在一项针对健康成年人的纵向研究中，肺功能的快速下降在时间上与代谢活性更高的肥胖症相关。
Rapid decline in lung function is temporally associated with greater metabolically active adiposity in a longitudinal study of healthy adults.
作者信息
Moualla Maan, Qualls Clifford, Arynchyn Alexander, Thyagarajan Bharat, Kalhan Ravi, Smith Lewis J, Carr John J, Jacobs David R, Sood Akshay
机构信息
Department of Medicine, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
Office of Research, Clinical Translational Science Center, University of New Mexico, Albuquerque, New Mexico, USA.
出版信息
Thorax. 2017 Dec;72(12):1113-1120. doi: 10.1136/thoraxjnl-2016-209125. Epub 2017 Jul 20.
RATIONALE
Adiposity is associated with low lung function, but the longitudinal relationship between lung function and adiposity is inadequately studied.
OBJECTIVE
To examine the bidirectional longitudinal associations between rapid decline in lung function and adiposity phenotypes in healthy adults.
METHODS
This secondary analysis used a 25-year longitudinal dataset from the Coronary Artery Risk Development in Young Adults (CARDIA) study that enrolled 5115 participants.
MEASUREMENTS
In the first analysis, metabolic syndrome at or before CARDIA year (Y) 10 (Y10) was the predictor, and subsequent rapid decline in forced vital capacity (FVC) or forced expiratory volume in 1 s (FEV) between Y10 and Y20 was the outcome. In the second analysis, rapid decline was the predictor, and incident metabolic syndrome at Y20 and/or Y25 was the outcome. In the third analysis, rapid decline was the predictor, and subsequent CT-assessed regional fat depots at Y25 were the outcome.
RESULTS
Metabolic syndrome at or before Y10 is temporally associated with rapid decline in FVC between Y10 and Y20 (adjusted p=0.04), but this association was explained by body mass index (BMI) at Y10. Rapid decline in FVC or FEV is temporally associated with greater incident metabolic syndrome at Y20 and/or Y25 (adjusted OR 2.10 (1.69, 2.61); p<0.001, and 1.56 (1.26, 1.94); p<0.001, respectively) and greater CT-assessed intrathoracic visceral adiposity at Y25 (adjusted standardised β 0.09; p<0.001 for both analyses). These associations were not explained by BMI levels prior to the outcome measurement.
CONCLUSIONS
Healthy adults with rapid decline in lung function are at risk for developing metabolic syndrome and for disproportionate accumulation of intrathoracic visceral fat. Metabolic abnormalities may be an early extrapulmonary manifestation of lung impairment that may be preventable by improving lung health.
原理
肥胖与肺功能低下有关，但肺功能与肥胖之间的纵向关系研究不足。
目的
研究健康成年人肺功能快速下降与肥胖表型之间的双向纵向关联。
方法
这项二次分析使用了来自青年成人冠状动脉风险发展研究（CARDIA）的25年纵向数据集，该研究招募了5115名参与者。
测量
在第一次分析中，以CARDIA研究第10年（Y10）及之前的代谢综合征为预测因素，以Y10至Y20期间随后的用力肺活量（FVC）或1秒用力呼气量（FEV）快速下降为结果。在第二次分析中，以快速下降为预测因素，以Y20和/或Y25时发生的代谢综合征为结果。在第三次分析中，以快速下降为预测因素，以Y25时随后CT评估的局部脂肪堆积为结果。
结果
Y10及之前的代谢综合征与Y10至Y20期间FVC的快速下降在时间上相关（校正p = 0.04），但这种关联可由Y10时的体重指数（BMI）解释。FVC或FEV的快速下降与Y20和/或Y25时更高的代谢综合征发生率（校正OR 2.10（1.69，2.61）；p <0.001，以及1.56（1.26，1.94）；p <0.001）以及Y25时更高的CT评估的胸内内脏脂肪量在时间上相关（校正标准化β 0.09；两项分析的p均<0.001）。这些关联不能由结果测量之前的BMI水平解释。
结论
肺功能快速下降的健康成年人有发生代谢综合征和胸内内脏脂肪不成比例堆积的风险。代谢异常可能是肺损伤的早期肺外表现，可能通过改善肺健康来预防。
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