Forced vital capacity, airway obstruction and survival in a general population sample from the USA
Forced vital capacity, airway obstruction and survival in a general population sample from the USA
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DOI：
10.1136/thx.2010.147041
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发表时间：
2011-01-01
期刊：
影响因子：
10
通讯作者：
Hooper, R.
中科院分区：
文献类型：
--
作者：
Burney, P. G. J.;Hooper, R.
背景：许多研究表明，S的用力呼气量(FEV(1))与普通人群的存活率之间存在联系，这被解释为呼吸道阻塞与存活率之间的联系。然而，肺活量也与生存相关的观察结果削弱了这种解释。方法有关肺活量和生存的数据来自社区动脉粥样硬化风险(ARIC)有限访问数据集。在控制了许多其他可能与生存相关的因素后，有可用的肺活量测量和完整数据的7489名参与者的存活率与呼吸功能的测量进行了回归。结果经FEV(1)校正后，存活率与用力肺活量(FVC)密切相关，但反之亦然。与高FVC相关的完全调整危险比(HR)男性为0.9(95%可信区间0.80至1.00；p=0.049)，女性为0.82(95%可信区间0.70至0.95；p=0.01)。相比之下，男性的FEV(1)为0.98(95%可信区间为0.90至1.07；p.0.72)，女性为1.01(95%可信区间为0.89至1.15；p=0.84)。以FEV(1)/FVC比率衡量，生存与气道阻塞之间没有相关性。结论对于无慢性呼吸道诊断或持续呼吸道症状的无症状成人，FVC而不是气道阻塞可以预测生存。这种联系不能用年龄、人体测量、吸烟、收入职业或血压来解释。由于FVC的晚年、心血管风险、II型糖尿病和低度全身炎症都与胎儿生长不良有关，这些其他条件可能是FVC低的患者生存不良的部分原因。
Background Many studies show a link between forced expiratory volume in 1 s (FEV(1)) and survival in the general population and this has been interpreted as a link between airway obstruction and survival. However, the observation that vital capacity is also associated with survival weakens this interpretation.Methods Data on spirometry and survival were taken from the Atherosclerosis Risk in Communities (ARIC) limited access dataset. Survival among 7489 participants with usable spirometry and complete data was regressed against measures of ventilatory function after controlling for many other factors likely to be associated with survival.Results Survival was strongly associated with forced vital capacity (FVC) after adjustment for FEV(1), but not the other way round. The fully adjusted hazard ratio (HR) associated with high FVC was 0.90 in men (95% CI 0.80 to 1.00; p = 0.049) and 0.82 in women (95% CI 0.70 to 0.95; p = 0.01). This compares with 0.98 for FEV(1) in men (95% CI 0.90 to 1.07; p. 0.72) and 1.01 in women (95% CI 0.89 to 1.15; p = 0.84). There was no association between survival and airway obstruction as measured by the FEV(1)/FVC ratio.Conclusions FVC but not airway obstruction predicts survival in asymptomatic adults without chronic respiratory diagnoses or persistent respiratory symptoms. The association is not explained by age, anthropometry, smoking, income occupation or blood pressure. As FVC later in life, cardiovascular risk, type II diabetes mellitus and low-grade systemic inflammation are all associated with poor fetal growth, these other conditions may be partly responsible for the poor survival in those with low FVC.