-invasive test for identifying pulmonary microangiopathy among T2DM patients. Presence of pulmonary microangiopathy has significant association with diabetic nephropathy and retinopathy. CI - Copyright (c) 2021 Diabetes India. Published by Elsevier Ltd. All rights reserved. FAU - Gurudatta Pawar, Sridatta AU - Gurudatta Pawar S AD - Department of General Medicine, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India. FAU - K, Arun AU - K A AD - Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India. Electronic address: arunkrish86@yahoo.com. FAU - Santhanam, Jennie AU - Santhanam J AD - Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India. FAU - Nellaiappa Ganesan, S K AU - Nellaiappa Ganesan SK AD - Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India. FAU - Vidya, T A AU - Vidya TA AD - Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India. FAU - Kumarasamy, Subramaniyan AU - Kumarasamy S AD - Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India. FAU - Meenakshi Sundari, S N AU - Meenakshi Sundari SN AD - Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India. FAU - Ramya, S G AU - Ramya SG AD - Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu(DT), Tamil Nadu, India. LA - eng PT - Journal Article DEP - 20211206 PL - Netherlands TA - Diabetes Metab Syndr JT - Diabetes & metabolic syndrome JID - 101462250 RN - 7U1EE4V452 (Carbon Monoxide) SB - IM MH - Adolescent MH - Carbon Monoxide MH - *Diabetes Mellitus, Type 2/complications MH - Humans MH - Lung MH - Lung Volume Measurements MH - Respiratory Function Tests OTO - NOTNLM OT - DLCO OT - Diabetic microangiopathy OT - Lung function OT - Pulmonary microangiopathy OT - Type II Diabetes mellitus COIS- Declaration of competing interest All authors declare that there is no conflict of interest. EDAT- 2021/12/18 06:00 MHDA- 2022/04/01 06:00 CRDT- 2021/12/17 20:16 PHST- 2021/03/15 00:00 [received] PHST- 2021/11/09 00:00 [revised] PHST- 2021/12/02 00:00 [accepted] PHST- 2021/12/18 06:00 [pubmed] PHST- 2022/04/01 06:00 [medline] PHST- 2021/12/17 20:16 [entrez] AID - S1871-4021(21)00380-5 [pii] AID - 10.1016/j.dsx.2021.102360 [doi] PST - ppublish SO - Diabetes Metab Syndr. 2022 Jan;16(1):102360. doi: 10.1016/j.dsx.2021.102360. Epub 2021 Dec 6.