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肺功能降低、C反应蛋白与心血管疾病死亡风险增加

Reduced lung function, C-reactive protein, and increased risk of cardiovascular mortality.

作者信息

Min Kyoung-Bok, Min Jin-Young

机构信息

Department of Occupational and Environmental Medicine, Ajou University School of Medicine.

出版信息

Circ J. 2014;78(9):2309-16. doi: 10.1253/circj.cj-14-0308. Epub 2014 Jun 30.

DOI:10.1253/circj.cj-14-0308
PMID:24976509
Abstract

BACKGROUND

We explored whether reduced lung function is a predictor of mortality due to cardiovascular or coronary artery disease (CVD or CAD), and, if this hypothesis is correct, whether C-reactive protein (CRP), a systemic inflammatory marker, is responsible for this association in a general population-based cohort. METHODS AND RESULTS: We used the Third Nutrition and Health Examination Survey (NHANES III) database and the NHANES III Linked Mortality File. A total of 13,310 participants ≥20 years of age who completed a spirometric test at baseline examination were included. On comparison of the participants in the lowest forced vital capacity percent predicted (FVC% pred) quartile with those in the highest quartile, the hazard ratio (HR) was 2.1 (95% CI: 1.7-2.6) for cardiovascular mortality and 2.2 (95% CI: 1.6-3.2) for coronary mortality. A similar association was observed for forced expiratory volume in 1 s percent predicted (FEV1% pred). When the participants with the highest FVC% pred or FEV1% pred (Q4) and low CRP (≤0.22 mg/dl) were defined as the reference group, the adjusted HR for cardiovascular mortality was significantly increased in the individuals with the lowest spirometric volume (Q1), and the risk was prominent in individuals with high CRP (>0.22 mg/dl).

CONCLUSIONS

There is a significant association between lung function parameters and death from CVD and CAD in the general population.

摘要

背景

我们探讨了肺功能降低是否是心血管疾病或冠状动脉疾病(CVD或CAD)导致死亡的预测因素,以及如果这一假设正确,全身性炎症标志物C反应蛋白(CRP)是否在基于普通人群的队列中导致了这种关联。方法与结果:我们使用了第三次营养与健康检查调查(NHANES III)数据库和NHANES III关联死亡率文件。纳入了13310名年龄≥20岁且在基线检查时完成肺活量测定的参与者。将预测的用力肺活量百分比(FVC% pred)最低四分位数的参与者与最高四分位数的参与者进行比较,心血管疾病死亡率的风险比(HR)为2.1(95% CI:1.7 - 2.6),冠心病死亡率的HR为2.2(95% CI:1.6 - 3.2)。对于预测的第1秒用力呼气量百分比(FEV1% pred)也观察到了类似的关联。当将预测的FVC% pred或FEV1% pred最高(Q4)且CRP较低(≤0.22 mg/dl)的参与者定义为参照组时,肺活量最低(Q1)的个体心血管疾病死亡率的校正HR显著升高,且在CRP较高(>0.22 mg/dl)的个体中风险更为突出。

结论

在普通人群中,肺功能参数与CVD和CAD导致的死亡之间存在显著关联。

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