Yang Kai, Wu Ying, Chen Dandan, Liu Shengming, Chen Rongchang
Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, People's Republic of China.
Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
Clin Epidemiol. 2020 Sep 25;12:997-1005. doi: 10.2147/CLEP.S270599. eCollection 2020.
Spirometric lung function is usually used to evaluate respiratory health. However, the impact of lung function on extra-pulmonary diseases and all-cause mortality has not been fully elucidated, especially in people without chronic obstructive pulmonary disease (COPD).
Participants aged ≥20 and underwent spirometry test from the US National Health and Nutrition Examination Surveys (NHANES) 2007-2012 were analyzed in this study. Multivariate logistic and Cox regressions were used to evaluate the impact of forced expiratory volume in 1 second percent of predicted (FEV% predicted) and forced vital capacity percent of predicted (FVC% predicted) on 14 extra-pulmonary diseases and all-cause morbidity after adjusting for multiple confounders.
During 2007-2012, 1800 COPD patients and 11,437 non-COPD subjects were included. The prevalence of hypertension, diabetes mellitus (DM), dyslipidemia, metabolic syndrome (MS), congestive heart failure (CHF), coronary disease, stroke, chronic kidney disease (CKD), arthritis, cancer, underweight and osteoporosis in COPD patients was higher than that in the non-COPD population. After adjusting for confounders, the decrease of FEV% predicted and FVC% predicted was related with higher odds of having hypertension, DM, obesity, MS, CHF, coronary disease and depression (OR > 1, <0.05) in both the COPD and non-COPD populations. These 2 indices were also related with higher odds of dyslipidemia, CKD, arthritis and osteoporosis in the non-COPD population. The risk of stroke, anemia and cancer was not related with the decrease of lung function. In addition, the decrease of lung function was independent risk factors for the increase of all-cause mortality. These risks were gradually increased with the decrease of lung function.
The decrease of FEV% predicted and FVC% predicted was related with higher risk of multiple extra-pulmonary diseases and all-cause mortality in both the COPD and non-COPD population.
肺量计测定的肺功能通常用于评估呼吸健康状况。然而，肺功能对肺外疾病和全因死亡率的影响尚未完全阐明，尤其是在无慢性阻塞性肺疾病（COPD）的人群中。
本研究分析了2007 - 2012年美国国家健康与营养检查调查（NHANES）中年龄≥20岁且接受了肺量计测试的参与者。在调整多个混杂因素后，使用多变量逻辑回归和Cox回归来评估一秒用力呼气量占预计值百分比（FEV%预计值）和用力肺活量占预计值百分比（FVC%预计值）对14种肺外疾病和全因病发病率的影响。
在2007 - 2012年期间，纳入了1800例COPD患者和11437例非COPD受试者。COPD患者中高血压、糖尿病（DM）、血脂异常、代谢综合征（MS）、充血性心力衰竭（CHF）、冠心病、中风、慢性肾脏病（CKD）、关节炎、癌症、体重过轻和骨质疏松症的患病率高于非COPD人群。调整混杂因素后，在COPD和非COPD人群中，FEV%预计值和FVC%预计值的降低均与患高血压、DM、肥胖、MS、CHF、冠心病和抑郁症的较高几率相关（OR > 1，<0.05）。在非COPD人群中，这两个指标还与血脂异常、CKD、关节炎和骨质疏松症的较高几率相关。中风、贫血和癌症的风险与肺功能下降无关。此外，肺功能下降是全因死亡率增加的独立危险因素。这些风险随着肺功能的下降而逐渐增加。
在COPD和非COPD人群中，FEV%预计值和FVC%预计值的降低均与多种肺外疾病的较高风险和全因死亡率相关。
