The determinants of pulmonary diffusing capacity in a national sample of US adults
The determinants of pulmonary diffusing capacity in a national sample of US adults
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DOI：
10.1164/ajrccm.153.2.8564114
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发表时间：
1996-02-01
影响因子：
24.7
通讯作者：
Schwartz, J
中科院分区：
文献类型：
--
作者：
Neas, LM;Schwartz, J
种族和性别在单呼吸肺一氧化碳弥散能力（DL(CO)）方面的差异以前很少受到关注。1971年至1975年间，第一次全国健康和营养检查调查确定了4439名年龄在25岁至74岁之间居住在美国的成年人的DL(CO)，其中包括2345名女性和438名黑人。大样本允许评估与DL（CO）的相互作用和非线性关系，以及它与炎症生物标志物的关联。在一个单独的种族、性别和吸烟状况的模型中，与FVC、身高、体重、血红蛋白浓度呈正相关，与年龄和中性粒细胞计数负相关，解释了女性DL（CO）变异的59%，DL（CO）随年龄的下降远低于男性，但在47岁以后，随年龄的下降接近男性。无论是否调整FVC，黑人的DL（CO）水平都较低（-1.96 ml/min/mm Hg， 95%可信区间[CI] -0.77 ~ -3.14），但两个种族的DL（CO）随年龄和身高的变化相似。前吸烟者的DL（CO）较低（-1.13 ml/min/mm Hg, 95% CI -1.57 ~ -0.69），但这种降低完全可以用吸烟的包年数来解释。在当前吸烟者中，即使在控制FVC后，每天吸烟和包年仍可预测DL(CO)，并且控制这些变量完全解释了从不吸烟者和当前吸烟者之间DL（CO）的差异。外周中性粒细胞计数，炎症的生物标志物，与降低DL（CO）有关。因此，在美国普通人群中，DL（CO）存在着实质性的性别和种族差异。
Racial and gender differences in single-breath pulmonary diffusing capacity for carbon monoxide (DL(CO)) have previously received little attention. Between 1971 and 1975, the first National Health and Nutrition Examination Survey determined DL(CO) for 4,439 adults ages 25 to 74 residing in the United States, including 2,345 women and 438 blacks. The large sample permitted an evaluation of interactions and nonlinear relationships with DL(CO), and its association with biomarkers of inflammation. In a model with separate race, sex, and smoking status intercepts, positive associations with FVC, height, weight, hemoglobin concentration, and negative associations with age and neutrophil count explained 59% of the variation in DL(CO) in women, the decline in DL(CO) with age was much less than in men, but after age 47 the decline with age approached that seen in men. Blacks had lower DL(CO) levels (-1.96 ml/min/mm Hg, 95% confidence interval [CI] -0.77 to -3.14) with or without adjustment for FVC, but the changes in DL(CO) with age and height were similar in both races. Former smokers had lower DL(CO) (-1.13 ml/min/mm Hg, 95% CI -1.57 to -0.69), but this reduction was fully explained by the number of pack-years smoked. In current smokers, cigarettes per day and pack-years were predictive of DL(CO) even after control for FVC and controlling for these variables fully explained the difference in DL(CO) between never and current smokers. Peripheral neutrophil count, a biomarker of inflammation, was associated with reduced DL(CO). Thus, substantial sex and race differences exist for DL(CO) within the general United States population.