Aging-Related Considerations When Evaluating the Forced Expiratory Volume in 1 Second (FEV1) Over Time
Aging-Related Considerations When Evaluating the Forced Expiratory Volume in 1 Second (FEV1) Over Time
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DOI：
10.1093/gerona/glv201
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发表时间：
2016-07-01
影响因子：
5.1
通讯作者：
Gill, Thomas M.
中科院分区：
文献类型：
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作者：
Fragoso, Carlos A. Vaz;McAvay, Gail;Gill, Thomas M.
背景资料：1秒用力呼气量（FEV 1）随时间的变化通常以升和预测百分比（%Pred）表示，或者以L/m（3）和Z评分表示。哪种方法更有临床意义尚未得到评价。因为它独特地解释了年龄对FEV 1和肺功能的影响，我们假设Z评分方法更有临床意义，基于心肺预测因子和FEV 1随时间的相关性。方法：使用线性混合效应模型和来自巴尔的摩老龄化纵向研究的数据，我们纳入了501名年龄在40-95岁之间的白色参与者，他们至少完成了三次纵向肺量计评估，我们评估了心肺预测因子之间的相关性。（肥胖、吸烟状况、高血压、慢性支气管炎、糖尿病和心肌梗死）和FEV 1随时间的变化，单位为升、%Pred、L/m（3）和Z评分。FEV 1的平均基线值为3.240 L，96.4% Pred，0.621 L/m（3），Z评分为-0.239（第40.6百分位数）。FEV 1的年下降率为0.040 L、0.234% Pred、0.007 L/m（3）和0.008 Z评分单位。基线年龄与FEV 1随时间变化的升数和L/m3相关（p <0.001），包括%Pred的时间交互作用（p <0.001），但与Z评分无关（p = 0.933）。当使用Z分数时，心肺预测因子与FEV 1随时间的相关性都是显著的（p <0.05）。
Background: Forced expiratory volume in 1 second (FEV1) over time is commonly expressed in liters and percent predicted (%Pred), or alternatively in L/m(3) and Z-scores. which approach is more clinically meaningful has not been evaluated. Because it uniquely accounts for the effect of aging on FEV1 and spirometric performance, we hypothesized that the Z-score approach is more clinically meaningful, based on associations between cardiopulmonary predictors and FEV1 over time.Methods: Using linear mixed-effects models and data from the Baltimore Longitudinal Study on Aging, including 501 white participants aged 40-95 who had completed at least three longitudinal spirometric assessments, we evaluated the associations between cardiopulmonary predictors (obesity, smoking status, hypertension, chronic bronchitis, diabetes mellitus, and myocardial infarction) and FEV1 over time, in liters, %Pred, L/m(3), and Z-scores.Results: Mean baseline values for FEV1 were 3.240 L, 96.4% Pred, 0.621 L/m(3), and -0.239 as a Z-score (40.6th percentile). The annual decline in FEV1 was 0.040 L, 0.234 %Pred, 0.007 L/m(3), and 0.008 Z-score units. Baseline age was associated with FEV1 over time in liters and L/m(3) (p < .001), and included a time interaction for %Pred (p < .001), but was not associated with Z-scores (p = .933). The associations of cardiopulmonary predictors with FEV1 over time were all significant when using Z-scores (p <