Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2010 Oct;25(10):1480-6. doi: 10.3346/jkms.2010.25.10.1480. Epub 2010 Sep 17.
The aim of this study was done to assess the association of lung function with insulin resistance (IR), systemic inflammation, and metabolic syndrome (MetS). In 9,581 apparently healthy non-smoking male adults, pulmonary function, fasting glucose, insulin, lipid profiles and serum high-sensitivity C-reactive protein (hs-CRP) levels were measured, and homeostatic model assessment (HOMA) was used to assess IR. The presence of MetS was defined according to the AHA/NHLBI criteria. The prevalence of MetS was 19.3%. The odds ratio of MetS for restrictive ventilatory pattern was 1.55 (95% confidence interval, 1.12-2.14), and that for obstructive ventilatory pattern was 1.39 (0.66-2.94) after adjustment for confounders. When subjects were divided in 4 groups according to quartiles of FVC or FEV(1) (% predicted [pred]), HOMA-IR significantly increased as the FVC or FEV(1) (% predicted [pred]) decreased. Individuals in the lowest FVC or FEV(1) quartile had the highest hs-CRP level. Prevalence of MetS increased as FVC or FEV(1) (% predicted [pred]) quartiles decreased. The abdominal obesity, hs-CRP and HOMA-IR were the independent predictors for the lowest FVC and FEV(1) (% predicted [pred]) even after adjustment for confounders. These results indicate that MetS, IR, and systemic inflammation are important risk factors for reduced lung function in nonsmoking Korean males.
本研究旨在评估肺功能与胰岛素抵抗(IR)、全身炎症和代谢综合征(MetS)的相关性。在 9581 名无吸烟的貌似健康的成年男性中,测量了肺功能、空腹血糖、胰岛素、血脂谱和血清高敏 C 反应蛋白(hs-CRP)水平,并使用稳态模型评估(HOMA)来评估 IR。MetS 的存在根据 AHA/NHLBI 标准定义。调整混杂因素后,限制性通气模式的 MetS 比值比为 1.55(95%置信区间,1.12-2.14),阻塞性通气模式的比值比为 1.39(0.66-2.94)。当根据 FVC 或 FEV1(%pred)的四分位数将受试者分为 4 组时,HOMA-IR 随着 FVC 或 FEV1(%pred)的降低而显著增加。FVC 或 FEV1(%pred)最低四分位数的个体 hs-CRP 水平最高。MetS 的患病率随着 FVC 或 FEV1(%pred)四分位数的降低而增加。即使在调整混杂因素后,腹型肥胖、hs-CRP 和 HOMA-IR 仍是 FVC 和 FEV1(%pred)最低的独立预测因素。这些结果表明,在不吸烟的韩国男性中,MetS、IR 和全身炎症是肺功能下降的重要危险因素。