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肺功能与心血管风险的关联:一项队列研究。

Association of lung function with cardiovascular risk: a cohort study.

机构信息

Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.

Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.

出版信息

Respir Res. 2018 Nov 6;19(1):214. doi: 10.1186/s12931-018-0920-y.

Abstract

BACKGROUND

The potential effects of pulmonary dysfunction on cardiovascular diseases (CVD) are receiving attention. We aimed to investigate and quantify the cross-sectional and longitudinal associations between lung function and overall cardiovascular risk among Chinese general population.

METHODS

We studied 4019 participants from the Wuhan-Zhuhai cohort, with a follow-up of 3 years. A multivariable risk algorithm generated from the Framingham study was used to calculate individuals' overall cardiovascular risk i.e. 10-Year CVD Risk, which was further classified into 2 categories: low (< 10%) and high (≥10%) CVD risk. General linear model and logistic regression model were separately used to assess the associations of lung function with continuous and dichotomous 10-Year CVD Risk.

RESULTS

Cross-sectionally, each 5% decrease in FEV/FVC was associated with a 0.47% increase in 10-Year CVD Risk (P < 0.001). The adjusted odds ratio (OR) (95% confidence interval [CI]) for the prevalence of high CVD risk (10-Year CVD Risk≥10%) was 1.12 (1.07, 1.17) corresponding to each 5% decrease in FEV/FVC. The OR (95% CI) for high CVD risk in the lowest group of FEV/FVC (< 70% i.e. chronic obstructive pulmonary disease [COPD]) was 2.37 (1.43, 3.91) when compared with the highest group. Longitudinally, the adjusted risk ratio (RR) (95% CI) for the incidence of high CVD risk was 1.14 (1.03, 1.25) with each 5% decrease in baseline FEV/FVC. Compared with the highest group of FEV/FVC, the RR (95% CI) for high CVD risk in the lowest group (COPD) was 4.06 (1.46, 11.26). Analyses of 10-Year CVD Risk with FVC or FEV showed similar trends and significant associations (all P < 0.05).

CONCLUSION

Reduced lung function was cross-sectionally and longitudinally associated with increased cardiovascular risk in Chinese general population.

摘要

背景

肺功能障碍对心血管疾病(CVD)的潜在影响正受到关注。我们旨在研究和量化中国一般人群中肺功能与整体心血管风险之间的横断面和纵向关联。

方法

我们研究了来自武汉-珠海队列的 4019 名参与者,随访时间为 3 年。使用来自弗雷明汉研究的多变量风险算法计算个体的整体心血管风险,即 10 年 CVD 风险,进一步分为低(<10%)和高(≥10%)CVD 风险两类。分别使用一般线性模型和逻辑回归模型评估肺功能与连续和二分 10 年 CVD 风险之间的关联。

结果

在横截面上,每 5%的 FEV/FVC 下降与 10 年 CVD 风险增加 0.47%相关(P<0.001)。与 FEV/FVC 每下降 5%对应的高 CVD 风险(10 年 CVD 风险≥10%)患病率的调整比值比(OR)(95%置信区间[CI])为 1.12(1.07,1.17)。在 FEV/FVC 最低组(<70%,即慢性阻塞性肺疾病[COPD])中,与最高组相比,高 CVD 风险的 OR(95%CI)为 2.37(1.43,3.91)。纵向研究中,与 FEV/FVC 每下降 5%对应的高 CVD 风险发生率的调整风险比(RR)(95%CI)为 1.14(1.03,1.25)。与 FEV/FVC 最高组相比,在 FEV/FVC 最低组(COPD)中,高 CVD 风险的 RR(95%CI)为 4.06(1.46,11.26)。FEV/FVC、FVC 或 FEV 分析的 10 年 CVD 风险显示出相似的趋势和显著关联(均 P<0.05)。

结论

中国一般人群中,肺功能降低与心血管风险增加呈横断面和纵向关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da7/6219159/573ec389e777/12931_2018_920_Fig1_HTML.jpg

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