Journal of Occupational
Health and Epidemiology
Rafsanjan university Of medical sciences
Volume 15, Issue 2 (Spring 2026)
J Occup Health Epidemiol 2026, 15(2): 93-101 |
Back to browse issues page
Ethics code: IR.SKUMS.REC.1396.110
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Torkian S, Ahmadi A, Kiani F Z, Rouhi H, Soleymani Babadi A. Spirometry-Based Airflow Obstruction and Pulmonary Function in Type 2 Diabetes: A Cross-Sectional Study. J Occup Health Epidemiol 2026; 15 (2) :93-101
URL: http://johe.rums.ac.ir/article-1-1151-en.html
URL: http://johe.rums.ac.ir/article-1-1151-en.html
Related article in
Google Scholar
Google Scholar
Similar articles
1- Assistant Prof., Dept. of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.
2- Professor, Dept. of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran. ,aliahmadi2007@gmail.com
3- Ph.D Student in Epidemiology, Dept. of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Ph.D Student in Epidemiology, Dept. of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4- Retired Associate Prof., Dept.of pulmonary, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
5- Associate Prof., Dept. of Internal Medicine, School of Medicine, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran.
2- Professor, Dept. of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran. ,
3- Ph.D Student in Epidemiology, Dept. of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Ph.D Student in Epidemiology, Dept. of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4- Retired Associate Prof., Dept.of pulmonary, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
5- Associate Prof., Dept. of Internal Medicine, School of Medicine, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Article history
Received: 2025/12/7
Accepted: 2026/05/5
ePublished: 2026/10/5
Accepted: 2026/05/5
ePublished: 2026/10/5
Subject:
Epidemiology
Abstract: (12 Views)
Background: Systemic inflammation, oxidative stress, and microvascular dysfunction may predispose individuals with diabetes to impaired lung function. This cross-sectional study aimed to ascertain pulmonary function, the prevalence of spirometric airflow obstruction consistent with COPD, as well as associated factors among adults with type 2 diabetes in Southwest Iran.
Materials & Methods: This cross-sectional study included 732 adults with type 2 diabetes, aged 35–70 years, enrolled in the Shahrekord PERSIAN Cohort Study. Demographic, comorbidities, anthropometric measurements, and spirometry findings were collected according to the standardized cohort protocol. Chi-square test, Fisher's exact test, and multivariable logistic regression analyses were undertaken to identify factors related to spirometric airflow obstruction. Spirometric patterns were classified as obstructive, restrictive, mixed, and normal based on standard criteria.
Results: The prevalence of spirometric airflow obstruction was 8.5% (62/732). The most common pattern was restrictive (467, 63.8%), followed by mixed (47, 6.4%) and obstructive (15, 2.0%). In the multivariable logistic regression model, alcohol use (OR = 2.23; 95% CI: 1.09, 4.56), marital status (OR = 2.62; 95% CI: 1.14, 6.00), and chronic pulmonary disease (OR = 2.59; 95% CI: 1.21, 5.53) were independently linked to airflow obstruction.
Conclusions: This study indicated a notable prevalence of spirometric airflow obstruction among adults with type 2 diabetes, with restrictive abnormalities being the predominant pattern. These findings offer preliminary epidemiological evidence for respiratory impairment in this population and establish a baseline for future longitudinal as well as interventional studies.
Materials & Methods: This cross-sectional study included 732 adults with type 2 diabetes, aged 35–70 years, enrolled in the Shahrekord PERSIAN Cohort Study. Demographic, comorbidities, anthropometric measurements, and spirometry findings were collected according to the standardized cohort protocol. Chi-square test, Fisher's exact test, and multivariable logistic regression analyses were undertaken to identify factors related to spirometric airflow obstruction. Spirometric patterns were classified as obstructive, restrictive, mixed, and normal based on standard criteria.
Results: The prevalence of spirometric airflow obstruction was 8.5% (62/732). The most common pattern was restrictive (467, 63.8%), followed by mixed (47, 6.4%) and obstructive (15, 2.0%). In the multivariable logistic regression model, alcohol use (OR = 2.23; 95% CI: 1.09, 4.56), marital status (OR = 2.62; 95% CI: 1.14, 6.00), and chronic pulmonary disease (OR = 2.59; 95% CI: 1.21, 5.53) were independently linked to airflow obstruction.
Conclusions: This study indicated a notable prevalence of spirometric airflow obstruction among adults with type 2 diabetes, with restrictive abnormalities being the predominant pattern. These findings offer preliminary epidemiological evidence for respiratory impairment in this population and establish a baseline for future longitudinal as well as interventional studies.
Keywords: Chronic Obstructive Pulmonary Disease [MeSH], Type 2 Diabetes Mellitus [MeSH], Pulmonary Function [MeSH], Spirometry [MeSH], Respiratory Function Test [MeSH]
References
1. Mohamed HI Abd-Elsalam KA. Fungal Secondary Metabolites: Synthesis and Applications in Agroecosystem. 1st ed. Amsterdam, Netherlands: Elsevier; 2023.
