Pefura-Yone Eric Walter, Balkissou Adamou Dodo, Kengne Andre Pascal
Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon; Pneumology Service, Yaounde Jamot Hospital, Yaounde, Cameroon.
South African Medical Research Council, Cape Town, South Africa; University of Cape Town, Cape Town, South Africa, Cape Town, South Africa.
Open Respir Med J. 2016 Nov 30;10:86-95. doi: 10.2174/1874306401610010086. eCollection 2016.
Restrictive spirometric pattern is a risk factor for all-cause and cause-specific mortality.
We assessed the prevalence of restrictive pattern and investigated its determinants in a major sub-Saharan Africa city.
Participants were adults (≥ 19 years) who took part in a population-based survey in Yaounde (Cameroon) between December 2013 and April 2014. Restrictive pattern was based on a FVC below the lower limit of the normal (LLN) and a ratio forced expiratory volume in one second (FEV1)/FVC ≥ LLN (LLN-based restrictive pattern) or a FVC <80% and FEV1/FVC ≥ LLN (fixed cut-off based restrictive pattern). Determinants were investigated by logistic regressions.
In all, 1003 participants [514 (51.2%) women] with a mean age of 33.7 years were included. The prevalence of restrictive pattern was 18.8% (95%CI: 16.6-21.2) based on LLN and 15.0% (13.0-17.2) based on fixed cut-off. LLN-based restrictive pattern was mild in 148 (78.3%) subjects, moderate in 35 (18.5%) and severe in 6 (3.2%). Determinants of LLN-based restrictive pattern were age ≥ 60 years [adjusted odds ratio 2.90 (95%CI 1.46-5.77), p=0.002), history of pulmonary tuberculosis [3.81(1.42-10.20), p=0.008], prevalent heart diseases [3.81 (1.20-12.12), p=0.024] and underweight [5.15(1.30-20.39), p=0.020]. Determinants were largely similar with slightly different effect sizes for fixed cut-off based restrictive pattern.
Restrictive pattern was very frequent in this city.
These results enhance the needs to increase the efforts to prevent and control tuberculosis, cardiovascular diseases and underweight in this setting.
限制性肺通气功能模式是全因死亡率和特定病因死亡率的一个危险因素。
我们评估了限制性模式的患病率，并在撒哈拉以南非洲的一个主要城市调查了其决定因素。
参与者为2013年12月至2014年4月在雅温得（喀麦隆）参加基于人群调查的成年人（≥19岁）。限制性模式基于用力肺活量（FVC）低于正常下限（LLN）且一秒用力呼气容积（FEV1）/FVC≥LLN（基于LLN的限制性模式），或FVC<80%且FEV1/FVC≥LLN（基于固定截断值的限制性模式）。通过逻辑回归研究决定因素。
总共纳入了1003名参与者[514名（51.2%）女性]，平均年龄为33.7岁。基于LLN的限制性模式患病率为18.8%（95%置信区间：16.6 - 21.2），基于固定截断值的患病率为15.0%（13.0 - 17.2）。基于LLN的限制性模式在148名（78.3%）受试者中为轻度，35名（18.5%）为中度，6名（3.2%）为重度。基于LLN的限制性模式的决定因素为年龄≥60岁[调整后的优势比2.90（95%置信区间1.46 - 5.77），p = 0.002]、肺结核病史[3.81（1.42 - 10.20），p = 0.008]、现患心脏病[3.81（1.20 - 12.12），p = 0.024]和体重过轻[5.15（1.30 - 20.39），p = 0.020]。对于基于固定截断值的限制性模式，决定因素大致相似，效应大小略有不同。
在这个城市，限制性模式非常常见。
这些结果强化了在这种情况下加大预防和控制结核病、心血管疾病及体重过轻力度的必要性。
