Diurnal variation in lung function in subgroups from two Dutch populations - Consequences for longitudinal analysis
Diurnal variation in lung function in subgroups from two Dutch populations - Consequences for longitudinal analysis
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DOI：
10.1164/ajrccm.159.4.9703106
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发表时间：
1999-04-01
影响因子：
24.7
通讯作者：
Quanjer, PH
中科院分区：
文献类型：
--
作者：
Borsboom, GJJM;van Pelt, W;Quanjer, PH
我们研究了FVC、FEV1、PEF、TLC、VC和RV在上午9点至晚上9点之间的昼夜变化，并分析了这种变化如何影响估计的纵向变化。研究人员对荷兰两个地区的876名成年人进行了纵向调查。研究对象参加了1975年至1985年间每三年进行一次的四次调查。FVC、FEV1、PEF和VC在上午9:00至中午呈上升趋势，之后呈下降趋势。TLC全天不变，而RV从上午9点到中午下降。FVC、FEV1和PEF的平均变化（以平均水平的百分比表示）分别为4.8% （200 ml）、2.8% （86 ml）和3.1% （250 ml/s）。这些结果与气道大小的昼夜变化是一致的。在男性和女性之间没有发现差异。与其他亚组相比，年轻人、吸烟者和有呼吸道症状的人在上午9点到中午之间的变化明显更大。对日变化的调整虽然稍微减少了估计纵向下降的残差标准差。平均日变化相对于底层纵向变化较大。因此，它对个体纵向变化的影响可能很大，这取决于年龄、吸烟习惯、症状、就诊次数、测量时间以及两次测量之间的时间差异。然而，当人们在一天中的随机时间进行至少三次访问时，或者在上午11点之后进行测量时，肺功能的日变化对估计的平均纵向下降的影响最小。
We studied circadian variation in FVC, FEV1, PEF, TLC, VC, and RV between 9:00 A.M. and 9:00 P.M. and analyzed how this variation affected estimated longitudinal change. Data from 876 adults were obtained in a longitudinal survey of samples from two Dutch areas. Subjects participated in four surveys held at 3-yr intervals between 1975 and 1985. FVC, FEV1, PEF, and VC increased from 9:00 A.M. until noon and decreased afterwards. TLC was constant over the day, whereas RV decreased from 9:00 A.M. to noon. Average variation in FVC, FEV1 and PEF, expressed as percentages of average level, was 4.8% (200 ml), 2.8% (86 ml), and 3.1% (250 ml/s), respectively. These results are compatible with circadian changes in airway size. No differences in variability were found between men and women. Significantly larger changes between 9:00 A.M. and noon were found in young adults, smokers, and those with respiratory symptoms than in other subgroups. Adjustment for diurnal variation reduced, albeit slightly, residual standard deviations of estimated longitudinal declines. Average diurnal change was large relative to underlying longitudinal change. Its effect on longitudinal change within an individual can therefore be large depending on age, smoking habits, symptomatology, number of visits, time of measurement, and difference in time between measurements. However, when people are measured at random times during the day for at least three visits, or when measurements are made after 11:00 A.M., effects of diurnal variation in pulmonary function on estimated average longitudinal decline are minimal.