Association of FVC and Total Mortality in US Adults With Metabolic Syndrome and Diabetes
Association of FVC and Total Mortality in US Adults With Metabolic Syndrome and Diabetes
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DOI：
10.1378/chest.08-1901
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发表时间：
2009-07-01
期刊：
影响因子：
9.6
通讯作者：
Wong, Nathan D.
中科院分区：
文献类型：
--
作者：
Lee, Hwa Mu;Chung, Sarah J.;Wong, Nathan D.
背景资料：肺功能降低是代谢综合征（MetS）和糖尿病（DM）的独立预测因子，与死亡率增加相关。我们调查是否降低肺功能与死亡率增加的人与这些conditions.Methods：我们检查了5,633（预计，6240万）美国成年人（年龄范围，IS至79岁）在第三次全国健康和营养检查调查，谁是从不吸烟者，没有已知的心血管或阻塞性肺病。采用考克斯回归（校正了年龄、性别和种族）分析了患有代谢综合征、糖尿病或无代谢综合征的患者的FVC分类（FVC：低，≥ 95%预测值）的全因死亡风险。结果：随着预测FVC的降低，糖尿病和代谢综合征的患病率显著增加（p < 0.01）。在既无MetS也无DM（3.5 - 8.0）、MetS（4.1 - 8.1）和DM（9.9 - 13.3）的患者中，年龄和性别校正的死亡率（每1，000人-年）随预测FVC降低而逐步升高。与FVC高的患者相比，MetS患者中FVC低的患者的死亡率增加了4倍以上（风险比[HR]，4.27; 95%置信区间[CI]，1.59至11.45; p < 0.01），并且在两种疾病均未发生的患者中增加了两倍以上（HR，2.40; 95% CI，1.06至5.43; p < 0.05）。此外，在MetS患者中，FVC每降低10%，死亡率就增加77%（HR，1.77; 95%CI，1.33 - 2.37; p < 0.05）。然而，在那些与DM，FVC并没有进一步增加死亡率risk.Conclusion：在人与代谢综合征，减少FVC与死亡率的进一步增加，这表明肺功能的评价可能是有用的危险分层与代谢综合征。（CHEST 2009，136：171-176）
Background: Reduced pulmonary function is an independent predictor of metabolic syndrome (MetS) and diabetes mellitus (DM), conditions associated with increased mortality. We investigated whether reduced pulmonary function is associated with increased mortality in persons with these conditions.Methods: We examined 5,633 (projected, 62.4 million) US adults (age range, IS to 79 years) in the Third National Health and Nutrition Examination Survey, who were never-smokers and were without known cardiovascular or obstructive lung disease. Cox regression (adjusted for age, sex, and ethnicity) was used to examine all-cause mortality risk across FVC categories (FVC: low, = 95% predicted) among those with MetS, DM, or neither disease.Results: The prevalence of DM and MetS significantly increased as predicted FVC decreased (p < 0.01). Age- and sex-adjusted mortality rates (per 1,000 person-years) increased in a stepwise manner as predicted FVC decreased in those patients with neither MetS nor DM (3.5 to 8.0), MetS (4.1 to 8.1), and DM (9.9 to 13.3). Compared to those with high FVC, those with low FVC had more than a fourfold increase in mortality among those with MetS (hazard ratio [HR], 4.27; 95% confidence interval [CI], 1.59 to 11.45; p < 0.01) and more than a twofold increase among those with neither disease (HR, 2.40; 95% CI, 1.06 to 5.43; p < 0.05). Also, every 10% reduction in FVC was associated with a 77% higher mortality (HR, 1.77; 95% CI, 1.33 to 2.37; p < 0.05) among persons with MetS. However, in those with DM, FVC did not contribute further to mortality risk.Conclusion: In persons with MetS, a reduced FVC is associated with further increases in mortality, suggesting that the evaluation of lung function may be useful for risk stratification in those with MetS. (CHEST 2009,136:171-176)