Yoon Jin-Ha, Won Jong-Uk, Ahn Yeon-Soon, Roh Jaehoon
The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea; Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Korea; Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea.
Department of Occupational and Environmental Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.
PLoS One. 2014 Apr 9;9(4):e94125. doi: 10.1371/journal.pone.0094125. eCollection 2014.
Despite epidemiological evidences of relationship between poor lung function and atherosclerosis, the relationship between poor lung function and microalbuminuria (MAU), an early surrogate marker of both kidney damage and atherosclerosis, is not well understood. Hence, we plan to investigate the relationship between poor lung function and MAU using multivariate models to adjust for other atherogenic risk factors.
We used data from the 5th Korean National Health and Nutrition Examination Survey. Poor lung function is determined by spirometric measurement, primarily through estimation of the forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). Declines in the percent predicted FVC (<80%) and in the FEV1/FVC ratio (<0.7) are defined as restrictive and obstructive patterns, respectively. Urine albumin to urine creatinine levels ratio (UACR) were measured in spot urine samples. MAU was defined as UACR >30 mg/g.
Inverse relationship was observed between lung function and UACR. In an age-adjusted regression model, the regression coefficient (B) of 10% lower FVC was 11.09 in men (P = 0.002), which remained significant after adjustment for SBP, FBG, triglyceride level, BMI, smoking history, and heavy alcohol consumption (B = 7.52, P = 0.043). When the restrictive pattern was compared to the normal pattern, the odds ratios (OR) (95% confidence interval, 95%CI) for MAU were 1.90 (1.32-2.72) in men, after adjustment for age, hypertension, diabetes mellitus, triglyceride level, obesity, smoking history, physical activity, and heavy alcohol consumption.
Our study, the first investigation in Asia, demonstrated that the restrictive pattern is related to MAU in men. Furthermore, there was linear relationship between lower FVC and UACR. Thus, our current study suggests that poor lung function, particularly the restrictive pattern, is related to kidney damage as well as atherosclerosis.
尽管有流行病学证据表明肺功能差与动脉粥样硬化之间存在关联，但肺功能差与微量白蛋白尿（MAU）之间的关系尚未完全明确，MAU是肾脏损伤和动脉粥样硬化的早期替代标志物。因此，我们计划使用多变量模型来研究肺功能差与MAU之间的关系，以调整其他致动脉粥样硬化风险因素。
我们使用了韩国第五次全国健康与营养检查调查的数据。肺功能差通过肺活量测定来确定，主要通过估计用力肺活量（FVC）和1秒用力呼气量（FEV1）。预测FVC百分比下降（<80%）和FEV1/FVC比值下降（<0.7）分别定义为限制性和阻塞性模式。在随机尿样中测量尿白蛋白与尿肌酐水平比值（UACR）。MAU定义为UACR>30mg/g。
观察到肺功能与UACR之间存在负相关。在年龄调整回归模型中，FVC降低10%的回归系数（B）在男性中为11.09（P=0.002），在调整收缩压、空腹血糖、甘油三酯水平、体重指数、吸烟史和大量饮酒后仍具有显著性（B=7.52，P=0.043）。当将限制性模式与正常模式进行比较时，在调整年龄、高血压、糖尿病、甘油三酯水平、肥胖、吸烟史、体力活动和大量饮酒后，男性MAU的比值比（OR）（95%置信区间，95%CI）为1.90（1.32-2.72）。
我们的研究是亚洲的首次调查，表明限制性模式与男性MAU有关。此外，较低的FVC与UACR之间存在线性关系。因此，我们目前的研究表明，肺功能差，尤其是限制性模式，与肾脏损伤以及动脉粥样硬化有关。