2. Lu X, Xie Q, Pan X, Zhang R, Zhang X, Peng G, et al. Type 2 diabetes mellitus in adults: pathogenesis, prevention and therapy. Signal Transduct Target Ther. 2024;9(1):262. [DOI] [PMID]
3. Kumar A, Gangwar R, Zargar AA, Kumar R, Sharma A. Prevalence of diabetes in India: A review of IDF diabetes atlas 10th edition. Curr Diabetes Rev. 2024;20(1):e130423215752. [DOI] [PMID]
4. Vb A, Jha DK, Bhattacharjee S. Global Trends and Burden of Diabetes: A Comprehensive Review of Global Insights and Emerging Challenges. Curr J Appl Sci Technol. 2025;44(7):134-50. [DOI]
5. Jain R, Carleton G, Elley AK, Olejas S, Chauhan A. Global Diabetes Walk Campaign on World Diabetes Day 14th Nov in Up India & Its Impact on Public Health Facility & Policy. Diabetes Obes Metab. 2020;3(1):115.
6. Sanabria-de la Torre R, Garcia-Fontana C, Gonzalez-Salvatierra S, Andujar-Vera F, Martinez-Heredia L, Garcia-Fontana B, et al. The contribution of wnt signaling to vascular complications in type 2 diabetes mellitus. Int J Mol Sci. 2022;23(13):6995. [DOI] [PMID] [PMCID]
7. Kopf S, Kumar V, Kender Z, Han Z, Fleming T, Herzig S, et al. Diabetic pneumopathy–a new diabetes-associated complication: mechanisms, consequences and treatment considerations. Front Endocrinol (Lausanne). 2021;12:765201. [DOI] [PMID] [PMCID]
8. Stanojevic S, Kaminsky DA, Miller MR, Thompson B, Aliverti A, Barjaktarevic I, et al. ERS/ATS technical standard on interpretive strategies for routine lung function tests. Eur Respir J. 2022;60(1):2101499. [DOI] [PMID]
9. Singh D, Stockley R, Anzueto A, Agusti A, Bourbeau J, Celli BR, et al. GOLD Science Committee recommendations for the use of pre-and post-bronchodilator spirometry for the diagnosis of COPD. Eur Respir J. 2025;65(2):2401603. [DOI] [PMID] [PMCID]
10. Halpin DMG, Masekela R, Vogelmeier CF, Ozoh OB, Cruz AA, Reddel HK, et al. Addressing the global challenges of chronic obstructive pulmonary disease and asthma: a shared vision from the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) and the Global Initiative for Asthma (GINA). Am J Respir Crit Care Med. 2026;212(2):297-302. [DOI] [PMID]
11. Lawlor DA, Ebrahim S, Smith GD. Associations of measures of lung function with insulin resistance and Type 2 diabetes: findings from the British Women’s Heart and Health Study. Diabetologia. 2004:47(2):195-203. [DOI] [PMID]
12. Sun J, Chen J, Shen Y, Yao X, Sun H, Chen B, et al. Diabetes mellitus-driven pulmonary injury: multidimensional mechanisms linking metabolic dysregulation to gut-lung axis and promising therapies. Front Pharmacol. 2025;16:1689522. [DOI] [PMID] [PMCID]
13. Ararat E, Rastogi D, Martin BC. Metformin use is associated with reduced systemic steroid courses among pediatric asthma patients with diabetes or elevated blood glucose levels. Respir Med. 2025;248:108403. [DOI] [PMID] [PMCID]
14. Lecky R, Grogan S, Shukla P, Atkinson S, McClean PL, Kelly C. The role of obesity and Type 2 diabetes in lung health: A systematic review (2024). PLoS One. 2026;21(1):e0340692. [DOI] [PMID] [PMCID]
15. American Diabetes Association Professional Practice Committee. 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes-2025. Diabetes Care. 2025;48(1 Suppl 1):S59-85. [DOI] [PMID] [PMCID]
16. Hazar N, Jokar M, Namavari N, Hosseini S, Rahmanian V. An updated systematic review and Meta-analysis of the prevalence of type 2 diabetes in Iran, 1996–2023. Front Public Health. 2024;12:1322072. [DOI] [PMID] [PMCID]
17. Wang N, Wang G, Liu T, Ji W, Li M, Li T, et al. Effects of Diabetes Mellitus and Glycemic Traits on COPD and Pulmonary Function Traits: Insights From Mendelian Randomization and NHANES. Int J Chron Obstruct Pulmon Dis. 2025;20:3575-90. [DOI] [PMID] [PMCID]
18. Khaledifar A, Hashemzadeh M, Solati K, Poustchi H, Bollati V, Ahmadi A, et al. The protocol of a population-based prospective cohort study in southwest of Iran to analyze common non-communicable diseases: Shahrekord cohort study. BMC Public Health. 2018;18(1):660. [DOI] [PMID] [PMCID]
19. World Health Organization. Classification of diabetes mellitus 2019. Geneva, Switzerland: World Health Organization; 2019. [URL]
20. Tan WC, Bourbeau J, Aaron SD, Zhou G, Maltais F, Hernandez P, et al. Global initiative for chronic obstructive lung disease 2017 classification and lung function decline in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2018;197(5):670-3. [DOI] [PMID]
21. Kiani FZ, Ahmadi A. Prevalence of different comorbidities in chronic obstructive pulmonary disease among Shahrekord PERSIAN cohort study in southwest Iran. Sci Rep. 2021;11(1):1548. [DOI] [PMID] [PMCID]
22. Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49(12):1373-9. [DOI] [PMID]
23. Sisson JH, Stoner JA, Romberger DJ, Spurzem JR, Wyatt TA, Owens-Ream J, et al. Alcohol intake is associated with altered pulmonary function. Alcohol. 2005;36(1):19-30. [DOI] [PMID]
24. Wang D, Cao L, Zhou M, Ma J, Wang B, Yuan J, et al. Alcohol intake, beverage type, and lung function: a multicohort study of Chinese adults. Ann N Y Acad Sci. 2022;1511(1):164-72.
