Association of Insulin Resistance With Radiographic Lung Abnormalities and Incident Lung Disease: The Framingham Offspring Study

Authors

• Sarath Raju
• Paula Sierra
• Vickram Tejwani
• Kristen A Staggers
• Meredith McCormack
• Dennis T Villareal
• Ivan O Rosas
• Nicola A Hanania
• Tianshi David Wu

Language

English

Publication Date

1-1-2025

Journal

Diabetes Care

DOI

10.2337/dc24-1754

PMID

39571139

PMCID

PMC11664196

PubMedCentral® Posted Date

11-21-2024

PubMedCentral® Full Text Version

Post-print

Abstract

Objective: Insulin resistance (IR) may be a risk factor for lung disease, but objective evidence is limited. We sought to define the relationship of longitudinal IR with radiographic imaging outcomes and examiner-identified incident lung disease in the Framingham Offspring Study.

Research design and methods: Participants without baseline lung disease underwent repeated measurements of fasting insulin and glucose levels over an average period of 13.6 years, from which time-weighted average HOMA-IR was calculated. Each participant then underwent a cardiac gated whole-lung computed tomography scan, which was analyzed for the presence of emphysema, interstitial lung abnormalities (ILAs), and quantitative airway features. Incident lung disease was determined by a study examiner. The relationship of HOMA-IR to these outcomes was estimated in models adjusted for demographics, BMI, and lifetime smoking.

Results: A total of 875 participants with longitudinal IR data and outcomes were identified. Their mean age was 51.5 years, and BMI was 26.7 kg/m2. HOMA-IR was temporally unstable, with a within-person SD approximately two-thirds of the between-person SD. In adjusted models, a 1 SD increase in log(HOMA-IR) z score was associated with higher odds of qualitative emphysema (odds ratio [OR] 1.33; 95% CI 1.04-1.70), ILAs (OR 1.35; 95% CI 1.05-1.74), and modest increases in airway wall thickness and wall area percentage. These radiographic findings were corroborated by a positive association of HOMA-IR with incident lung disease.

Conclusions: IR is associated with radiographic lung abnormalities and incident lung disease. Deeper phenotyping is necessary to define mechanisms of IR-associated lung injury.

Keywords

Humans, Insulin Resistance, Female, Middle Aged, Male, Lung Diseases, Adult, Lung, Tomography, X-Ray Computed

Published Open-Access

yes

Recommended Citation

Raju, Sarath; Sierra, Paula; Tejwani, Vickram; et al., "Association of Insulin Resistance With Radiographic Lung Abnormalities and Incident Lung Disease: The Framingham Offspring Study" (2025). Faculty, Staff and Students Publications. 6783.
https://digitalcommons.library.tmc.edu/baylor_docs/6783