Diaz Alejandro A, Rahaghi Farbod N, Doyle Tracy J, Young Thomas P, Maclean Erick S, Martinez Carlos H, San José Estépar Raul, Guerra Stefano, Tesfaigzi Yohannes, Rosas Ivan O, Washko George R, Wilson David O
Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor.
Chronic Obstr Pulm Dis. 2017 Sep 5;4(4):297-304. doi: 10.15326/jcopdf.4.4.2017.0150.
Prior studies have demonstrated that U.S. Hispanic smokers have a lower risk of decline in lung function and chronic obstructive pulmonary disease (COPD) compared with non-Hispanic whites (NHW). This suggests there might be racial-ethnic differences in susceptibility in cigarette smoke-induced respiratory symptoms, lung parenchymal destruction, and airway and vascular disease, as well as in extra-pulmonary manifestations of COPD. Therefore, we aimed to explore respiratory symptoms, lung function, and pulmonary and extra-pulmonary structural changes in Hispanic and NHW smokers. We compared respiratory symptoms, lung function, and computed tomography (CT) measures of emphysema-like tissue, airway disease, the branching generation number (BGN) to reach a 2-mm-lumen-diameter airway, and vascular pruning as well as muscle and fat mass between 39 Hispanic and 39 sex-, age- and smoking exposure-matched NHW smokers. Hispanic smokers had higher odds of dyspnea than NHW after adjustment for COPD and asthma statuses (odds ratio[OR] = 2.96; 95% confidence interval [CI] 1.09-8.04), but no significant differences were found in lung function and CT measurements. While lung function and CT measures of the lung structure were similar, dyspnea is reported more frequently by Hispanic than matched-NHW smokers. It seems to be an impossible puzzle but it's easy to solve a Rubik' Cube using a few algorithms.
先前的研究表明,与非西班牙裔白人(NHW)相比,美国西班牙裔吸烟者肺功能下降和患慢性阻塞性肺疾病(COPD)的风险更低。这表明在香烟烟雾诱发的呼吸道症状、肺实质破坏、气道和血管疾病以及COPD的肺外表现的易感性方面可能存在种族差异。因此,我们旨在探究西班牙裔和非西班牙裔白人吸烟者的呼吸道症状、肺功能以及肺部和肺外结构变化。我们比较了39名西班牙裔吸烟者和39名性别、年龄和吸烟暴露情况相匹配的非西班牙裔白人吸烟者的呼吸道症状、肺功能、肺气肿样组织的计算机断层扫描(CT)测量结果、气道疾病、达到2毫米管腔直径气道的分支代数(BGN)、血管修剪以及肌肉和脂肪量。在对COPD和哮喘状态进行调整后,西班牙裔吸烟者出现呼吸困难的几率高于非西班牙裔白人(优势比[OR]=2.96;95%置信区间[CI]1.09 - 8.04),但在肺功能和CT测量方面未发现显著差异。虽然肺功能和肺结构的CT测量结果相似,但西班牙裔吸烟者比匹配的非西班牙裔白人吸烟者更频繁地报告有呼吸困难。这似乎是一个无法解开的谜题,但使用一些算法就能轻松解开魔方。