Estilos de Vida, Innovación y Salud, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.
Departamento de Enfermería, Famarcología y Fisioterapia, Universidad de Córdoba, Córdoba, Spain.
JMIR Public Health Surveill. 2023 Sep 5;9:e43737. doi: 10.2196/43737.
Metabolic syndrome (MetS) is a constellation of risk factors increasingly present in the world's population. People with this syndrome are at an increased risk of cardiovascular disease and type 2 diabetes mellitus. Moreover, evidence has shown that it affects different organs. MetS and its risk factors are independently associated with impaired lung function, which can be quantified through spirometric variables.
This study aims to determine whether a high number of MetS criteria is associated with increased lung function decline.
We conducted a descriptive cross-sectional study with a random sample of 1980 workers. Workers with acute respiratory pathology (eg, influenza), chronic respiratory pathology (eg, chronic bronchitis), or exposure to substances harmful to the lungs (eg, organic and inorganic dust) were not included. MetS was established based on harmonized criteria, and lung function was assessed according to spirometric variables. On the basis of these, classification into restrictive lung disease (RLD), obstructive lung disease, and mixed lung disease (MLD) was performed. In addition, the association between MetS and lung function was established based on analysis of covariance, linear trend analysis, and multiple linear regression.
MetS was associated with worse lung function according to all the spirometric parameters analyzed (percentage of predicted forced expiratory volume in 1 second: mean 83, SD 13.8 vs mean 89.2, SD 12.8; P<.001 and percentage of predicted forced vital capacity: mean 85.9, SD 11.6 vs mean 92, SD 11.3; P<.001). Moreover, those diagnosed with MetS had a higher prevalence of lung dysfunction (41% vs 21.9%; P<.001), RLD (23.4% vs 11.2%; P<.001), and MLD (7.3% vs 2.2%; P<.001). Furthermore, an increasing number of MetS criteria was associated with a greater impairment of pulmonary mechanics (P<.001). Similarly, with an increasing number of MetS criteria, there was a significant linear trend (P<.001) in the growth of the prevalence ratio of RLD (0 criteria: 1, 1: 1.46, 2: 1.52, 3: 2.53, 4: 2.97, and 5: 5.34) and MLD (0 criteria: 1, 1: 2.68, 2: 6.18, 3: 9.69, and 4: 11.37). Regression analysis showed that the alteration of all MetS risk factors, adjusted for various explanatory variables, was significantly associated with a worsening of spirometric parameters, except for forced expiratory volume in 1 second/forced vital capacity.
The findings have shown that an increase in cardiometabolic risk factors is associated with a more significant worsening of spirometric variables and a higher prevalence of RLD and MLD. As spirometry could be a crucial tool for monitoring patients at risk of developing chronic pathologies, we conclude that this inexpensive and easily accessible test could help detect changes in lung function in patients with cardiometabolic disorders. This highlights the need to consider the importance of cardiometabolic health in lung function when formulating public health policies.
代谢综合征（MetS）是一种在世界人口中越来越常见的风险因素组合。患有这种综合征的人患心血管疾病和 2 型糖尿病的风险增加。此外，有证据表明它会影响不同的器官。MetS 及其风险因素与肺功能受损独立相关，可以通过肺活量测定变量来量化。
本研究旨在确定存在较多 MetS 标准是否与肺功能下降加速有关。
我们进行了一项描述性的横断面研究，随机抽取了 1980 名工人作为样本。患有急性呼吸道疾病（例如流感）、慢性呼吸道疾病（例如慢性支气管炎）或接触对肺部有害的物质（例如有机和无机粉尘）的工人不包括在内。MetS 根据协调一致的标准确定，肺功能根据肺活量测定变量进行评估。在此基础上，进行了限制性肺疾病（RLD）、阻塞性肺疾病和混合性肺疾病（MLD）的分类。此外，还基于协方差分析、线性趋势分析和多元线性回归，确定了 MetS 与肺功能之间的关联。
根据所有分析的肺活量参数，MetS 与更差的肺功能有关（1 秒用力呼气量百分比：平均 83，SD 13.8 与平均 89.2，SD 12.8；P<.001 和用力肺活量百分比：平均 85.9，SD 11.6 与平均 92，SD 11.3；P<.001）。此外，患有 MetS 的患者更有可能出现肺功能障碍（41%比 21.9%；P<.001）、RLD（23.4%比 11.2%；P<.001）和 MLD（7.3%比 2.2%；P<.001）。此外，随着 MetS 标准数量的增加，肺力学的损害也更大（P<.001）。同样，随着 MetS 标准数量的增加，RLD（无标准：1，1：1.46，2：1.52，3：2.53，4：2.97，5：5.34）和 MLD（无标准：1，1：2.68，2：6.18，3：9.69，4：11.37）的患病率比值呈显著线性趋势（P<.001）。回归分析显示，在调整了各种解释变量后，所有 MetS 风险因素的改变与肺活量参数的恶化显著相关，除了 1 秒用力呼气量/用力肺活量。
研究结果表明，代谢风险因素的增加与肺活量测定变量的显著恶化以及 RLD 和 MLD 的更高患病率有关。由于肺活量测定可能是监测有发展为慢性疾病风险的患者的重要工具，我们得出结论，这种廉价且易于获取的测试可以帮助检测患有代谢紊乱的患者的肺功能变化。这突显了在制定公共卫生政策时，需要考虑代谢健康对肺功能的重要性。
