Introduction and Objective: Diabetes and chronic respiratory diseases (RD) frequently coexist and share inflammatory features. However, whether metabolic dysfunction similarly influences inflammatory and vascular profiles across these conditions is unclear.Methods: We investigated shared and disease-specific metabolic inflammatory patterns in diabetes, RD, and their coexistence. We analyzed 262 subjects after excluding major confounders. Participants were classified as healthy controls (n = 45), diabetes (n = 86), RD without diabetes (asthma n = 85; chronic obstructive pulmonary disease, COPD, n = 31), and RD with diabetes (n = 15). Intergroup comparisons were adjusted for false discovery rate, and correlation analyses were conducted in the overall cohort and disease-specific subgroups.Results: Compared with controls, diabetes was associated with higher BMI, glucose, HbA1c, and insulin levels (all p <0.01), alongside adipokine imbalance and systemic inflammation (leptin, resistin, C-reactive protein; all p <0.05). Asthma and COPD without diabetes exhibited inflammatory and hematological changes (e.g., neutrophilia in COPD; p <0.05) without relevant metabolic alterations. RD with diabetes displayed a combined phenotype, with concurrent metabolic dysregulation and inflammatory activation. Platelet-corrected thrombospondin-1 was reduced in diabetes (p <0.05) but not in RD without diabetes, suggesting an early diabetes-specific vascular alteration. Metabolic variables correlated with inflammatory and vascular markers only in diabetes and RD with diabetes.Conclusion: In conclusion, metabolic dysfunction drives inflammatory and vascular coupling in diabetes and modulates inflammation in RD when diabetes coexists, whereas inflammation in RD without diabetes appears largely metabolically independent.
M. Mirabelli: None. M. Greco: None. A. Andreadi: None. F. Dragone: None. F. Todaro: None. A. Bellia: None. P. Rogliani: None. D.P. Foti: None. D. Lauro: None. A. Brunetti: None.
Italian Ministry of Health (PNRR POC-2022-12376842)
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