Abstract
BACKGROUND: Type 2 diabetes mellitus (T2DM) and silicosis both have significant impacts on cardiopulmonary health. However, there is a lack of research investigating whether the presence of T2DM causes additional damage to the heart and lungs of patients with silicosis. This study aims to assess the alterations in pulmonary and cardiac structures, as well as lung function, in patients with silicosis who also have T2DM, and to explore the factors influencing lung function. METHODS: We included 30 silicosis patients with T2DM and 30 silicosis patients without diabetes. The two groups were matched by age, silicosis stage, smoking history, and dust exposure duration. Demographic details, occupational history, hematological results, computed tomography (CT)-measured cardiac and lung parameters, and pulmonary function test (PFT) results were collected. We compared these parameters between the two groups, evaluated the correlation between lung function and CT parameters in the diabetic group, and analyzed factors affecting lung function in this group. RESULTS: The silicosis combined with T2DM group showed significantly higher values for body mass index (BMI), the longest diameters from left to right of the left ventricle (LVLR), blood glucose, and triglycerides compared to the silicosis but without T2DM group (all P<0.05). The silicosis combined with T2DM group showed significantly lower total lung mass, and the ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) compared to the silicosis but without T2DM group (all P<0.05). In the silicosis with T2DM group, FEV1/FVC ratio showed significant correlations with total lung mass, the longest diameters from left to right of the left atrium, LVLR, and the longest diameters from left to right of the right atrium (r values were 0.51, 0.47, 0.40, and 0.44, respectively; all P<0.05). Multivariate analysis revealed that BMI and the LVLR were independent determinants of FEV1/FVC ratio in the silicosis with T2DM group (t values were -3.367 and 2.471, respectively; all P<0.05). CONCLUSIONS: Diabetes mellitus induces structural changes in the lungs and heart of patients with silicosis and exacerbates the impairment of lung function. BMI and LVLR are key determinants of the FEV1/FVC ratio highlighting the need for enhanced comprehensive management strategies.