Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstaedter Landstrasse 1, D-85764, Neuherberg, Germany.
Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-Universität, Ziemssenstrasse 1, 80336, Munich, Germany.
BMC Pulm Med. 2018 Feb 6;18(1):27. doi: 10.1186/s12890-018-0582-z.
The relationship of spirometric values to other respiratory and functional parameters in advanced age is not well studied. We assessed this relationship in elderly subjects with either good or poor spirometric parameters to reveal whether different domains of lung function show comparable differences between the two groups.
Among subjects of the population-based KORA-Age cohort (n = 935, 65-90y; 51% male) two groups were selected from either the lower (LED; n = 51) or the upper (UED; n = 72) end of the FEV distribution. All subjects did not have a history of lung disease and were non-smokers at the time of the study. Measurements included spirometry, body plethysmography, diffusing capacity for NO and CO, respiratory pump function and exhaled NO (FeNO). In addition, 6-min walking distance as a functional overall measure, as well as telomere length of blood leukocytes and serum 8-hydroxydeoxyguanosine (8-OHdG) as potential markers of overall biological ageing and stress were determined.
In the majority of parameters, LED subjects showed significantly impaired values compared to UED subjects. Differences in spirometric parameters, airway resistance and respiratory pump function ranged between 10% and more than 90% in terms of predicted values. In contrast, volume-related CO and NO diffusing capacity showed differences between groups of lower than 5%, while telomere length, 8-OHdG and FeNO were similar. This was reflected in the differences in "functional age" as derived from prediction equations.
In elderly subjects without a history of lung disease differences in spirometric parameters were associated with differences in other lung-mechanical parameters including body plethysmography but not with differences in volume-corrected gas exchange measures. Thus, the concept of a general "lung age" as suggested by the widespread use of this term in connection with spirometry should be considered with caution.
目前对于高龄人群中肺功能指标与其他呼吸及功能参数之间的关系尚未进行充分研究。本研究旨在评估肺功能良好和较差的高龄人群中这些参数之间的关系，以揭示不同肺功能指标是否在两组人群中存在类似的差异。
在基于人群的 KORA-Age 队列研究中（n=935，年龄 65-90 岁，51%为男性），从 FEV 分布的低端（LED，n=51）或高端（UED，n=72）选择两组人群。所有参与者在研究时均无肺部疾病病史且非吸烟者。检测指标包括肺量计检查、体描法、NO 和 CO 的弥散量、呼吸泵功能以及呼出气一氧化氮（FeNO）。此外，还测量了 6 分钟步行距离作为整体功能指标，以及白细胞端粒长度和血清 8-羟基脱氧鸟苷（8-OHdG）作为整体生物老化和应激的潜在标志物。
在大多数参数中，LED 组与 UED 组相比，其检测值显著下降。基于预测值，两组间肺功能参数、气道阻力和呼吸泵功能的差异范围为 10%至 90%以上。相比之下，CO 和 NO 的弥散量与体积相关的差异低于 5%，而端粒长度、8-OHdG 和 FeNO 则无明显差异。这些差异反映在通过预测方程计算的“功能年龄”差异上。
在无肺部疾病病史的高龄人群中，肺功能参数的差异与体描法等其他肺力学参数的差异相关，但与体积校正后的气体交换指标的差异无关。因此，在与肺量计检查广泛相关的情况下，作为一般“肺年龄”的概念，应谨慎考虑。
