中国老年人群肺功能与颈动脉粥样硬化的关联：广州生物样本库队列研究-心血管疾病亚队列
The association of pulmonary function with carotid atherosclerosis in older Chinese: Guangzhou Biobank Cohort Study-CVD Subcohort.
作者信息
Pan Jing, Xu Lin, Cai Shao Xi, Jiang Chao Qiang, Cheng Kar Keung, Zhao Hai Jin, Zhang Wei Sen, Jin Ya Li, Lin Jie Ming, Thomas G Neil, Lam Tai Hing
机构信息
Chronic Airways Diseases Laboratory, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Guangzhou No.12 Hospital, Guangzhou, Guangdong, China.
School of Public Health, The University of Hong Kong, Hong Kong, China.
出版信息
Atherosclerosis. 2015 Dec;243(2):469-76. doi: 10.1016/j.atherosclerosis.2015.09.036. Epub 2015 Oct 3.
BACKGROUND
Evidence describing the association between pulmonary function and carotid atherosclerosis has been inconclusive and the role of smoking in this association is unclear. We therefore examined this association in the Guangzhou Biobank Cohort Study-CVD Subcohort.
METHODS
Common carotid artery (CCA) intima-media thickness (IMT) and carotid plaques were measured by B-mode ultrasonography and lung function by spirometry using a turbine flowmeter. Chronic obstructive pulmonary disease (COPD) was defined as the ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) of less than 0.70. Predicted FEV1 and FVC were derived using equations for Chinese.
RESULTS
Of 1625 participants aged 50 + years, 382 (23.5%) had evidence of carotid plaque. The mean CCA-IMT was higher in those with COPD than those without (0.82 ± 0.29 mm versus 0.76 ± 0.31 mm, P = 0.02). We found no evidence that the association of pulmonary function with CCA-IMT varied by smoking status (P values interaction: 0.23-0.83). After adjustment for a wide range of potential confounders, the increased risks of thickened CCA-IMT (CCA-IMT ≥1.0 mm) in those with COPD became marginally nonsignificant (adjusted odds ratio (OR) 1.45, 95% confidence interval (CI) 0.91-2.29; P = 0.12). Compared to those in the highest tertile, participants in the lowest tertile of FEV1 observed to predicted ratio had increased risk of thickened CCA-IMT (adjusted OR 2.18, 95% CI 1.42-3.34) and carotid plaque (adjusted OR 1.50, 95% CI 1.08-2.09), while participants in the lowest tertile of FVC observed to predicted ratio had increased risk of thickened CCA-IMT (adjusted OR 2.29, 95% CI 1.46-3.58), but the adjusted OR for carotid plaque was marginally nonsignificant (adjusted OR 1.29, 95% CI 0.93-1.80; P = 0.13).
CONCLUSION
Independent of smoking status, poor pulmonary function was dose-dependently associated with carotid atherosclerosis in older Chinese. (281 words).
背景
关于肺功能与颈动脉粥样硬化之间关联的证据尚无定论，吸烟在这种关联中的作用也不明确。因此，我们在广州生物银行队列研究 - 心血管疾病亚队列中研究了这种关联。
方法
采用B型超声测量颈总动脉（CCA）内膜中层厚度（IMT）和颈动脉斑块，使用涡轮流量计通过肺活量测定法测量肺功能。慢性阻塞性肺疾病（COPD）定义为1秒用力呼气量（FEV1）与用力肺活量（FVC）之比小于0.70。预测的FEV1和FVC使用中国人的方程得出。
结果
在1625名50岁及以上的参与者中，382人（23.5%）有颈动脉斑块证据。COPD患者的平均CCA - IMT高于无COPD者（0.82±0.29毫米对0.76±0.31毫米，P = 0.02）。我们没有发现肺功能与CCA - IMT的关联因吸烟状况而异的证据（P值交互作用：0.23 - 0.83）。在对一系列潜在混杂因素进行调整后，COPD患者中CCA - IMT增厚（CCA - IMT≥1.0毫米）的风险增加变得边缘不显著（调整后的优势比（OR）为1.45，95%置信区间（CI）为0.91 - 2.29；P = 0.12）。与最高三分位数者相比，FEV1实测值与预测值之比处于最低三分位数的参与者，其CCA - IMT增厚的风险增加（调整后的OR为2.18，95%CI为1.42 - 3.34）以及颈动脉斑块的风险增加（调整后的OR为1.50，95%CI为1.08 - 2.09），而FVC实测值与预测值之比处于最低三分位数的参与者，其CCA - IMT增厚的风险增加（调整后的OR为2.29，95%CI为1.46 - 3.58），但颈动脉斑块的调整后OR边缘不显著（调整后的OR为1.29，95%CI为0.93 - 1.80；P = 0.13）。
结论
在老年中国人中，独立于吸烟状况，肺功能差与颈动脉粥样硬化呈剂量依赖性关联。 （281字）
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