慢性阻塞性肺疾病和/或代谢综合征相关心血管事件风险：一项大规模全国范围内基于人群的队列研究。

Risk of Cardiovascular Events Associated with Chronic Obstructive Pulmonary Disease and/or Metabolic Syndrome: A Large-Scale Nationwide Population-Based Cohort Study.

机构信息

Yonsei University Wonju College of Medicine, Wonju, 26426, Korea.

Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Korea.

出版信息

Int J Chron Obstruct Pulmon Dis. 2024 Jun 25;19:1447-1456. doi: 10.2147/COPD.S458779. eCollection 2024.

DOI:10.2147/COPD.S458779

PMID:38948908

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11214538/

Abstract

PURPOSE

Chronic obstructive pulmonary disease (COPD) and metabolic syndrome (MetS) are among the most prevalent conditions that might predispose individuals to life-threatening events. We aimed to examine their associations with cardiovascular (CV) events and mortality using a large-scale population dataset from the National Health Information Database in Korea.

PATIENTS AND METHODS

This population-based cohort study enrolled adults aged ≥40 years who had undergone more than two health examinations between 2009 and 2011. They were divided into four groups based on the presence of COPD and MetS. Analysis of the outcomes and CV events or deaths was performed from 2014 to 2019. We compared CV event incidence and mortality rates using a multivariate Cox proportional hazards model and Kaplan-Meier curves.

RESULTS

Totally, 5,101,810 individuals were included, among whom 3,738,458 (73.3%) had neither COPD nor MetS, 1,193,014 (23.4%) had only MetS, 125,976 (2.5%) had only COPD, and 44,362 (0.9%) had both. The risk of CV events was significantly higher in individuals with both COPD and MetS than in those with either COPD or MetS alone (HRs: 2.4 vs 1.6 and 1.8, respectively; all P <0.001). Similarly, among those with both COPD and MetS, all-cause and CV mortality risks were also elevated (HRs, 2.9 and 3.0, respectively) compared to the risks in those with either COPD (HRs, 2.6 and 2.1, respectively) or MetS (HRs, 1.7 and 2.1, respectively; all P <0.001).

CONCLUSION

The comorbidity of MetS in patients with COPD increases the incidence of CV events and all-cause and cardiovascular mortality rates.

摘要

目的

慢性阻塞性肺疾病（COPD）和代谢综合征（MetS）是最常见的疾病之一，可能使个体易发生危及生命的事件。我们旨在使用来自韩国国家健康信息数据库的大规模人群数据集来检查它们与心血管（CV）事件和死亡率的关系。

方法

这项基于人群的队列研究纳入了 2009 年至 2011 年期间接受了两次以上健康检查的年龄≥40 岁的成年人。他们根据是否存在 COPD 和 MetS 分为四组。从 2014 年到 2019 年，对结局和 CV 事件或死亡进行分析。我们使用多变量 Cox 比例风险模型和 Kaplan-Meier 曲线比较 CV 事件发生率和死亡率。

结果

总共纳入了 5101810 人，其中 3738458 人（73.3%）既没有 COPD 也没有 MetS，1193014 人（23.4%）只有 MetS，125976 人（2.5%）只有 COPD，44362 人（0.9%）同时患有 COPD 和 MetS。与仅有 COPD 或 MetS 的个体相比，同时患有 COPD 和 MetS 的个体 CV 事件的风险明显更高（HRs：2.4 比 1.6 和 1.8，均 P<0.001）。同样，在同时患有 COPD 和 MetS 的个体中，全因和 CV 死亡率的风险也升高（HRs，分别为 2.9 和 3.0），与仅有 COPD（HRs，分别为 2.6 和 2.1）或 MetS（HRs，分别为 1.7 和 2.1）的个体相比（均 P<0.001）。