Lung microcirculation disorders in patients with diabetes mellitus and a combination of diabetes mellitus and chronic obstructive pulmonary disease

Introduction. Type 2 diabetes mellitus (DM2) and chronic obstructive pulmonary disease (COPD) are common and socially significant diseases. Endothelial dysfunction in both diseases plays an important role in the progression of changes in the vascular bed of the lungs and the development of irreversible changes in the parenchyma. Objective. The aim of the study was to determine the features of microcirculation disorders in the lung tissue using a single-photon emission computed tomography in patients with a combination of chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus and patients with type 2 diabetes mellitus (DM2). Materials and methods. The work analyzed clinical and laboratory data, indicators of respiratory function, the results of computed tomography, and the single-photon emission computed tomography of the lungs in patients with COPD in combination with type 2 diabetes (39 people) and type 2 diabetes (32 people). Parametric and nonparametric methods of analysis were used for statistical analysis. Result. The features of impaired lung parenchyma perfusion in the described groups of patients were revealed. The discrepancy between the extent of changes detected by radionuclide study and computed tomography of the chest in patients with a combination of COPD and type 2 diabetes is described. The relationship between a decrease in DLCO and the presence of subsegmental perfusion defects was revealed in patients with a combination of COPD and type 2 diabetes. In addition, the number of irregularly shaped defects significantly negatively correlated with FEV1/VC in patients with a combination of COPD and T2DM, which is probably a manifestation of perfusion disorders caused by bronchial obstruction. Conclusion. Microcirculation disorders correspond to different structural changes and are detected at the initial stages of COPD and DM2. When COPD and DM2 are combined, microcirculation disorders have a significantly greater extent than areas of emphysematous altered lung tissue, and they are a reflection of micro- and macroangiopathy.

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