Geng Yang, Ding Yi, Lu Xujia, Pei Yalong, Jankowich Matthew D, Ke Chaofu
Department of Epidemiology and Biostatistics, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China.
Department of Preventive Medicine, College of Clinical Medicine, Suzhou Vocational Health College, Suzhou, Jiangsu, China.
Thorax. 2025 Mar 18;80(4):227-235. doi: 10.1136/thorax-2024-222473.
Although morbidity and mortality are reportedly increased in individuals with preserved ratio impaired spirometry (PRISm), little is known about how to optimise PRISm-related health.
Is Life's Essential 8 (LE8) associated with mortality and cardiovascular morbidity in individuals with PRISm and with PRISm transition trajectories?
Participants with PRISm (n=31 943) with complete data on LE8 and 23 179 individuals with two spirometry measurements were included from the UK Biobank. Eight health components were used to create the LE8 score (0-100). Cox proportional hazards models were used to assess associations of LE8 with cardiovascular morbidity and all-cause, cardiovascular and respiratory mortality. Multinomial logistic regression models were conducted to assess associations between LE8 and transition trajectories of PRISm.
Among participants with PRISm, 3113 (9.75%), 25 254 (79.06%) and 3576 (11.19%) were categorised as high (LE8≥80), moderate (50≤LE8<80) and low LE8 (LE8<50) score groups, respectively. Compared with the high LE8 group, the low LE8 group demonstrated higher risks of cardiovascular disease (HR: 2.702, 95% CI 2.391 to 3.054) and all-cause (2.496, 2.082 to 2.993), cardiovascular (4.165, 2.672 to 6.493) and respiratory mortality (4.103, 1.866 to 9.020). Individuals with low LE8 score (vs high LE8) had higher odds to transition from normal spirometry to PRISm (OR: 2.238, 95% CI 1.638 to 3.057) and lower odds to transition from PRISm to normal spirometry (OR: 0.506, 95% CI 0.339 to 0.757).
A lower LE8 score was associated with increased risks of cardiovascular morbidity and all-cause, cardiovascular and respiratory mortality in PRISm. A lower LE8 score was related to higher likelihood of developing PRISm and lower likelihood of PRISm recovery.
尽管据报道，肺功能测定比值受损但保留（PRISm）的个体的发病率和死亡率有所增加，但对于如何优化与PRISm相关的健康状况知之甚少。
在患有PRISm的个体以及PRISm转变轨迹中，生命基本八项（LE8）是否与死亡率和心血管疾病发病率相关？
从英国生物银行纳入了具有完整LE8数据的PRISm参与者（n = 31943）以及23179名进行了两次肺功能测定的个体。使用八个健康组成部分来创建LE8评分（0 - 100）。Cox比例风险模型用于评估LE8与心血管疾病发病率以及全因、心血管和呼吸死亡率之间的关联。进行多项逻辑回归模型以评估LE8与PRISm转变轨迹之间的关联。
在患有PRISm的参与者中，分别有3113人（9.75%）、25254人（79.06%）和3576人（11.19%）被分类为高（LE8≥80）、中（50≤LE8<80）和低LE8（LE8<50）评分组。与高LE8组相比，低LE8组表现出更高的心血管疾病风险（HR：2.702，95%CI 2.391至3.054）以及全因（2.496，2.082至2.993）、心血管（4.165，2.672至6.493）和呼吸死亡率（4.103，1.866至9.020）。低LE8评分的个体（与高LE8相比）从正常肺功能转变为PRISm的几率更高（OR：2.238，95%CI 1.638至3.057），而从PRISm转变为正常肺功能的几率更低（OR：0.506，95%CI 0.339至0.757）。
较低的LE8评分与PRISm个体的心血管疾病发病率以及全因、心血管和呼吸死亡率的风险增加相关。较低的LE8评分与发生PRISm的较高可能性以及PRISm恢复的较低可能性相关。
