Résumé
We studied some cardiopulmonary functions in relation to metabolic control and procollagen III in 35 patients with type I diabetes mellitus; 15 normoalbuminuric [Gl] and 20 microalbuminuric [GIl]. Fifteen subjects of comparable age and sex were studied as controls [GIII]. Patients suffering from cardiac, pulmonary or renal diseases other than diabetic nephropathy were excluded. Non of our patients had hypertension, hyperuricaemia or autonomic neuropathy. Echodoppler study showed that E/A ratio, PFR, NPFR and TPF were significantly lower in GIl than GIll [P<0.05 in all parameters except Ei/Ai ratio where P<0,01]. The IRT was significantly prolonged in GIl than Gill [P< 0.01]. There were insignificant difference of all LV diastolic parameters between Gl and GIII [P>0.05] and there were weak-ve correlation between E/A and HbA[1c] [P=0.07] and significant -ve correlation between E/A and procollagen III [P< 0.01]. Although the anthropometric variables did not differ significantly among diabetics and controls, yet the lung functions did between GIl and GIII. The mean values of DLCO and its percent predicted were significantly reduced in GIl than GIll [P<0.01]. Significant -ve correlations were observed between DLCO and both HbA[1c] [p< 0.01] and procollagen III [P<0.05]. Except a significantly lower MVV [P<0.05], there were no significant differences between Gl and GIII in all pulmonary functions [P>0.05]. It could be concluded that type I diabetic patients with microalbuminuria may have LV diastolic dysfunction as well as combined restrictive and obstructive pulmonary defects with significant reduction in the diffusing capacity. These cardiopulmonary changes increase with poor glycaemic control and could be attributed to deposition of collagen in the myocardium and lung paranchyma