Department of Respiratory Medicine, Hvidovre Hospital, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
Respir Med. 2012 Mar;106(3):397-405. doi: 10.1016/j.rmed.2011.08.016. Epub 2011 Dec 3.
We hypothesize that airflow limitation is associated with increasing arterial stiffness and that having COPD increases a non-invasive measure of arterial stiffness - the aortic augmentation index (AIx) - independently of other CVD risk factors.
This population study is based on 3374 subjects from the Copenhagen City Heart Study; 494 had COPD. We used multiple linear regression analyses to examine the association between COPD and AIx adjusted for CVD risk factors. Furthermore, we analyzed the association between AIx and FEV(1), FVC and FEV(1)/FVC in the entire population.
AIx was higher in subjects with COPD than in subjects without: 25.7 vs. 21.0 (p < 0.001) in men and 33.6 vs. 29.4 (p < 0.001) in women. We found no increase in AIx with COPD adjusted for CVD risk factors: difference 0.63 (-0.26 to 1.52, p = 0.16). In sensitivity analyses in subjects younger than 60 years with exclusion of mild COPD from the analyses, COPD was associated with an increase in AIx in men only of 4.1 (0.88-7.22, p = 0.007). AIx had a curvilinear association with FEV(1) and FVC but no association with the FEV(1)/FVC ratio.
AIx and COPD are only weakly associated. In the general population, this finding argues against increased arterial stiffness, as measured by AIx, being a complication of COPD.
我们假设气流受限与动脉僵硬度的增加有关，并且 COPD 独立于其他心血管疾病危险因素增加了一种非侵入性的动脉僵硬度测量指标——主动脉增强指数（AIx）。
本人群研究基于哥本哈根城市心脏研究的 3374 名受试者；其中 494 名患有 COPD。我们使用多元线性回归分析来检查 COPD 与 AIx 之间的关联，调整了心血管疾病危险因素。此外，我们分析了 AIx 与整个人群中 FEV1、FVC 和 FEV1/FVC 之间的关联。
COPD 患者的 AIx 高于无 COPD 患者：男性分别为 25.7%和 21.0%（p<0.001），女性分别为 33.6%和 29.4%（p<0.001）。我们发现，在调整了心血管疾病危险因素后，COPD 患者的 AIx 并没有增加：差值为 0.63（-0.26 至 1.52，p=0.16）。在年龄小于 60 岁的受试者中进行的敏感性分析中，将轻度 COPD 从分析中排除后，COPD 仅与男性 AIx 的增加有关，增加了 4.1（0.88-7.22，p=0.007）。AIx 与 FEV1 和 FVC 呈曲线相关，但与 FEV1/FVC 比值无关。
AIx 和 COPD 之间的相关性较弱。在一般人群中，这一发现表明，AIx 测量的动脉僵硬度增加并不是 COPD 的并发症。
