Li J C, Lan F L, Yu C Q, Lyu J, Guo Y, Bian Z, Tan Y L, Pei P, Chen J S, Chen Z M, Li L M
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Apr 10;38(4):446-451. doi: 10.3760/cma.j.issn.0254-6450.2017.04.007.
To examine the prospective associations between airflow obstruction (AFO) and risks of major chronic diseases morbidity in Chinese adults. Samples of this study were from the China Kadoorie Biobank. A total of 486 996 participants aged 30 to 79 years (mean 51.5 years) at the baseline study, were included after excluding those who self-reported of having heart disease, stroke and cancer at baseline. AFO was defined under the Global Initiative on Obstructive Lung Disease (GOLD) criteria and forced expiratory volume per one second in percentage of the expected one (FEV(1) P). Cox regression models were used to investigate the associations of AFO with incidence rates of ischemic heart disease, cerebrovascular disease and lung cancer after adjusted for potential confounders. Over a period of 7 years through the follow-up program, the incident cases of ischemic heart disease, cerebrovascular disease and lung cancer appeared as 24 644, 36 336 and 3 218, respectively. Compared with people without AFO, the (95) of GOLD-1 to GOLD-4 were 0.89 (0.78-1.01), 1.05 (0.98-1.12), 1.29 (1.18-1.40) and 1.65 (1.42-1.91) respectively for ischemic heart disease. The (95) of GOLD-1 to GOLD-4 were 0.96 (0.70-1.26), 1.12 (0.96-1.31), 1.38 (1.14-1.65) and 1.48 (1.05-2.02) respectively for lung cancer. No statistically significant differences in the associations between GOLD level and cerebrovascular disease morbidity were found. However, each 10 decrease in FEV(1) P was associated with 7.2 (95 6.4-8.0), 3.6 (95 3.0-4.3) and 10.5 (95 8.4-12.6) increased the risks of ischemic heart disease, cerebrovascular disease and lung cancer respectively. The results were persistant when stratified by smoking status. Higher degree of AFO seemed to be associated with the risks of ischemic heart disease, cerebrovascular disease and lung cancer morbidity among the Chinese adults.
为研究中国成年人气流受限(AFO)与主要慢性病发病风险之间的前瞻性关联。本研究样本来自中国嘉道理生物银行。在基线研究中,共有486996名年龄在30至79岁(平均51.5岁)的参与者,排除那些在基线时自我报告患有心脏病、中风和癌症的人后被纳入研究。AFO根据慢性阻塞性肺疾病全球倡议(GOLD)标准和一秒用力呼气量占预计值的百分比(FEV₁%)来定义。使用Cox回归模型在调整潜在混杂因素后研究AFO与缺血性心脏病、脑血管疾病和肺癌发病率之间的关联。在为期7年的随访过程中,缺血性心脏病、脑血管疾病和肺癌的发病例数分别为24644例、36336例和3218例。与无AFO的人相比,GOLD-1至GOLD-4级别的缺血性心脏病发病风险比(95%置信区间)分别为0.89(0.78 - 1.01)、1.05(0.98 - 1.12)、1.29(1.18 - 1.40)和1.65(1.42 - 1.91)。GOLD-1至GOLD-4级别的肺癌发病风险比(95%置信区间)分别为0.96(0.70 - 1.26)、1.12(0.96 - 1.31)、1.38(1.14 - 1.65)和1.48(1.05 - 2.02)。未发现GOLD级别与脑血管疾病发病之间的关联存在统计学显著差异。然而,FEV₁%每降低10%,缺血性心脏病、脑血管疾病和肺癌的发病风险分别增加7.2(95%置信区间6.4 - 8.0)、3.6(95%置信区间3.0 - 4.3)和10.5(95%置信区间8.4 - 12.6)。按吸烟状况分层时结果依然成立。较高程度的AFO似乎与中国成年人缺血性心脏病、脑血管疾病和肺癌的发病风险相关。