Reduced lung function predicts risk of incident type 2 diabetes: insights from a meta-analysis of prospective studies.

Epidemiological studies have repeatedly investigated the association between reduced pulmonary function and incident type 2 diabetes mellitus (T2DM). However, the results have been inconsistent. This meta-analysis aimed to clarify this association with prospective cohort studies. We searched PubMed, Web of Science (ISI), and Google Scholar for all studies (in English) reporting reduced lung function with a risk of T2DM. The measures of lung function included percentage of forced vital capacity for predicted values (FVC%pre), percentage of forced expiratory volume in the first second after expiration for predicted values (FEV1%pre) and FEV1-to-FVC ratio%. Summary risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using fixed-effects or random-effects meta-analyses. A total of 5,480 incident T2DM patients among 88,799 individuals were identified from nine prospective cohort studies. Compared to the highest category of FVC%pre and FEV1%pre, the lowest category of FVC%pre and FEV1%pre were significantly associated with increased incident T2DM risk (FVC%pre: RR = 1.49, 95% CI: 1.39-1.59; FEV1%pre: RR = 1.52, 95% CI: 1.42-1.62). However, no significant relationship was found between the FEV1/FVC ratio and incident T2DM risk (RR = 1.01, 95% CI: 0.91-1.13). Current evidence suggests that restrictive rather than obstructive impairment of lung function is significantly associated with the incidence of T2DM. Further research is warranted to explore potential mediators of this relationship.

• Publication year

  2021

• Venue

  Endocrine journal

• Publication date

  2021-10-22

• Fields of study

  Medicine

• Identifiers
  DOI 10.1507/endocrj.ej21-0403PMID 34690216
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• The Association between Pulmonary Functions and Incident Diabetes: Longitudinal Analysis from the Ansung Cohort in Korea

  2020influential reference
• Lung function as a predictor of incident type 2 diabetes in community-dwelling adults: A longitudinal finding over 12 years from the Korean Genome and Epidemiology Study.

  2019cited by this paper
• Dietary intake of flavonoid subclasses and risk of type 2 diabetes in prospective cohort studies: A dose-response meta-analysis.

  2018cited by this paper
• Overweight, Obesity, and Lung Function in Children and Adults-A Meta-analysis.

  2017cited by this paper
• Diabetes risks and outcomes in chronic obstructive pulmonary disease patients: Two nationwide population-based retrospective cohort studies

  2017cited by this paper
• The temporal relationship between poor lung function and the risk of diabetes

  2016influential reference
• Low Vital Capacity Was Associated with Incident Diabetes in a Japanese Health Screening Population in Whom Obesity Was Not Prevalent.

  2016influential reference
• Association of restrictive ventilatory dysfunction with the development of prediabetes and type 2 diabetes in Koreans

  2015influential reference
• Inverse relationship between body mass index and mortality in older nursing home residents: a meta‐analysis of 19,538 elderly subjects

  2015cited by this paper
• The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses

  2014cited by this paper
• The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies.

  2013cited by this paper
• Low lung function and risk of type 2 diabetes in Japanese men: the Toranomon Hospital Health Management Center Study 9 (TOPICS 9).

  2012influential reference
• Reduced lung function is independently associated with increased risk of type 2 diabetes in Korean men

  2012influential reference
• Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses

  2010cited by this paper
• Pulmonary function in diabetes: a metaanalysis.

  2010cited by this paper
• Lung Function and Risk of Type 2 Diabetes and Fatal and Nonfatal Major Coronary Heart Disease Events: Possible Associations With Inflammation

  2010influential reference
• Systematic review of the association between lung function and Type 2 diabetes mellitus

  2010cited by this paper
• Systemic and local inflammation in asthma and chronic obstructive pulmonary disease: is there a connection?

  2009cited by this paper
• Lung function measurements in traditional bakers.

  2008cited by this paper
• Systemic inflammation and lung function in young adults

  2007cited by this paper
• Plasma fibrinogen and lung function: the CARDIA Study.

  2006cited by this paper
• Vital capacity as a predictor of incident type 2 diabetes: the Atherosclerosis Risk in Communities study.

  2005influential reference
• Lung function and glucose metabolism: an analysis of data from the Third National Health and Nutrition Examination Survey.

  2005cited by this paper
• Consensus Statement

  2004cited by this paper
• Prospective association between lung function and the incidence of diabetes: findings from the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study.

  2004cited by this paper
• Measuring inconsistency in meta-analyses

  2003cited by this paper
• Lung function, insulin resistance and incidence of cardiovascular disease: a longitudinal cohort study

  2003cited by this paper
• How meta-analysis increases statistical power.

  2003cited by this paper
• Quantifying heterogeneity in a meta‐analysis

  2002cited by this paper
• C-Reactive Protein, Insulin Resistance, Central Obesity, and Coronary Heart Disease Risk in Indian Asians From the United Kingdom Compared With European Whites

  2001cited by this paper
• Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group.

  2000cited by this paper
• Bias in meta-analysis detected by a simple, graphical test

  1997cited by this paper
• Poor physical fitness, and impaired early insulin response but late hyperinsulinaemia, as predictors of NIDDM in middle-aged Swedish men

  1996cited by this paper

• The role of obesity and Type 2 diabetes in lung health: A systematic review (2024)

  2026cites this paper
• Lung function and onset of cardiometabolic diseases in the longitudinal Burden of Obstructive Lung Disease study

  2025cites this paper
• Is type 2 diabetes a link between lung function and metabolic dysfunction–associated steatotic liver disease? Insights from population studies and Mendelian randomization

  2025cites this paper
• Type II diabetes in systemic sclerosis patients: insights from an observational, multicenter study of GIRRCS (Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale)

  2025cites this paper
• Cardiac troponin and increased mortality risk among individuals with restrictive spirometric pattern on lung function testing

  2024cites this paper
• Non-apoptotic programmed cell deaths in diabetic pulmonary dysfunction: the new side of advanced glycation end products

  2023cites this paper