Department of Pediatrics, University of California, San Francisco, California.
Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
Pediatr Pulmonol. 2019 Sep;54(9):1382-1390. doi: 10.1002/ppul.24377. Epub 2019 May 29.
Hispanic subjects with cystic fibrosis (CF) have increased morbidity and mortality than non-Hispanic white subjects. The ethnic disparity in mortality varies by region. Factors influencing pulmonary function vary by both ethnicity and region.
To determine if the ethnic difference in pulmonary function varies by region.
This retrospective cohort study compared differences in longitudinal pulmonary function (percent-predicted forced vital capacity [FVC], forced expiratory volume in 1 second [FEV ], forced expiratory flow at 25% to 75% [FEF ], FEV /FVC, and FEV decline) between Hispanic and non-Hispanic white subjects with CF by Census region of the United States (West, South, Midwest, and Northeast). Subjects were of ages 6 to 25 years and in the CF Foundation Patient Registry from 2008 to 2013. We used linear mixed effects models with subject-specific slopes and intercepts, adjusting for 14 demographic and clinical variables.
Of 14 932 subjects, 1433 (9.6%) were Hispanic and 13 499 (90.4%) were non-Hispanic white. Hispanic subjects' FEV was 9.0% (8.3%-9.8%) lower than non-Hispanic white subjects in the West, while Hispanic subjects' FEV was only 4.0% (3.0%-5.0%) lower in the Midwest, 4.4% (3.1%-5.7%) lower in the Northeast, and 4.4% (3.2%-5.5%) lower in the South. Similarly, FVC and FEF were lower among Hispanic subjects compared to non-Hispanic white subjects in all US regions, with the biggest differences in the West. Only in the West was FEV /FVC significantly lower in Hispanic subjects (-0.019; -0.022 to -0.015). FEV decline was not significantly different between ethnicities in any region.
In CF, Hispanic subjects have lower pulmonary function than non-Hispanic white subjects in all geographic regions with the largest difference in occurring in the West.
与非西班牙裔白人相比，患有囊性纤维化（CF）的西班牙裔患者发病率和死亡率更高。死亡率的种族差异因地区而异。影响肺功能的因素因种族和地区而异。
确定肺功能的种族差异是否因地区而异。
本回顾性队列研究比较了美国不同地区（西部、南部、中西部和东北部）的 CF 患者中，西班牙裔和非西班牙裔白种人之间的纵向肺功能（预测用力肺活量百分比 [FVC]、1 秒用力呼气量 [FEV ]、25%至 75%用力呼气流量 [FEF ]、FEV/FVC 和 FEV 下降）的差异。研究对象年龄为 6 至 25 岁，且在 CF 基金会患者注册中心登记时间为 2008 年至 2013 年。我们使用带有受试者特定斜率和截距的线性混合效应模型，调整了 14 个人口统计学和临床变量。
在 14932 名受试者中，有 1433 名（9.6%）为西班牙裔，13499 名（90.4%）为非西班牙裔白人。在西部，西班牙裔患者的 FEV 比非西班牙裔白人低 9.0%（8.3%-9.8%），而在中西部，西班牙裔患者的 FEV 仅低 4.0%（3.0%-5.0%），在东北部低 4.4%（3.1%-5.7%），在南部低 4.4%（3.2%-5.5%）。同样，与非西班牙裔白人相比，在所有美国地区，西班牙裔患者的 FVC 和 FEF 均较低，其中在西部差异最大。只有在西部，西班牙裔患者的 FEV/FVC 显著降低（-0.019；-0.022 至-0.015）。在任何地区，FEV 下降在种族间均无显著差异。
在 CF 中，与非西班牙裔白人相比，所有地理区域的西班牙裔患者的肺功能均较低，其中在西部差异最大。
