普通人群中第一秒用力呼气容积/用力肺活量（FEV/FVC）水平与全因死亡率之间的关联。
Association between FEV/FVC levels and all-cause mortality in the general population.
作者信息
Tang Leheng, Wu Fan, Zhang Shiyu, Ou Jie, Liang Juncheng, Peng Ranxi, Liao Siman, Zhou Qiaorui, Chen Yingtong, Guo Xiaozi, Chen Jingxian, Wan Qi, Wang Zihui, Deng Zhishan, Zhou Yumin
机构信息
The First Clinical College, Guangzhou Medical University, Guangzhou, China.
State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
出版信息
BMC Pulm Med. 2025 Mar 11;25(1):108. doi: 10.1186/s12890-025-03573-5.
BACKGROUND
The ratio of the forced expiratory volume in 1 s (FEV) to the forced vital capacity (FVC) is an essential tool for the diagnosis of chronic obstructive pulmonary disease (COPD). However, the relationship between levels of FEV/FVC and mortality in the general population remains unclear, particularly its non-linear relationship. Therefore, we aimed to explore the association between the FEV/FVC and all-cause mortality in the general population.
METHODS
The data of participants included in the National Health and Nutrition Examination Survey (1988-1994 and 2007-2012 cycles) were analyzed. Participants aged ≥20 years, who were not pregnant, who underwent quality-controlled lung function tests, and with follow-up data on mortality status were enrolled. The study outcome was all-cause mortality. The participants were grouped by FEV/FVC ratio in 0.10 increments. Cox proportional-hazards models were used to estimate the association between the FEV/FVC ratio and all-cause mortality before and after confounder adjustment. Non-linear associations were explored using restricted cubic spline curves.
RESULTS
Overall, 25,501 participants were included. During the median follow up of 308 months, 6431 (25.2%) deaths were recorded. Among all participants, the mean age is 46.3 years, and 48.7% of which were male. In unadjusted model, individuals with an FEV/FVC ratio < 0.90 had an increased risk of all-cause mortality compared to those with an FEV/FVC ratio ≥ 0.90. After adjusting for age, sex, body mass index, race, and smoking status, participants in the 0.60 ≤ FEV/FVC < 0.90 group had a lower all-cause mortality risk than those in the FEV/FVC ≥ 0.90 group, while the mortality risk of individuals with an FEV/FVC ratio < 0.50 was higher. Restricted cubic splines revealed a U-shaped association between the FEV/FVC ratio and all-cause mortality. Below and above the inflection point, an inverse trend was observed.
CONCLUSION
Our study first revealed a U-shaped association between the level of FEV/FVC and all-cause mortality in general population.
CLINICAL TRIAL NUMBER
Not applicable.
背景
1秒用力呼气容积（FEV）与用力肺活量（FVC）的比值是诊断慢性阻塞性肺疾病（COPD）的重要工具。然而，一般人群中FEV/FVC水平与死亡率之间的关系仍不清楚，尤其是其非线性关系。因此，我们旨在探讨一般人群中FEV/FVC与全因死亡率之间的关联。
方法
分析了纳入国家健康与营养检查调查（1988 - 1994年和2007 - 2012年周期）的参与者数据。纳入年龄≥20岁、未怀孕、接受了质量控制的肺功能测试且有死亡率随访数据的参与者。研究结局为全因死亡率。参与者按FEV/FVC比值以0.10的增量分组。使用Cox比例风险模型估计FEV/FVC比值与全因死亡率在混杂因素调整前后的关联。使用受限立方样条曲线探索非线性关联。
结果
总体上，纳入了25501名参与者。在308个月的中位随访期内，记录了6431例（25.2%）死亡。在所有参与者中，平均年龄为46.3岁，其中48.7%为男性。在未调整模型中，FEV/FVC比值<0.90的个体与FEV/FVC比值≥0.90的个体相比，全因死亡风险增加。在调整年龄、性别、体重指数、种族和吸烟状况后，FEV/FVC为0.60≤FEV/FVC<0.90组的参与者全因死亡风险低于FEV/FVC≥0.90组，而FEV/FVC比值<0.50的个体死亡风险更高。受限立方样条显示FEV/FVC比值与全因死亡率之间呈U形关联。在拐点以下和以上，观察到相反的趋势。
结论
我们的研究首次揭示了一般人群中FEV/FVC水平与全因死亡率之间的U形关联。
临床试验编号
不适用。
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