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2007 - 2012年美国国家健康与营养检查调查中内脏脂肪代谢评分与成人肺功能之间的关联。

Associations between metabolic score for visceral fat and adult lung functions from NHANES 2007-2012.

作者信息

Zhou Jiacai, You Linlin, Zhou Xin, Li Yuying

机构信息

Department of Respiratory and Critical Care Medicine, School of Clinical Medicine, Southwest Medical University, Luzhou, Sichuan, China.

Inflammation & Allergic Diseases Research Unit, Department of Allergy, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.

出版信息

Front Nutr. 2024 Nov 26;11:1436652. doi: 10.3389/fnut.2024.1436652. eCollection 2024.

Abstract

BACKGROUND

Obesity is a significant part of the factors affecting lung function, and the assessment of obesity using the Metabolic Score for Visceral Fat (METS-VF) is more precise than other indicators like waist circumference and body mass index. This study investigated the relationship between lung function and METS-VF in The National Health and Nutrition Examination Survey (NHANES) database from 2007 to 2012.

METHOD

The data utilized in this study was obtained from National Health and Nutrition Examination Survey spanning the years 2007 to 2012. A multivariate linear regression analysis was employed to investigate the association between METS-VF and lung function, followed by subgroup analysis to identify populations that may exhibit heightened sensitivity. Nonlinear correlations were assessed by fitting a restricted cubic spline, with validation of results conducted via threshold effect analysis.

RESULT

In a study involving 4,356 participants, a weighted multiple linear regression model revealed a significant negative association between the METS-VF and forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and forced expiratory flow between 25 and 75% of FVC (FEF25-75%). However, no association was observed with peak expiratory flow rate (PEF). When dividing the METS-VF into thirds, participants in the highest third exhibited significantly decreased levels of FEV1 (: -342, 95%CI: -440, -245,  < 0.001), FVC (: -312, 95%CI: -431, -192,  < 0.001), FEV1/FVC (: -0.020, 95%CI: -0.030, -0.010,  < 0.001), and FEF25-75% (: -424, 95%CI: -562, -285,  < 0.001). However, there was no significant relationship with PEF (: -89, 95%CI: -325, 147,  = 0.446). RCS curve indicated a nonlinear negative correlation between METS-VF and FEV1, FVC, and FEV1/FVC. For FEV1, a significant negative correlation was found when the METS-VF < 6.426 ( = -158.595, 95%CI: -228.183, -89.007). This negative association became more pronounced when the METS-VF > 6.426 ( = -314.548, 95%CI: -387.326, -241.770). For FVC, a negative association was observed when the METS-VF < 6.401, ( = -5.477, 95%CI: -91.655, 80.702), but it did not reach statistical significance. However, METS-VF > 6.401, METS VF and lung function show a significant negative correlation ( = -399.288, 95%CI: -486.187, -312.388). FEV1/FVC showed a negative correlation only before the inflection point (METS-VF < 6.263) ( = -0.040, 95%CI: -0.047, -0.032), after the inflection point (METS-VF > 6.263), no correlation was found, but there was no statistical significance ( = 0.000; 95%CI: -0.006, 0.007), and METS-VF had a linear negative correlation with FEF25-75%. Subgroup analysis showed that the association was consistent across a variety of demographic factors, including age, sex, race, hypertension, and coronary heart disease. In addition, we found a stronger association between men under 40 and lung function.

CONCLUSION

METS-VF showed a linear negative correlation with FEF25-75%, and a nonlinear negative correlation with FEV1, FVC, FEV1/FVC, and FEF25-75%, but was not associated with PEF, particularly among males under the age of 40. These findings offer valuable insights into managing lung function by controlling visceral fat.

摘要

背景

肥胖是影响肺功能的重要因素之一,使用内脏脂肪代谢评分(METS-VF)评估肥胖比腰围和体重指数等其他指标更精确。本研究利用2007年至2012年美国国家健康与营养检查调查(NHANES)数据库,探究肺功能与METS-VF之间的关系。

方法

本研究使用的数据来自2007年至2012年的美国国家健康与营养检查调查。采用多元线性回归分析探究METS-VF与肺功能之间的关联,随后进行亚组分析以确定可能表现出更高敏感性的人群。通过拟合受限立方样条评估非线性相关性,并通过阈值效应分析验证结果。

结果

在一项涉及4356名参与者的研究中,加权多元线性回归模型显示,METS-VF与第一秒用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC比值以及FVC的25%至75%之间的用力呼气流量(FEF25-75%)呈显著负相关。然而,未观察到与呼气峰值流速(PEF)的关联。将METS-VF分为三等份时,最高三等份的参与者中,FEV1(β = -342,95%CI:-440,-245,P < 0.001)、FVC(β = -312,95%CI:-431,-192,P < 0.001)、FEV1/FVC(β = -0.020,95%CI:-0.030,-0.010,P < 0.001)和FEF25-75%(β = -424,95%CI:-562,-285,P < 0.001)水平显著降低。然而,与PEF无显著关系(β = -89,95%CI:-325,147,P = 0.446)。RCS曲线表明METS-VF与FEV1、FVC和FEV1/FVC之间存在非线性负相关。对于FEV1,当METS-VF < 6.426时,发现显著负相关(β = -158.595,95%CI:-228.183,-89.007)。当METS-VF > 6.426时,这种负相关变得更加明显(β = -314.548,95%CI:-387.326,-241.770)。对于FVC,当METS-VF < 6.401时,观察到负相关(β = -5.477,95%CI:-91.655,80.702),但未达到统计学意义。然而,当METS-VF > 6.401时,METS-VF与肺功能显示出显著负相关(β = -399.288,95%CI:-486.187,-312.388)。FEV1/FVC仅在拐点之前(METS-VF < 6.263)显示负相关(β = -0.040,95%CI:-0.047,-0.032),在拐点之后(METS-VF > 6.263)未发现相关性,但无统计学意义(P = 0.000;95%CI:-0.006,0.007),并且METS-VF与FEF25-75%呈线性负相关。亚组分析表明,在包括年龄、性别、种族、高血压和冠心病在内的各种人口统计学因素中,这种关联是一致的。此外,我们发现40岁以下男性与肺功能之间的关联更强。

结论

METS-VF与FEF25-75%呈线性负相关,与FEV1、FVC、FEV1/FVC呈非线性负相关,但与PEF无关,尤其是在40岁以下男性中。这些发现为通过控制内脏脂肪来管理肺功能提供了有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c7/11628286/51f31286e83b/fnut-11-1436652-g001.jpg

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