Department of Respiratory, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center of Chinese PLA General Hospital, Beijing, China.
Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center of Chinese PLA General Hospital, Beijing, China.
Heart Lung Circ. 2023 Oct;32(10):1167-1177. doi: 10.1016/j.hlc.2023.06.862. Epub 2023 Aug 12.
Chronic lung diseases (CLDs) and cardiovascular diseases (CVDs) are the main chronic diseases responsible for a considerable burden of disease. This study aimed to estimate the interrelation of CLDs and CVDs using two Chinese national longitudinal cohort studies.
The China Health and Retirement Longitudinal Study (CHARLS) and Chinese Longitudinal Healthy Longevity Survey (CLHLS) were used in this study with 15,052 and 9,765 participants, respectively. The Cox proportional risk model was used to estimate the interrelation between CLDs and CVDs. Mediating effects were performed to detect possible influencing pathways between CLDs and CVDs.
The association of CLDs with CVDs was identified in 1,647 participants (10.9%) with newly diagnosed CVDs in CHARLS and 332 participants (11.6%) in CLHLS. The Cox proportional risk model showed that CLDs were a significant predictor of CVDs (HR 1.49, 95% CI 1.27-1.76) after adjusting for covariates, and the hazard ratios of stroke and CVDs excluding stroke were (HR 1.02, 95% CI 0.79-1.31) and (HR 1.76, 95% CI 1.46-2.13), respectively. These association were mediated by body mass index (BMI) and Center for Epidemiological Studies Depression Scale (CES-D-10) scores. No significant association was found in CHARLS and CLHLS regarding CVDs with CLDs. In CHARLS, CVDs was a significant predictor of CLDs (HR 1.40, 95% CI 1.09-1.79).
Chronic lung disease was associated with increased incidence of CVDs in middle-aged and older people in the community population and vice versa. Body mass index and depressive symptoms might be mediated by the effect of CLD on CVD.
慢性肺部疾病（CLD）和心血管疾病（CVD）是导致疾病负担的主要慢性疾病。本研究旨在使用两项中国国家纵向队列研究来评估 CLD 和 CVD 之间的相互关系。
本研究使用了中国健康与养老追踪调查（CHARLS）和中国老年健康长寿调查（CLHLS），分别纳入了 15052 名和 9765 名参与者。采用 Cox 比例风险模型来估计 CLD 和 CVD 之间的相互关系。进行中介效应分析以检测 CLD 和 CVD 之间可能的影响途径。
CHARLS 中有 1647 名参与者（10.9%）和 CLHLS 中有 332 名参与者（11.6%）在研究期间被诊断为新发 CVD。Cox 比例风险模型显示，在调整了协变量后，CLD 是 CVD 的显著预测因素（HR 1.49，95%CI 1.27-1.76），且中风和不包括中风的 CVD 的风险比分别为（HR 1.02，95%CI 0.79-1.31）和（HR 1.76，95%CI 1.46-2.13）。这些关联是通过体重指数（BMI）和流行病学研究抑郁量表（CES-D-10）评分的中介作用实现的。在 CHARLS 和 CLHLS 中，均未发现 CVD 与 CLD 之间存在显著关联。在 CHARLS 中，CVD 是 CLD 的显著预测因素（HR 1.40，95%CI 1.09-1.79）。
在社区人群中，中年及以上人群的慢性肺部疾病与 CVD 发生率增加有关，反之亦然。BMI 和抑郁症状可能是 CLD 对 CVD 影响的中介因素。
