Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Respir Med. 2010 Sep;104(9):1326-35. doi: 10.1016/j.rmed.2010.02.024. Epub 2010 Mar 23.
Impaired lung function is an independent predictor of cardiovascular mortality. We assessed the relationships of lung function with insulin resistance (IR), metabolic syndrome (MetS), systemic inflammation and coronary artery calcification score (CACS) measured by computed tomography (CT) scan an indicator of coronary atherosclerosis.
We identified 4905 adult male patients of the Health Promotion Center in Samsung Medical Center between March 2005 and February 2008 and retrospectively reviewed the following data for these patients: pulmonary function, CT-measured CACS, anthropometric measurement, fasting glucose, insulin, lipid profiles, serum C-reactive protein (CRP) and homeostatic model assessment (HOMA-IR). MetS was defined according to the AHA/NHLBI criteria.
When the subjects were divided into four groups according to quartiles of FVC or FEV(1) (% pred), serum CRP level, HOMA-IR, prevalence of MetS and CACS significantly increased as the FVC or FEV(1) (% pred) decreased. The odds ratios (ORs) for MetS in the lowest quartiles of FVC and FEV(1) (% pred) were 1.85 (95% CI, 1.49-2.30; p<0.001) and 1.47 (95% CI, 1.20-1.81; p<0.001) respectively. The ORs for the presence of coronary artery calcification in the lowest quartiles of FVC and FEV(1) (% pred) were 1.31 (95% CI, 1.09-1.58; p=0.004) and 1.22 (95% CI, 1.02-1.46; p=0.029) respectively. Obesity, CRP, HOMA-IR, and the presence of coronary artery calcium were independent risk predictors for impaired lung function.
Metabolic syndrome, insulin resistance, coronary atherosclerosis, and systemic inflammation are closely related to the impaired lung function.
肺功能受损是心血管死亡率的独立预测因子。我们评估了肺功能与胰岛素抵抗（IR）、代谢综合征（MetS）、全身炎症和冠状动脉钙化评分（CACS）的关系，CACS 是冠状动脉粥样硬化的指标，通过计算机断层扫描（CT）测量得出。
我们从 2005 年 3 月至 2008 年 2 月期间在三星医疗中心健康促进中心确定了 4905 名成年男性患者，并回顾性地审查了这些患者的以下数据：肺功能、CT 测量的 CACS、人体测量、空腹血糖、胰岛素、血脂谱、血清 C 反应蛋白（CRP）和稳态模型评估（HOMA-IR）。MetS 根据 AHA/NHLBI 标准定义。
当根据 FVC 或 FEV1（%pred）的四分位数或 FVC 或 FEV1（%pred）将受试者分为四组时，血清 CRP 水平、HOMA-IR、MetS 患病率和 CACS 随着 FVC 或 FEV1（%pred）的降低而显著增加。FVC 和 FEV1（%pred）最低四分位数的 MetS 的比值比（OR）分别为 1.85（95%CI，1.49-2.30；p<0.001）和 1.47（95%CI，1.20-1.81；p<0.001）。FVC 和 FEV1（%pred）最低四分位数存在冠状动脉钙化的 OR 分别为 1.31（95%CI，1.09-1.58；p=0.004）和 1.22（95%CI，1.02-1.46；p=0.029）。肥胖、CRP、HOMA-IR 和冠状动脉钙的存在是肺功能受损的独立危险因素。
代谢综合征、胰岛素抵抗、冠状动脉粥样硬化和全身炎症与肺功能受损密切相关。
