Department of Thoracic Medicine, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.
Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
Medicina (Kaunas). 2021 Oct 25;57(11):1160. doi: 10.3390/medicina57111160.
chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and a history of exposure to noxious stimuli. Cigarette smoking is the most important causal factor for developing COPD. Cadmium, a minor metallic element, is one of the main inorganic components in tobacco smoke. Inhaled cadmium was associated with a decline in lung function, gas exchange impairment, and the development of obstructive lung disease. Patients with COPD who had oxygen desaturation during the 6-min walk test (6MWT) had a significantly worse prognosis than non-desaturation in COPD patients. Nonetheless, few studies have addressed the influence of blood cadmium levels on exercise-induced oxygen desaturation in COPD patients. Our objective was to assess the potential impact of blood cadmium levels on oxygen desaturation during the 6MWT among COPD patients. we performed a retrospective analysis of patients with COPD who were examined for blood cadmium levels in a tertiary care referral center in Taiwan, between March 2020 and May 2021. The 6-min walk test was performed. Normal control subjects who had no evidence of COPD were also enrolled. a total of 73 COPD patients were analyzed and stratified into the high-blood cadmium group (13 patients) and low-blood cadmium group (60 patients). A total of 50 normal control subjects without a diagnosis of COPD were enrolled. The high-blood cadmium group had a significantly higher extent of desaturation than the low-blood cadmium group. The frequency of desaturation during 6MWT revealed a stepwise-increasing trend with an increase in blood cadmium levels. A multivariable logistic regression model revealed that blood cadmium levels were independently associated with desaturation during the 6MWT (odds ratio 12.849 [95% CI 1.168-141.329]; = 0.037). our findings indicate that blood cadmium levels, within the normal range, were significantly associated with desaturation during 6MWT in patients with COPD.
慢性阻塞性肺疾病（COPD）的特征是持续的气流受限和接触有害刺激物的病史。吸烟是导致 COPD 发生的最重要的因果因素。镉是一种次要的金属元素，是烟草烟雾中的主要无机成分之一。吸入的镉与肺功能下降、气体交换受损和阻塞性肺疾病的发展有关。在 6 分钟步行试验（6MWT）中出现氧饱和度下降的 COPD 患者比非缺氧患者的预后明显更差。尽管如此，很少有研究探讨血液镉水平对 COPD 患者运动引起的氧饱和度下降的影响。我们的目的是评估血液镉水平对 COPD 患者 6MWT 期间氧饱和度下降的潜在影响。
我们对 2020 年 3 月至 2021 年 5 月在台湾一家三级转诊中心检查血液镉水平的 COPD 患者进行了回顾性分析。进行了 6 分钟步行试验。还招募了没有 COPD 证据的正常对照受试者。
共分析了 73 例 COPD 患者，并将其分为高血镉组（13 例）和低血镉组（60 例）。共招募了 50 名没有 COPD 诊断的正常对照受试者。高血镉组的脱氧程度明显高于低血镉组。6MWT 期间的脱氧频率随着血液镉水平的增加呈现出逐步增加的趋势。多变量逻辑回归模型显示，血液镉水平与 6MWT 期间的脱氧独立相关（比值比 12.849[95%CI 1.168-141.329]；P=0.037）。
我们的研究结果表明，在正常范围内，血液镉水平与 COPD 患者 6MWT 期间的脱氧显著相关。
