School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Lipids Health Dis. 2024 Aug 10;23(1):246. doi: 10.1186/s12944-024-02235-5.
Previous findings have revealed that disorders of lipid metabolism may be a risk factor for pulmonary function damage; however, the combined effect of dyslipidemia and central obesity on pulmonary function is unclear. The cardiometabolic index (CMI) is a composite of serum lipids (triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C)) and visceral fat parameters (waist-to-height ratio (WHtR)). This research aimed to investigate the link between CMI and pulmonary function, employing large-scale demographic data sourced from the National Health and Nutrition Examination Survey (NHANES) database.
This cross-sectional study used data involving 4125 adults aged 20 and above collected by NHANES between 2007 and 2012. We defined CMI as the exposure variable and measured outcomes using forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC to evaluate pulmonary function. Weighted multiple linear regression models and subgroup analyses were employed to investigate separate relationships between CMI and pulmonary function. In addition, to investigate variations across different strata and evaluate the robustness of the findings, interaction tests and sensitivity analyses were conducted.
Results from the weighted multiple linear regression analysis indicated a unit increase in log2-CMI was associated with a reduction of 82.63 mL in FEV1 and 112.92 mL in FVC. The negative association remained significant after transforming log2-CMI by quartile (Q). When the log2-CMI level reached Q4, β coefficients (β) were -128.49 (95% CI: -205.85, -51.13), -169.01 (95% CI: -266.72, -71.30), respectively. According to the interaction test findings, the negative association linking log2-CMI with FEV1 and FVC persists regardless of confounding factors including age, gender, BMI, physical activity (PA), and smoking status. A subsequent sensitivity analysis provided additional confirmation of the stability and reliability of the results. For females, the inflection points for the nonlinear relationships between log2-CMI and FEV1, as well as log2-CMI and FVC, were identified at 2.33 and 2.11, respectively. While in males, a consistent negative association was observed.
Our findings suggest that higher CMI is associated with lower FEV1 and FVC. CMI may serve as a complementary consideration to the assessment and management of pulmonary function in clinical practice.
先前的研究结果表明，脂质代谢紊乱可能是肺功能损害的一个危险因素；然而，血脂异常和中心性肥胖对肺功能的综合影响尚不清楚。心脏代谢指数（CMI）是血清脂质（甘油三酯（TG）/高密度脂蛋白胆固醇（HDL-C））和内脏脂肪参数（腰高比（WHtR））的综合指标。本研究旨在利用国家健康和营养检查调查（NHANES）数据库中的大规模人口统计学数据，探讨 CMI 与肺功能之间的关系。
本横断面研究使用了 2007 年至 2012 年 NHANES 收集的 4125 名 20 岁及以上成年人的数据。我们将 CMI 定义为暴露变量，并使用一秒用力呼气量（FEV1）、用力肺活量（FVC）和 FEV1/FVC 来衡量肺功能。采用加权多线性回归模型和亚组分析分别探讨 CMI 与肺功能之间的单独关系。此外，为了探讨不同分层之间的差异并评估研究结果的稳健性，还进行了交互检验和敏感性分析。
加权多线性回归分析的结果表明，log2-CMI 每增加一个单位，FEV1 减少 82.63mL，FVC 减少 112.92mL。log2-CMI 经四分位（Q）转换后，这种负相关仍然显著。当 log2-CMI 水平达到 Q4 时，β系数（β）分别为-128.49（95%CI：-205.85，-51.13）和-169.01（95%CI：-266.72，-71.30）。根据交互检验结果，无论包括年龄、性别、BMI、体力活动（PA）和吸烟状况在内的混杂因素如何，log2-CMI 与 FEV1 和 FVC 之间的负关联仍然存在。随后的敏感性分析进一步证实了结果的稳定性和可靠性。对于女性，log2-CMI 与 FEV1 以及 log2-CMI 与 FVC 之间的非线性关系的拐点分别为 2.33 和 2.11。而对于男性，观察到一致的负相关关系。
我们的研究结果表明，较高的 CMI 与较低的 FEV1 和 FVC 相关。CMI 可能成为临床实践中评估和管理肺功能的一个补充考虑因素。
