1376-P: Association of Lung Function and Glycemic Control with All-Cause and Cardiovascular Mortality in Persons with Type 2 Diabetes

Introduction & Objective: Hyperglycemia is associated with impaired pulmonary function, which can ultimately lead to all-cause and cardiovascular mortality. Few studies have examined the potential interaction effect of pulmonary function on the association between glycemic control and mortality. The aim of this study examined the association of pulmonary function parameters with mortality, and whether glycemic level modified the effect of pulmonary function on mortality in persons with type 2 diabetes (T2DM).

Methods: A retrospective cohort study identified 3846 persons with T2DM with pulmonary function testing in Taiwan between 2002 and 2020. Pulmonary function parameter was assessed by expiratory volume in 1 second (FEV1). Multivariate Cox proportional hazards model with product terms of pulmonary function parameters and glucose control were added to evaluate their interaction.

Results: A total of 733 deaths (19.06%) and 274 expanded CVD deaths (7.12%) were observed during an average follow-up of 7.83 years. The adjusted hazard ratios of all-cause mortality for persons with FEV1 Z-scores of < 0 to -1, <-1 to -2 and <-2 were 1.47 (1.20, 1.80), 2.48 (1.95, 3.14) and 3.07 (1.74, 5.44) compared to participants with Z-score ≥ 0, respectively (P for trend p<0.001). Subgroup analysis revealed that the association between FEV1 and all-cause mortality was stronger in persons with good glycemic control compared with poor glycemic control (FEV1-FPG interaction, P = 0.01; FEV1-HbA1c interaction, P = 0.03).

Conclusion: Our results showed that FEV1 is a strong predictor of mortality in persons with T2DM. Glycemic status had significantly modified the association between lung function parameters and mortality.