Division of Pulmonary and Critical Care Medicine (Drs Diaz, Come, Pinto-Plata, Divo, Celli, and Washko)Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Division of Pulmonary and Critical Care Medicine (Drs Diaz, Come, Pinto-Plata, Divo, Celli, and Washko)Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Chest. 2014 Feb;145(2):282-289. doi: 10.1378/chest.13-1414.
Although obstructive lung disease (OLD), which includes COPD, affects all the populations, Hispanics seem to be protected against COPD development and progression. Whether this advantage translates into a survival benefit for this population is unknown. We aimed to determine the risk for OLD in Mexican Americans, the largest US Hispanic subgroup, compared with non-Hispanic whites and to assess all-cause mortality in subjects with OLD.
We assessed the relationships between Mexican American ethnicity and spirometric OLD and risk of death among 6,456 US adults aged ≥ 40 years who participated in the Third National Health and Nutritional Examination Survey Follow-up Study. We used logistic and Cox regression analyses to estimate the OR for OLD among Mexican Americans and the hazard ratio (HR) for all-cause mortality among Mexican Americans with OLD, respectively.
After adjustment for demographic factors, socioeconomic status, and COPD risk factors, Mexican Americans had decreased odds of OLD diagnosis compared with whites (OR, 0.72 [95% CI, 0.54-0.95]). Among the 1,734 participants with OLD, 1,054 (60.8%) died during median follow-up of 12 years. In an adjusted model, Mexican Americans had no advantage in mortality from all causes (HR, 0.88 [95% CI, 0.69-1.13]). After accounting for the fact that some Mexican Americans may have moved back to Mexico and died there (thus, had no US death certificate), there was still no difference in mortality between these groups.
Although Mexican Americans appear to have lower risk for OLD, subjects of this ethnicity with OLD do not seem to have a survival advantage.
阻塞性肺疾病（OLD）包括 COPD，影响所有人群，但西班牙裔似乎对 COPD 的发生和发展有保护作用。尚不清楚这种优势是否能转化为该人群的生存获益。我们旨在确定美国最大的西班牙裔亚群——墨西哥裔美国人患 OLD 的风险，并评估 OLD 患者的全因死亡率。
我们评估了 6456 名年龄≥40 岁的美国成年人的墨西哥裔美国人种族与肺功能 OLD 及死亡风险之间的关系，这些成年人参加了第三次国家健康和营养检查调查随访研究。我们使用逻辑回归和 Cox 回归分析分别估计了墨西哥裔美国人患 OLD 的比值比（OR）和 OLD 墨西哥裔美国人的全因死亡率的危险比（HR）。
在调整了人口统计学因素、社会经济地位和 COPD 危险因素后，与白人相比，墨西哥裔美国人 OLD 的诊断几率降低（OR，0.72 [95%CI，0.54-0.95]）。在 1734 名 OLD 患者中，1054 名（60.8%）在中位 12 年的随访期间死亡。在调整后的模型中，墨西哥裔美国人的全因死亡率没有优势（HR，0.88 [95%CI，0.69-1.13]）。考虑到一些墨西哥裔美国人可能已经搬回墨西哥并在那里死亡（因此，没有美国死亡证明），这些组之间的死亡率仍然没有差异。
尽管墨西哥裔美国人似乎 OLD 的风险较低，但患有 OLD 的该族裔人群似乎没有生存优势。
