Department of Pulmonary Diseases, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Meilahti Triangle Hospital, 6th Floor, PO Box 372, 00029 HUS, Helsinki, Finland; National Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland.
University of Turku, Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, PO Box 52 (Hämeentie 11), 20521, Turku, Finland; Finnish Lung Health Association (FILHA), Filha ry, Sibeliuksenkatu 11 A 1, 00250, Helsinki, Finland.
Respir Med. 2023 Feb;207:107112. doi: 10.1016/j.rmed.2022.107112. Epub 2022 Dec 31.
We studied asthma, COPD, and asthma-COPD overlap (ACO) to predict mortality in a cohort of Finnish adults with an 18-year follow up.
A national health examination survey representing Finnish adults aged ≥30 years was performed in 2000-2001. The study cohort included 5922 participants (73.8% of the sample) with all relevant data, including a comprehensive clinical examination and spirometry. These participants were followed continuously from baseline until end of 2018 for total, cardiovascular, cancer, and respiratory mortality through a record linkage. Asthma, COPD, and ACO were defined based on the survey data, including spirometry and register data. There were three separate groups of obstructive subjects (one definition excluding the others).
Asthma and COPD were significantly associated with higher total mortality in Cox's model adjusted for sex, age, smoking, education level, BMI, leisure time physical activity, cardiovascular disease, diabetes, and hypertension. Hazard ratios (HR) (95% confidence interval [CI]) for asthma, COPD, and ACO were 1.29 (1.05-1.58), 1.50 (1.20-1.88), and 1.26 (0.97-1.65), respectively. Additionally, asthma (HR 1.47, 95% CI 1.09-1.97) and COPD (HR 1.53, 95% CI 1.08-2.16) were associated with cardiovascular mortality. Although ACO did not predict mortality in the whole cohort, there was a significant association with mortality risk among those with hs-CRP 1-2.99 mg/l.
Asthma or COPD predicts higher total mortality and premature death from cardiovascular diseases.
我们研究了哮喘、COPD 和哮喘-COPD 重叠（ACO），以预测芬兰成年人队列中 18 年随访的死亡率。
2000-2001 年进行了一项代表芬兰≥30 岁成年人的全国健康检查调查。研究队列包括 5922 名参与者（样本的 73.8%），他们具有所有相关数据，包括全面的临床检查和肺功能检查。这些参与者从基线开始连续随访至 2018 年底，通过记录链接跟踪总死亡率、心血管死亡率、癌症死亡率和呼吸死亡率。哮喘、COPD 和 ACO 是根据调查数据（包括肺功能检查和登记数据）定义的。有三组阻塞性疾病患者（一种定义排除其他定义）。
在调整性别、年龄、吸烟、教育程度、BMI、休闲时间体力活动、心血管疾病、糖尿病和高血压后，哮喘和 COPD 在 Cox 模型中与总死亡率显著相关。哮喘、COPD 和 ACO 的风险比（HR）（95%置信区间[CI]）分别为 1.29（1.05-1.58）、1.50（1.20-1.88）和 1.26（0.97-1.65）。此外，哮喘（HR 1.47，95% CI 1.09-1.97）和 COPD（HR 1.53，95% CI 1.08-2.16）与心血管死亡率相关。尽管 ACO 并未预测整个队列的死亡率，但在 hs-CRP 为 1-2.99mg/l 的患者中，与死亡率风险存在显著关联。
哮喘或 COPD 预测总死亡率和心血管疾病导致的过早死亡风险增加。
