Oda Masako, Omori Hisamitsu, Onoue Ayumi, Cui Xiaoyi, Lu Xi, Yada Hironori, Hisada Aya, Miyazaki Wataru, Higashi Noritaka, Ogata Yasuhiro, Katoh Takahiko
Department of Public Health, Faculty of Life Sciences, Kumamoto University, Japan.
Intern Med. 2015;54(20):2569-75. doi: 10.2169/internalmedicine.54.3778. Epub 2015 Oct 15.
Objective Chronic obstructive pulmonary disease (COPD) is often associated with concomitant systemic manifestations and comorbidities, such as cardiovascular disease. There are limited data regarding airflow limitation (AL) and atherosclerosis in Japanese patients, and the potential association between AL and arterial stiffness has not yet been investigated in Japanese patients. Therefore, the purpose of this study was to investigate the association between AL severity and arterial stiffness using the brachial-ankle pulse wave velocity (baPWV). Methods This cross-sectional study included 1,356 subjects aged 40-79 years without clinical cardiovascular diseases who underwent a comprehensive health screening that included spirometry, the baPWV measurement, and blood sampling during medical check-ups in 2009 at the Japanese Red Cross Kumamoto Health Care Center. AL was defined in accordance with the Global Initiative for COPD criteria (forced expiratory volume in one second / forced vital capacity of < 0.7). A cut-off baPWV value of >1,400 cm/s was used for risk prediction and screening. Results The average baPWV (SD) results were 1,578.0 (317.9), 1,647.3 (374.4), and 1,747.3 (320.1) cm/s in the patients with a normal pulmonary function, mild AL, and moderate-to-severe AL, respectively (p< 0.001). Using logistic regression models adjusted for the age, body mass index, smoking status, hypersensitive C-reactive protein levels, hypertension, hyperglycemia, and dyslipidemia, an increased baPWV (>1,400 cm/s) was significantly associated with moderate-to-severe AL compared with a normal pulmonary function (odds ratio=2.76; 95% confidence intervals, 1.37-5.55; p=0.004). Conclusion Our results indicated an association between AL and increased arterial stiffness. Arterial stiffness may therefore worsen with an increase in the severity of AL.
目的 慢性阻塞性肺疾病（COPD）常伴有全身性表现和合并症，如心血管疾病。关于日本患者气流受限（AL）和动脉粥样硬化的数据有限，且尚未在日本患者中研究AL与动脉僵硬度之间的潜在关联。因此，本研究的目的是使用臂踝脉搏波速度（baPWV）来研究AL严重程度与动脉僵硬度之间的关联。方法 这项横断面研究纳入了1356名年龄在40 - 79岁之间、无临床心血管疾病的受试者，他们于2009年在日本红十字熊本保健中心进行全面健康筛查，包括肺活量测定、baPWV测量和血液采样。根据慢性阻塞性肺疾病全球倡议标准（一秒用力呼气量/用力肺活量<0.7）定义AL。使用>1400 cm/s的baPWV截断值进行风险预测和筛查。结果 肺功能正常、轻度AL和中度至重度AL患者的平均baPWV（标准差）结果分别为1578.0（317.9）、1647.3（374.4）和1747.3（320.1）cm/s（p<0.001）。在对年龄、体重指数、吸烟状况、超敏C反应蛋白水平、高血压、高血糖和血脂异常进行校正的逻辑回归模型中，与肺功能正常相比，baPWV升高（>1400 cm/s）与中度至重度AL显著相关（比值比=2.76；95%置信区间，1.37 - 5.55；p = 0.004）。结论 我们的结果表明AL与动脉僵硬度增加之间存在关联。因此，动脉僵硬度可能会随着AL严重程度的增加而恶化。
