Guangzhou Institute of Respiratory Disease, Guangzhou, Guangdong, China.
First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
BMJ Open Respir Res. 2024 May 15;11(1):e001918. doi: 10.1136/bmjresp-2023-001918.
The prevalence, Medicaid use and mortality risk associated with low forced expiratory volume in 1 s (FEV) among young adults aged 20-35 years are not well understood, despite its potential implications for the development of chronic pulmonary disease and overall prognosis.
A retrospective cohort study was conducted among young adults aged 20-35 years old, using data from the National Health and Nutrition Examination Survey, National Death Index and Centers for Medicare & Medicaid Services. Participants were categorised into a low FEV group (pre-bronchodilator FEV%pred <80%) and a normal FEV group (FEV%pred ≥80%). Weighted logistic regression analysis was employed to identify the risk factors associated with low FEV, while Cox proportional hazard models were used to calculate the hazard ratio (HR) for Medicaid use and the all-cause mortality between the two groups.
A total of 5346 participants aged 20-35 were included in the study, with 329 in the low FEV group and 5017 in the normal group. The weighted prevalence of low FEV among young adults was 7.1% (95% CI 6.0 to 8.2). Low body mass index (OR=3.06, 95% CI 1.79 to 5.24), doctor-diagnosed asthma (OR=2.25, 1.28 to 3.93), and wheezing or whistling (OR=1.57, 1.06 to 2.33) were identified as independent risk factors for low FEV. Over a 15-year follow-up, individuals in the low FEV group exhibited a higher likelihood of Medicaid use compared with those in the normal group (HR=1.73, 1.07 to 2.79). However, there was no statistically significant increase in the risk of all-cause mortality over a 30-year follow-up period (HR=1.48, 1.00 to 2.19).
A considerable portion of young adults demonstrated low FEV levels, a characteristic that was associated with a higher risk of Medicaid use over a long-term follow-up, yet not linked to an augmented risk of all-cause mortality.
尽管低用力呼气量（FEV）可能对慢性肺部疾病的发展和整体预后有影响，但 20-35 岁的年轻成年人中，其流行程度、医疗补助使用情况和死亡率风险尚不清楚。
这项回顾性队列研究使用了来自国家健康和营养检查调查、国家死亡指数和医疗补助和医疗保险服务中心的数据，对 20-35 岁的年轻人进行了研究。参与者被分为低 FEV 组（支气管扩张剂前 FEV%预测值 <80%）和正常 FEV 组（FEV%预测值≥80%）。采用加权 logistic 回归分析确定与低 FEV 相关的危险因素，同时使用 Cox 比例风险模型计算两组之间医疗补助使用和全因死亡率的风险比（HR）。
研究共纳入 5346 名 20-35 岁的参与者，其中低 FEV 组 329 名，正常 FEV 组 5017 名。年轻成年人中低 FEV 的加权患病率为 7.1%（95%CI 6.0 至 8.2）。低体重指数（OR=3.06，95%CI 1.79 至 5.24）、医生诊断的哮喘（OR=2.25，1.28 至 3.93）和喘息或喘鸣（OR=1.57，1.06 至 2.33）被确定为低 FEV 的独立危险因素。在 15 年的随访中，与正常 FEV 组相比，低 FEV 组使用医疗补助的可能性更高（HR=1.73，1.07 至 2.79）。然而，在 30 年的随访期间，全因死亡率的风险没有统计学意义上的增加（HR=1.48，1.00 至 2.19）。
相当一部分年轻成年人的 FEV 水平较低，这一特征与长期随访中医疗补助使用风险增加有关，但与全因死亡率增加无关。
