Washio Yasuyoshi, Sakata Satoko, Fukuyama Satoru, Honda Takanori, Kan-O Keiko, Shibata Mao, Hata Jun, Inoue Hiromasa, Kitazono Takanari, Matsumoto Koichiro, Ninomiya Toshiharu
Research Institute for Diseases of the Chest.
Department of Epidemiology and Public Health.
Am J Respir Crit Care Med. 2022 Sep 1;206(5):563-572. doi: 10.1164/rccm.202110-2302OC.
Several Western studies have reported that participants with preserved ratio impaired spirometry (PRISm) have higher risks of airflow limitation (AFL) and death. However, evidence in East Asian populations is limited. To investigate the relationship between PRISm and the risks of death and incident AFL in a Japanese population. A total of 3,032 community-dwelling Japanese participants aged ⩾40 years were seen in follow-up for a median of 5.3 years by annual spirometry examinations. Participants were classified into lung function categories at baseline as follows: normal spirometry (FEV/FVC ⩾0.70 and FEV ⩾80% predicted), PRISm (⩾0.70 and <80%), AFL Global Initiative for Chronic Obstructive Lung Disease 1 (<0.70 and ⩾80%), and AFL Global Initiative for Chronic Obstructive Lung Disease 2-4 (<0.70 and <80%). Hazard ratios (HRs) and their 95% confidence intervals were computed using a Cox proportional hazards model. During the follow-up period, 131 participants died, 22 of whom died of cardiovascular disease, and 218 participants developed AFL. When examining the prognosis of each baseline lung function category, participants with PRISm had higher risks of all-cause death (HR, 2.20; 95% confidence interval, 1.35-3.59) and cardiovascular death (HR, 4.07; 1.07-15.42) than those with normal spirometry after adjusting for confounders. Moreover, the multivariable-adjusted risk of incident AFL was greater in participants with PRISm than in those with normal spirometry (HR, 2.48; 1.83-3.36). PRISm was associated with higher risks of all-cause and cardiovascular death and a greater risk of the development of AFL in a Japanese community.
几项西方研究报告称，肺量计检查中比率保留但肺功能受损（PRISm）的参与者气流受限（AFL）和死亡风险更高。然而，东亚人群中的相关证据有限。为了研究日本人群中PRISm与死亡风险及新发AFL之间的关系。通过年度肺量计检查，对总共3032名年龄≥40岁的日本社区居民参与者进行了中位时间为5.3年的随访。参与者在基线时被分类为以下肺功能类别：肺量计正常（FEV/FVC≥0.70且FEV≥预测值的80%）、PRISm（≥0.70且<80%）、慢性阻塞性肺疾病全球倡议1级AFL（<0.70且≥80%）和慢性阻塞性肺疾病全球倡议2 - 4级AFL（<0.70且<80%）。使用Cox比例风险模型计算风险比（HRs）及其95%置信区间。在随访期间，131名参与者死亡，其中22人死于心血管疾病，218名参与者发生了AFL。在检查每个基线肺功能类别的预后时，调整混杂因素后，PRISm参与者的全因死亡风险（HR，2.20；95%置信区间，1.35 - 3.59）和心血管死亡风险（HR，4.07；1.07 - 15.42）高于肺量计正常的参与者。此外，PRISm参与者发生新发AFL的多变量调整风险高于肺量计正常的参与者（HR，2.48；1.83 - 3.36）。在日本社区，PRISm与全因和心血管死亡的较高风险以及AFL发生的较大风险相关。
