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The Relationship between Lung Function and Metabolic Syndrome in Obese and Non-Obese Korean Adult Males (Korean Diabetes J 2010;34:253-60)

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This is an Open Access article distributed under the terms of the Creative Commons At- tribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

www.e-kdj.org Copyright © 2010 Korean Diabetes Association

The Relationship between Lung Function and

Metabolic Syndrome in Obese and Non-Obese Korean Adult Males (Korean Diabetes J 2010;34:253-60)

Bo Kyung Koo

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea

Corresponding author: Bo Kyung Koo

Department of Internal Medicine, Seoul Boramae Hospital, Seoul National University College of Medicine, 425 Sindaebang 2-dong, Dongjak-gu, Seoul 156-707, Korea

E-mail: [email protected]

The association between type 2 diabetes mellitus and impaired ventilatory lung function has been well documented in many studies [1-3]. One of the most important mechanisms under- lying the association between type 2 diabetes mellitus and im- paired lung function has been thought to be insulin resistance [4,5]. In Caucasians, forced vital capacity (FVC) and forced ex- piratory volume in one second (FEV1) have been significantly associated with homeostasis model assessment of insulin re- sistance (HOMA), the marker of insulin resistance [4,5].

Metabolic syndrome (MetS) is a disease characterized by insulin resistance [6], suggesting that MetS might be associat- ed with lung function. Kim et al. [7] showed that FVC values were significantly lower in a MetS group of Korean adult male subjects compared with those of the non-MetS group. In their study, the HOMA index was independently associated with FVC in multi-linear regression analysis after adjusting for age, height, and MetS components [7], consistent with the results of previ- ous studies [4,5]. However, in the present study, the MetS group was significantly older than the non-MetS group, and age is a very important determining factor in lung function. I wonder whether the MetS group had lower FVC or FEV1 than did the age-matched non-MetS group. In addition, the pulmonary function test using a spirometer is composed of forced inspira- tion and expiration, and the forced inspiration is affected by respiratory muscle power. The decrease in muscle mass often

found in subjects with insulin resistance results in muscle weakness and decreases in FVC and FEV1 [8]. The indepen- dent association between insulin resistance and FVC in this study may have been confounded by muscle mass; thus, fur- ther consideration of muscle mass is needed.

The elderly population is growing very rapidly in Korea.

This study is important to understand the association between MetS and lung function in the Korean population and indicates the importance of MetS management for preservation of pul- monary function, one of the important determinants of co- morbidity in the elderly population.

REFERENCES

1. Walter RE, Beiser A, Givelber RJ, O’Connor GT, Gottlieb DJ.

Association between glycemic state and lung function: the Framingham Heart Study. Am J Respir Crit Care Med 2003;

167:911-6.

2. Yeh HC, Punjabi NM, Wang NY, Pankow JS, Duncan BB, Brancati FL. Vital capacity as a predictor of incident type 2 dia- betes: the Atherosclerosis Risk in Communities study. Diabe- tes Care 2005;28:1472-9.

3. Davis WA, Knuiman M, Kendall P, Grange V, Davis TM. Gly- cemic exposure is associated with reduced pulmonary func- tion in type 2 diabetes: the Fremantle Diabetes Study. Diabetes

Letter

Korean Diabetes J 2010;34:327-328 doi: 10.4093/kdj.2010.34.5.327 pISSN 1976-9180 · eISSN 2093-2650

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328

Koo BK

Korean Diabetes J 2010;34:327-328 www.e-kdj.org Care 2004;27:752-7.

4. Lawlor DA, Ebrahim S, Smith GD. Associations of measures of lung function with insulin resistance and type 2 diabetes: find- ings from the British Women’s Heart and Health Study. Diabe- tologia 2004;47:195-203.

5. Lazarus R, Sparrow D, Weiss ST. Impaired ventilatory function and elevated insulin levels in nondiabetic males: the Normative Aging Study. Eur Respir J 1998;12:635-40.

6. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome: a new

world-wide definition. A Consensus Statement from the Inter- national Diabetes Federation. Diabet Med 2006;23:469-80.

7. Kim SK, Hur KY, Choi YH, Kim SW, Chung JH, Kim HK, Lee MK, Min YK, Kim KW, Kim JH. The relationship between lung function and metabolic syndrome in obese and non-obese Korean adult males. Korean Diabetes J 2010;34:253-60.

8. Lazarus R, Gore CJ, Booth M, Owen N. Effects of body com- position and fat distribution on ventilatory function in adults.

Am J Clin Nutr 1998;68:35-41.

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