Comparative Study Of Pulmonary Function Tests With Microvascular Complications, Retinopathy And Nephropathy In Type 2 Diabetes Mellitus And Correlation With Duration Of Diabetes

Background:Themajorintype2diabetesThough lung has been widely acknowledged to be a target organ in diabetes mellitus, its se-verity of involvement and correlation with other microvascular complications has not been studied. Aim:To study pulmonary function tests in type 2 diabetes mellitus and evaluate association of PFTs with microvascular complica-tions, retinopathy and nephropathy and further assess the relationship of retinopathy, nephropathy and lungs with duration of diabetes. Methods:A cross sectional study was carried out in 100 male type 2 diabetic patients attend-ing diabetic clinic in tertiary hospital. 100 non-diabetic subjects were selected as control from general population. PFTs tests were performed. Results were interpreted by one way ANOVA test. Association of PFT parameters FVC, FEV1, FEV1%in type 2 diabetic patients with nephropathy and retinopathy was analysed by Pearson’s correlation co-efficient. The patient population was subdivided according to the duration of diabetes into 2 groups; less than 10 years of illness and more than 10 years. Relationship of retinopathy, nephropathy and pulmonary function tests with duration of diabetes was assessed by one-way ANOVA test. Results:There was a significant decrease in PFT parame-ters as compared to non-diabetic controls. The PFTs in type 2 diabetic subjects with nephropathy showed decline in FVC, FEV1,FEV1%, however association of these parameters with Glomerular filtration rate (GFR) and microalbuminu-ria was not significant. Also, a similar decline of PFT parameters was observed with increasing grade of retinopathy, though not significant. There was a significant positive correlation of retinopathy with microalbuminuria and GFR (nephropathy) in type 2 diabetic subjects. Also, there was significant association of microalbuminuria, GFR and reti-nopathy with increase in duration of diabetes. On the contrary the decline in FVC, FEV1, FEV1%with duration of diabe-tes was not statistically significant. Conclusion:Type 2 diabetic patients with poor glycaemic control and longer du-ration of diabetes history had significant correlation with microvascular complications, nephropathy and retinopathy as compared to pulmonary complications (PFT parameters). It is highly suggestive that diabetic patients with reti-nopathy must be screened for nephropathy.

Study of Pulmonary Function Tests of Traffic Policemen In Jammu Region.

The present study was carried out to assess the lung functions of traffic policemen in Jammu region. A cross sectional study was carried out among 100 traffic policemen and compared with healthy persons with the subgroup comparison among rural and urban areas. Lung function like FVC, FEV1 , FEV3,PEFR & MVV on computerized spirometry. The results revealed that all lung functions were lower than the healthy controls and differences were statistically marked in FVC,FEV1, ,PEFR. Intergroup comparison between rural and urban revealed that police personnel's posted in rural areas had better lung function than urban counterpart which varied among each other statistically significantly .(FVC -0.04,FEV1- 0.0003,FEV3-0.0001,MVV-0.003,PEFR-0.03). The traffic policemen exposed to air pollution have lower lung function than the healthy persons and those posted at rural areas have better lung function

Correlation of physiological and radiological characteristics in chronic obstructive pulmonary disease.

Background. Diagnosis of chronic obstructive pulmonary disease (COPD) is confirmed on spirometry but the diagnosis of emphysema remains problematic. The objective of this study was to evaluate the utility of chest radiograph (CXR) and computed tomography (CT) for the diagnosis of emphysema and to correlate these findings with pulmonary function tests (PFTs). Methods. Thirty-five patients with COPD were studied. In all of them, CXR, CT and PFTs were done; three patients had bronchiectasis on CT and were excluded from the study. Chest radiographs (CXRs) were scored for signs of hyperinflation. Lung densities were measured on CT. Results. Functional indices of hyperinflation, i.e. functional residual capacity (FRC), residual volume (RV) and RV/total lung capacity (TLC) had significant correlation with CXR scores. The mean retrosternal space (RSP) measurement was 2.63±0.6 cm (range 1.2 to 3.6cm). Mean lung density (MLD) was -867.91 Hounsfield units (HU) which significantly correlated with functional indices of hyperinflation (FRC, RV, TLC, RV/TLC). Conclusions. In Indian population hyperinflation was found to occur even with lesser values of RSP than the western criteria. CT lung density gives good radiological evidence of emphysema and correlates with lung function abnormalities.

Relationship between smoking and pulmonary functions.

Background: Smoking is the most important factor contributing to the development of chronic obstructive pulmonary disease and is one of the major health risks in modern times. Aim: The purpose of the present study was to determine the relationship between cigarette smoking and pulmonary function tests between various groups of smokers and non-smokers. Methods: The study was carried out in 100 male subjects between 19-52 years of age. The subjects were drawn from the community such that they could be grouped as non-smokers (25), mild smokers (25), moderate smokers (25), and chronic smokers (25) according to their questionnaire response. Pulmonary Function Tests were carried out in each subject with a computerized spirometer. The various data was collected, compiled, statistically analyzed and valid conclusions were drawn Results: Results indicate that smoking is generally associated with lower levels of pulmonary functions. . It was established that pulmonary functions decreased with increasing number of pack years. The negative association was evident in most lung functions and capacities, but was largest and most progressive in FEV1, FEV1/FVC, FEF25-75% and PEFR. Conclusion: Pulmonary function data in smokers indicate narrowing of smaller airways, chiefly bronchioles. Rapidly declining pulmonary functions in smokers with increasing number of pack years is predictive of increased risk of development of chronic obstructive pulmonary disease (COPD). The study observed that spirometry was an effective and easy method for detection of COPD in risk group population like smokers and thus promotes smoking cessation efforts to reduce the burden of COPD in the community.