Lung function, insulin resistance and incidence of cardiovascular disease: a longitudinal cohort study

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Abstract
Abstract.  Engström G, Hedblad B, Nilsson P, Wollmer P, Berglund G, Janzon L (University of Lund, Malmö University Hospital, Malmö, Sweden). Lung function, insulin resistance and incidence of cardiovascular disease: a longitudinal cohort study. J Intern Med 2003; 253: 574–581.Objectives.  To explore whether a reduced lung function is a risk factor for developing diabetes and insulin resistance (IR), and whether such relationship contributes to the largely unexplained association between lung function and incidence of cardiovascular disease (CVD).Design.  Forced vital capacity (FVC) was assessed at baseline. Incidence of diabetes and IR [according to the homeostasis model assessment (HOMA) model] was assessed in a follow‐up examination after 13.9 ± 2.6 and 9.4 ± 3.6 years for men and women, respectively. After the follow‐up examination, incidence of CVD (stroke, myocardial infarction or cardiovascular death) was monitored over 7 years.Setting.  Populations‐based cohort study.Subjects.  Initially nondiabetic men (n = 1436, mean age 44.6 years) and women (n = 896, mean age 49.8 years).Results.  Prevalence of IR at the follow‐up examination was 34, 26, 21 and 21%, respectively, for men in the first (lowest), second, third and fourth quartile of baseline FVC (P for trend P for trend Conclusion.  Subjects with a moderately reduced FVC have an increased risk of developing IR and diabetes. This relationship seems to contribute to the largely unexplained association between reduced lung function and incidence of CVD.