Reduction of Diffusion Capacity for Carbon Monoxide in Diabetic Patients

Carbon monoxide diffusion capacity (DLCO) is negatively associated with patient survival in idiopathic pulmonary hypertension (PH), but is not included in the risk stratification score proposed by the 2015 European guidelines. Since 2015, several new stratification scores based on a 3- or 4-severity scale have been explored. This retrospective cohort single-center study sought to investigate the association between DLCO and PH severity and survival. We included 85 treatment-naive patients with precapillary PH and DLCO measurement at diagnosis. DLCO status, based on lower and upper quartiles ranges, was added to a 3- and a 4-strata modified-risk assessment. DLCO was strongly associated with transplant-free survival (HR 0.939, 95% CI: 0.908–0.971, p < 0.001). In the intermediate and high-risk categories, DLCO was associated with transplant-free survival, irrespective of the risk category (HR 0.934, 95% CI: 0.880–0.980, p = 0.005). The correlation between modified-risk category and transplant-free survival was significant (HR 4.60, 95% CI: 1.294–16.352, p = 0.018). Based on the Akaike information criterion (AIC) levels, the 3- and 4-strata modified-risk stratification fits our results better than the conventional stratification. Low DLCO is associated with patient transplant-free survival, independently of the risk category. Inclusion of DLCO into a PH risk stratification score seems promising and needs further investigation.

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Percent Predicted Hemoglobin Corrected Diffusion Capacity of the Lung for Carbon Monoxide

10.32388/ip5vlu ◽

2020 ◽

Author(s):

Keyword(s):

Carbon Monoxide ◽

Diffusion Capacity

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Diffusion Capacity Abnormalities for Carbon Monoxide in Patients with COVID-19 At Three-Month Follow-up

European Respiratory Journal ◽

10.1183/13993003.03677-2020 ◽

2021 ◽

pp. 2003677

Author(s):

Wei Qin ◽

Shi Chen ◽

Yunxia Zhang ◽

Fen Dong ◽

Zhu Zhang ◽

...

Keyword(s):

Carbon Monoxide ◽

Pulmonary Function ◽

Clinical Symptoms ◽

Pulmonary Function Tests ◽

Chest Ct ◽

Test Results ◽

Diffusion Capacity ◽

Impaired Lung Function ◽

Multivariable Regression

ObjectiveTo evaluate pulmonary function and clinical symptoms in coronavirus disease 2019 (COVID-19) survivors within 3 months after hospital discharge, and to identify risk factors associated with impaired lung function.Methods and materialCOVID-19 patients were prospectively followed up with pulmonary function tests and clinical characteristics for 3 months following discharge from a hospital in Wuhan, China between January and February 2020.Results647 patients were included. 87 (13%) patients presented with weakness, 63 (10%) with palpitation and 56 (9%) with dyspnea. Prevalences of the three symptoms were markedly higher in severe patients than non-severe patients (19% versus 10% for weakness, p=0.003; 14% versus 7% for palpitation, p=0.007; 12% versus 7% for dyspnea, p=0.014). Results of multivariable regression showed an increased odd in the ongoing symptoms among severe patients (OR: 1.7, 95%CI: 1.1–2.6, p=0.026) or patients with longer hospital stay (OR: 1.03, 95%CI: 1.00–1.05, p=0.041). Pulmonary function test results were available for 81 patients, including 41 non-severe and 40 severe patients. In this subgroup, 44 (54%) patients manifested abnormal diffusion capacity for carbon monoxide (DLCO) (68% severe versus 42% non-severe patients, p=0.019). Chest CT total severity score (TSS)>10.5 (OR: 10.4; 95%CI: 2.5–44.1; p=0.001) on admission and ARDS (OR: 4.6; 95%CI: 1.4–15.5; p=0.014) were significantly associated with impaired DLCO. Pulmonary interstitial damage may be associated with abnormal DLCO.ConclusionPulmonary function, particularly DLCO, declined in COVID-19 survivors. This decrease was associated with TSS of chest CT >10.5 and ARDS occurrence. Pulmonary interstitial damage might contribute to the imparied DLCO.

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Is the lung a target organ in diabetes?

Italian Journal of Medicine ◽

10.4081/itjm.2009.113 ◽

2013 ◽

pp. 113-115

Author(s):

Maurizio Marvisi ◽

Emanuele Bassi

Keyword(s):

Diabetes Mellitus ◽

English Language ◽

Target Organ ◽

Diabetic Patients ◽

Elastic Recoil ◽

Diffusion Capacity ◽

Alveolar Epithelial ◽

Pulmonary Capillary ◽

Pulmonary Diffusion Capacity ◽

Language Literature

BACKGROUND The lung is not considered a target organ in diabetes mellitus. In English language literature there are many papers showing the opposite. DISCUSSION Many studies demonstrated a thickened alveolar epithelial and pulmonary capillary basal lamina and a reduced lung elasticity, others showed that these histopathological alterations develop into functional abnormalities such as reduced lung volumes, pulmonary diffusion capacity and elastic recoil. The diabetes related pulmonary disease has not an impact on normal life in otherwise “healthy” patients, but it is possible that in specific pathologic (such as heart, kidney and lung comorbidities) or paraphysiologic (such as physical exercise, smoking or exposure to high altitude) conditions, diabetes could contribute to the clinical manifestation of a restricitive lung disease. On the other hand, diabetic patients have an increased propensity to acquire infections. The prevalence of pulmonary tuberculosis is reported to be four times than in healthy subjects; there is a predilection for the lower lobes and the disease is more aggressive in poorly controlled diabetes mellitus.

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