Leone Nathalie, Courbon Dominique, Thomas Frédérique, Bean Kathy, Jégo Bertrand, Leynaert Bénédicte, Guize Louis, Zureik Mahmoud
INSERM U700, Faculté de Médecine Xavier Bichat, 16 rue Henri Huchard, BP 416, 75018 Paris, France.
Am J Respir Crit Care Med. 2009 Mar 15;179(6):509-16. doi: 10.1164/rccm.200807-1195OC. Epub 2009 Jan 8.
Increased risk for cardiovascular morbidity and mortality has been related to both lung function impairment and metabolic syndrome. Data on the relationship between lung function and metabolic syndrome are sparse.
To investigate risk for lung function impairment according to metabolic syndrome traits.
This cross-sectional population-based study included 121,965 men and women examined at the Paris Investigations Préventives et Cliniques Center between 1999 and 2006. The lower limit of normal was used to define lung function impairment (FEV(1) or FVC < lower limit of normal). Metabolic syndrome was assessed according to the American Heart Association/National Heart, Lung, and Blood Institute statement.
We used a logistic regression model and principal component analysis to investigate the differential associations between lung function impairment and specific components of metabolic syndrome. Lung function impairment was associated with metabolic syndrome (prevalence = 15.0%) independently of age, sex, smoking status, alcohol consumption, educational level, body mass index, leisure-time physical activity, and cardiovascular disease history (odds ratio [OR] [95% confidence interval], 1.28 [1.20-1.37] and OR, 1.41 [1.31-1.51] for FEV(1) and FVC, respectively). Three factors were identified from factor analysis: "lipids" (low high-density lipoprotein cholesterol, high triglycerides), "glucose-blood pressure" (high fasting glycemia, high blood pressure), and "abdominal obesity" (large waist circumference). All factors were inversely related to lung function, but abdominal obesity was the strongest predictor of lung function impairment (OR, 1.94 [1.80-2.09] and OR, 2.11 [1.95-2.29], for FEV(1) and FVC, respectively). Similar results were obtained for women and men.
We found a positive independent relationship between lung function impairment and metabolic syndrome in both sexes, predominantly due to abdominal obesity. Further studies are required to clarify the underlying mechanisms.
心血管疾病发病率和死亡率的增加与肺功能损害和代谢综合征均有关。关于肺功能与代谢综合征之间关系的数据较为稀少。
根据代谢综合征特征调查肺功能损害的风险。
这项基于人群的横断面研究纳入了1999年至2006年期间在巴黎预防与临床研究中心接受检查的121965名男性和女性。采用正常下限来定义肺功能损害（第1秒用力呼气容积[FEV₁]或用力肺活量[FVC]<正常下限）。根据美国心脏协会/美国国立心肺血液研究所的声明评估代谢综合征。
我们使用逻辑回归模型和主成分分析来研究肺功能损害与代谢综合征特定组成部分之间的差异关联。肺功能损害与代谢综合征（患病率=15.0%）相关，独立于年龄、性别、吸烟状况、饮酒量、教育程度、体重指数、休闲时间身体活动和心血管疾病史（FEV₁和FVC的比值比[OR][95%置信区间]分别为1.28[1.20 - 1.37]和1.41[1.31 - 1.51]）。从因子分析中确定了三个因素：“脂质”（低高密度脂蛋白胆固醇、高甘油三酯）、“血糖 - 血压”（高空腹血糖、高血压）和“腹部肥胖”（大腰围）。所有因素均与肺功能呈负相关，但腹部肥胖是肺功能损害的最强预测因素（FEV₁和FVC的OR分别为1.94[1.80 - 2.09]和2.11[1.95 - 2.29]）。男性和女性均获得了类似结果。
我们发现肺功能损害与代谢综合征在两性中均存在独立的正相关关系，主要归因于腹部肥胖。需要进一步研究以阐明潜在机制。
