State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, No. 195 Dongfeng Xi Road, Guangzhou, 510000, Guangdong, China.
Guangzhou Laboratory, Bio-Island, Guangzhou, Guangdong, People's Republic of China.
Respir Res. 2022 Sep 4;23(1):229. doi: 10.1186/s12931-022-02148-w.
Aging has been evidenced to bring about some structural and functional lung changes, especially in COPD. However, whether aging affects SAD, a possible precursor of COPD, has not been well characterized.
We aimed to comprehensively assess the relationship between aging and SAD from computed tomography, impulse oscillometry, and spirometry perspectives in Chinese.
We included 1859 participants from ECOPD, and used a linear-by-linear association test for evaluating the prevalence of SAD across various age subgroups, and multivariate regression models for determining the impact of age on the risk and severity of SAD. We then repeated the analyses in these subjects stratified by airflow limitation.
The prevalence of SAD increases over aging regardless of definitional methods. After adjustment for other confounding factors, per 10-yrs increase in age was significantly associated with the risk of CT-defined SAD (OR 2.57, 95% CI 2.13 to 3.10) and the increase in the severity of air trapping (β 2.09, 95% CI - 0.06 to 4.25 for LAA), airway reactance (β - 0.02, 95% CI - 0.04 to - 0.01 for X5; β 0.30, 95% CI 0.13 to 0.47 for AX; β 1.75, 95% CI 0.85 to 2.66 for Fres), as well as the decrease in expiratory flow rates (β - 3.95, 95% CI - 6.19 to - 1.71 for MMEF%predicted; β - 5.42, 95% CI - 7.88 to - 2.95 for FEF%predicted) for SAD. All these associations were generally maintained in SAD defined by IOS or spirometry. After stratification of airflow limitation, we further found that the effect of age on LAA was the most significant among almost all subgroups.
Aging is significantly associated with the prevalence, increased risk, as well as worse severity of SAD. CT may be a more optimal measure to assess aging-related SAD. The molecular mechanisms for the role of aging in SAD need to be explored in the future. Trial registration Chinese Clinical Trial Registry ChiCTR1900024643. Registered on 19 July 2019.
衰老已被证明会导致肺部结构和功能发生一些变化，尤其是在 COPD 中。然而，衰老是否会影响 COPD 的潜在前体 SAD 尚不清楚。
我们旨在从 CT、脉冲振荡和肺量计的角度全面评估衰老与 SAD 之间的关系。
我们纳入了来自 ECOPD 的 1859 名参与者，使用线性-线性关联检验评估不同年龄亚组中 SAD 的患病率，并使用多元回归模型确定年龄对 SAD 风险和严重程度的影响。然后，我们在这些按气流受限分层的受试者中重复了这些分析。
无论采用何种定义方法，SAD 的患病率均随年龄增长而增加。在校正其他混杂因素后，年龄每增加 10 年，与 CT 定义的 SAD 风险（OR 2.57，95%CI 2.13 至 3.10）和空气潴留严重程度（β 2.09，95%CI -0.06 至 4.25 对于 LAA）、气道阻力（β-0.02，95%CI-0.04 至-0.01 对于 X5；β0.30，95%CI 0.13 至 0.47 对于 AX；β1.75，95%CI 0.85 至 2.66 对于 Fres）以及呼气流量的降低（β-3.95，95%CI-6.19 至-1.71 对于 MMEF%predicted；β-5.42，95%CI-7.88 至-2.95 对于 FEF%predicted）均显著相关。这些关联在 IOS 或肺量计定义的 SAD 中基本一致。在气流受限分层后，我们进一步发现，年龄对 LAA 的影响在几乎所有亚组中最为显著。
衰老与 SAD 的患病率、风险增加以及严重程度恶化显著相关。CT 可能是评估衰老相关 SAD 的更优方法。未来需要探索衰老在 SAD 中的作用的分子机制。
中国临床试验注册中心 ChiCTR1900024643。注册于 2019 年 7 月 19 日。
