Regional variations in longitudinal pulmonary function: A comparison of Hispanic and non-Hispanic subjects with cystic fibrosis in the United States
Regional variations in longitudinal pulmonary function: A comparison of Hispanic and non-Hispanic subjects with cystic fibrosis in the United States
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DOI：
10.1002/ppul.24377
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发表时间：
2019-09-01
影响因子：
3.1
通讯作者：
Ly, Ngoc P.
中科院分区：
文献类型：
--
作者：
McGarry, Meghan E.;Neuhaus, John M.;Ly, Ngoc P.
背景 患有囊性纤维化 (CF) 的西班牙裔受试者的发病率和死亡率高于非西班牙裔白人受试者。死亡率的种族差异因地区而异。影响肺功能的因素因种族和地区而异。目的确定肺功能的种族差异是否因地区而异。方法 这项回顾性队列研究比较了美国人口普查地区（西部、南部、中西部和西部）患有 CF 的西班牙裔和非西班牙裔白人 CF 受试者之间纵向肺功能（预测用力肺活量百分比 [FVC]、1 秒用力呼气量 [FEV1]、25% 至 75% 用力呼气流量 [FEF25-75]、FEV1/FVC 和 FEV1 下降）的差异。东北）。受试者年龄为 6 至 25 岁，2008 年至 2013 年在 CF 基金会患者登记处。我们使用具有受试者特定斜率和截距的线性混合效应模型，调整 14 个人口统计和临床变量。结果 在 14 932 名受试者中，1433 名 (9.6%) 为西班牙裔，13 499 名 (90.4%) 为非西班牙裔白人。西部地区西班牙裔受试者的 FEV1 比非西班牙裔白人受试者低 9.0% (8.3%-9.8%)，而中西部地区西班牙裔受试者的 FEV1 仅低 4.0% (3.0%-5.0%)，东北部低 4.4% (3.1%-5.7%)，南部低 4.4% (3.2%-5.5%)。同样，在美国所有地区，西班牙裔受试者的 FVC 和 FEF25-75 均低于非西班牙裔白人受试者，其中西部地区差异最大。仅在西方，西班牙裔受试者的 FEV1/FVC 显着较低（-0.019；-0.022 至 -0.015）。 FEV1 下降在任何地区的种族之间没有显着差异。结论 在 CF 中，所有地理区域中西班牙裔受试者的肺功能均低于非西班牙裔白人受试者，其中西部地区差异最大。
Background Hispanic subjects with cystic fibrosis (CF) have increased morbidity and mortality than non-Hispanic white subjects. The ethnic disparity in mortality varies by region. Factors influencing pulmonary function vary by both ethnicity and region. Objective To determine if the ethnic difference in pulmonary function varies by region. Methods This retrospective cohort study compared differences in longitudinal pulmonary function (percent-predicted forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], forced expiratory flow at 25% to 75% [FEF25-75], FEV1/FVC, and FEV1 decline) between Hispanic and non-Hispanic white subjects with CF by Census region of the United States (West, South, Midwest, and Northeast). Subjects were of ages 6 to 25 years and in the CF Foundation Patient Registry from 2008 to 2013. We used linear mixed effects models with subject-specific slopes and intercepts, adjusting for 14 demographic and clinical variables. Results Of 14 932 subjects, 1433 (9.6%) were Hispanic and 13 499 (90.4%) were non-Hispanic white. Hispanic subjects' FEV1 was 9.0% (8.3%-9.8%) lower than non-Hispanic white subjects in the West, while Hispanic subjects' FEV1 was only 4.0% (3.0%-5.0%) lower in the Midwest, 4.4% (3.1%-5.7%) lower in the Northeast, and 4.4% (3.2%-5.5%) lower in the South. Similarly, FVC and FEF25-75 were lower among Hispanic subjects compared to non-Hispanic white subjects in all US regions, with the biggest differences in the West. Only in the West was FEV1/FVC significantly lower in Hispanic subjects (-0.019; -0.022 to -0.015). FEV1 decline was not significantly different between ethnicities in any region. Conclusions In CF, Hispanic subjects have lower pulmonary function than non-Hispanic white subjects in all geographic regions with the largest difference in occurring in the West.