Department of Epidemiology, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO.
Minneapolis Veterans Affairs Health Care System, Pulmonary Section, Minneapolis, MN; Department of Medicine, University of Minnesota, Minneapolis, MN.
Ann Epidemiol. 2022 Dec;76:50-60. doi: 10.1016/j.annepidem.2022.10.005. Epub 2022 Oct 14.
We examined the associations between pulmonary impairments and physical function and whether age, HIV serostatus, or smoking modified these relationships.
Using Multicenter AIDS Cohort Study data, we examined associations between pulmonary function (diffusing capacity for carbon monoxide [DL], one-second forced expiratory volume [FEV]) and subsequent physical outcomes (gait speed, grip strength, frailty [non-frail, pre-frail, frail]) using mixed models.
Of 1,048 men, 55% were living with HIV, median age was 57(IQR=48,64) and median cumulative pack-years was 1.2(IQR = 0,18.1); 33% and 13% had impaired DL and FEV(<80% predicted), respectively. Participants with impaired DL had 3.5 kg (95%CI: -4.6, -2.4) weaker grip strength, 0.04 m/sec (95%CI: -0.06, -0.02) slower gait speed and 4.44-fold (95%CI: 1.81, 10.93) greater odds of frailty compared to participants with normal DL. Participants with impaired FEV had 3.1 kg (95%CI: -4.8, -1.4) weaker grip strength, similar gait speed (-0.001 m/sec [95%CI: -0.04, 0.03]) and 5.72-fold (95%CI: 1.90, 17.19) greater odds of frailty compared to participants with normal FEV. Age, but not smoking or HIV, significantly modified the DL effect on gait speed and grip strength.
Pulmonary impairment and decreased physical function were associated. Preserving pulmonary function may help preserve physical function in aging men with and without HIV.
我们研究了肺功能障碍与身体机能之间的关联,以及年龄、HIV 血清状态或吸烟是否会改变这些关系。
我们利用多中心艾滋病队列研究的数据,使用混合模型研究了肺功能(一氧化碳弥散量 [DL],一秒用力呼气量 [FEV])与随后的身体机能(步态速度、握力、虚弱[非虚弱、虚弱前期、虚弱])之间的关联。
在 1048 名男性中,55%携带 HIV,中位年龄为 57(IQR=48,64)岁,中位累计吸烟量为 1.2(IQR=0,18.1)包年;33%和 13%的人 DL 和 FEV 受损(<80%预计值)。与 DL 正常的参与者相比,DL 受损的参与者握力弱 3.5 公斤(95%CI:-4.6,-2.4),步态速度慢 0.04 米/秒(95%CI:-0.06,-0.02),虚弱的几率高 4.44 倍(95%CI:1.81,10.93)。与 FEV 正常的参与者相比,FEV 受损的参与者握力弱 3.1 公斤(95%CI:-4.8,-1.4),步态速度相似(-0.001 米/秒[95%CI:-0.04,0.03]),虚弱的几率高 5.72 倍(95%CI:1.90,17.19)。年龄,但不是吸烟或 HIV,显著改变了 DL 对步态速度和握力的影响。
肺功能障碍与身体机能下降相关。在有和没有 HIV 的老年男性中,保持肺功能可能有助于保持身体机能。