https://doi.org/10.1111/nyas.14744 [DOI] [PMID]
25. Frantz S, Wollmer P, Dencker M, Engström G, Nihlén U. Associations between lung function and alcohol consumption--assessed by both a questionnaire and a blood marker. Respir Med. 2014;108(1):114-21. [DOI] [PMID]
26. von Hintze L, Ilmarinen P, Vähätalo I, Tuomisto LE, Lehtimäki L, Niemelä O, et al. The Association Between Heavy Alcohol Use and Lung Function: A Clinical Study of Adult-Onset Asthma. J Allergy Clin Immunol Pract. 2025;13(11):3021-30.e2. [DOI] [PMID]
27. Bakke PS, Hanoa R, Gulsvik A. Educational level and obstructive lung disease given smoking habits and occupational airborne exposure: a Norwegian community study. Am J Epidemiol. 1995;141(11):1080-8. [DOI] [PMID]
28. Giannico OV, Ambrosino I, Patano F, Germinario C, Quarto M, Moretti AM. Educational level, marital status and sex as social gender discharge determinants in chronic obstructive pulmonary disease exacerbations: a time-to-event analysis. Monaldi Arch Chest Dis. 2019;89(2). [DOI] [PMID]
29. Zhang RH, Cai YH, Shu LP, Yang J, Qi L, Han M, et al. Bidirectional relationship between diabetes and pulmonary function: a systematic review and meta-analysis. Diabetes Metab. 2021;47(5):101186. [DOI] [PMID]
30. Kim HY, Sohn TS, Seok H, Yeo CD, Kim YS, Song JY, et al. Prevalence and risk factors for reduced pulmonary function in diabetic patients: The Korea National Health and Nutrition Examination Survey. Korean J Intern Med. 2017;32(4):682-9. [DOI] [PMID] [PMCID]
31. Lee DY, Nam SM. The Association Between Lung Function and Type 2 Diabetes in Koreans. Osong Public Health Res Perspect. 2020;11(1):27-33. [DOI] [PMID] [PMCID]
32. Lee DY, Nam SM. Association between restrictive pulmonary disease and type 2 diabetes in Koreans: A cross-sectional study. World J Diabetes. 2020;11(10):425-34. [DOI] [PMID] [PMCID]
33. Mittal S, Jindal M, Srivastava S, Sinha S. Evaluation of Pulmonary Functions in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study. Cureus. 2023;15(3):e35628. [DOI] [PMID] [PMCID]
34. Rajput S, Parashar R, Sharma JP, Raghuwanshi P, Pakhare AP, Joshi R, et al. Assessment of Pulmonary Functions and Dysfunctions in Type II Diabetes Mellitus: A Comparative Cross-Sectional Study. Cureus. 2023;15(2):e35081. [DOI] [PMID] [PMCID]
35. Klein OL, Krishnan JA, Glick S, Smith LJ. Systematic review of the association between lung function and Type 2 diabetes mellitus. Diabet Med. 2010;27(9):977-87. [DOI] [PMID]
36. Amaral AFS, Strachan DP, Burney PGJ, Jarvis DL. Female Smokers Are at Greater Risk of Airflow Obstruction Than Male Smokers. UK Biobank. Am J Respir Crit Care Med. 2017;195(9):1226-35. [DOI] [PMID]
37. Çolak Y, Allinson JP, van den Berge M, Jarvis D, Langhammer A, Breyer-Kohansal R, et al. Airflow obstruction among young adults in Europe: a Chronic Airway Diseases Early Stratification (CADSET) collaboration with 48 612 individuals across eight population-based cohorts. ERJ Open Res. 2025;11(6):00233-2025. [DOI] [PMID] [PMCID]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution 4.0 International License. |
