Schroeder Emily B, Welch Verna Lamar, Couper David, Nieto F Javier, Liao Duanping, Rosamond Wayne D, Heiss Gerardo
Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
Am J Epidemiol. 2003 Dec 15;158(12):1171-81. doi: 10.1093/aje/kwg276.
The authors examined the association between lung function, as measured by forced expiratory volume in 1 second (FEV1) and forced vital capacity, and the 10-year incidence of coronary heart disease among 14,480 participants in the Atherosclerosis Risk in Communities Study (1987-1998). Separate proportional hazards models were used for FEV1 and forced vital capacity, with gender-specific lung function quartiles and lung function x gender interaction terms. An association between lung function and coronary heart disease was observed in both genders and was stronger among women. After adjustment for age, race, study center, height, height squared, smoking, and cardiovascular disease risk factors, the hazard ratios for the first (lowest), second, and third quartiles of FEV1 were 3.70 (95% confidence interval (CI): 2.19, 6.24), 2.54 (95% CI: 1.49, 4.32), and 2.25 (95% CI: 1.31, 3.87) for women and 1.51 (95% CI: 1.07, 2.13), 1.59 (95% CI: 1.15, 2.20), and 1.52 (95% CI: 1.10, 2.09) for men. After stratification by smoking status, associations were observed in each smoking group for women, while those in men were weaker and less consistent. Similar results were obtained for forced vital capacity. This analysis indicates an association between lung function and incident coronary heart disease that may be stronger in women than in men.
作者在社区动脉粥样硬化风险研究(1987 - 1998年)的14480名参与者中,研究了用1秒用力呼气量(FEV1)和用力肺活量衡量的肺功能与冠心病10年发病率之间的关联。针对FEV1和用力肺活量分别使用了比例风险模型,纳入了按性别划分的肺功能四分位数以及肺功能×性别交互项。在男女两性中均观察到肺功能与冠心病之间存在关联,且在女性中这种关联更强。在调整了年龄、种族、研究中心、身高、身高平方、吸烟和心血管疾病危险因素后,女性FEV1第一(最低)、第二和第三四分位数的风险比分别为3.70(95%置信区间(CI):2.19,6.24)、2.54(95%CI:1.49,4.32)和2.25(95%CI:1.31,3.87),男性分别为1.51(95%CI:1.07,2.13)、1.59(95%CI:1.15,2.20)和1.52(95%CI:1.10,2.09)。按吸烟状态分层后,在女性的每个吸烟组中均观察到关联,而男性中的关联较弱且不太一致。用力肺活量也得到了类似结果。该分析表明肺功能与冠心病发病之间存在关联,且这种关联在女性中可能比男性更强。