Lung function and onset of cardiometabolic diseases in the longitudinal Burden of Obstructive Lung Disease study.

IF 3.6 3区医学 Q1 RESPIRATORY SYSTEM BMJ Open Respiratory Research Pub Date : 2025-01-19 DOI:10.1136/bmjresp-2024-002442

Christer Janson, James Potts, Andrei Malinovschi, Dhiraj Agarwal, Rana Ahmed, Althea Aquart-Stewart, Imed Harrabi, Meriam Denguezli, Graham Devereux, Gregory E Erhabor, Thorarinn Gislason, Rain Jogi, Sanjay K Juvekar, Ben Knox-Brown, Parvaiz Koul, Kevin Mortimer, Asaad Ahmed Nafees, Rune Nielsen, Padukudru Anand Mahesh, Stefanni Nonna M Paraguas, Anders Ørskov Rotevatn, Talant Sooronbaev, Peter G J Burney, Andre F S Amaral

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Abstract

Introduction: Previous population-based studies, mainly from high-income countries, have shown that a higher forced vital capacity (FVC) is associated with a lower risk of developing cardiometabolic diseases. The aim of this study was to assess the longitudinal association between spirometry measures and the onset of cardiometabolic diseases across sites in low-income, middle-income and high-income countries.

Methods: The study population comprised 5916 individuals from 15 countries participating in the Burden of Obstructive Lung Disease baseline and follow-up assessments. Postbronchodilator forced expiratory volume in 1 s (FEV1), FVC and FEV1/FVC were measured at baseline. Participants who reported having doctor-diagnosed hypertension, diabetes, heart disease and stroke at follow-up but not at baseline were considered new cases of these diseases. The association between lung function and the onset of participant-reported cardiometabolic diseases was assessed in each site using regression models, and estimates were combined using random effects meta-analysis. Models were adjusted for sex, age, smoking, body mass index and educational level.

Results: Participants with greater per cent predicted FVC were less likely to have new-onset diabetes (OR per 10%=0.91, 95% CI 0.84 to 0.99), heart disease (OR per 10%=0.86, 95% CI 0.80 to 0.92) and stroke (OR per 10%=0.81, 95% CI 0.73 to 0.89) during the follow-up period (mean±SD 9.5±3.6 years). A greater percentage of FEV₁ was associated with a lower risk of onset of heart disease and stroke. No significant association was found between FEV₁/FVC and onset of reported cardiometabolic diseases, except for a higher risk of diabetes (OR per 10%=1.21, 95% CI 1.08 to 1.35) in participants with higher FEV₁/FVC.

Conclusions: The findings of this study suggest that a low FVC is more important than a low FEV₁/FVC as a risk factor for developing cardiometabolic diseases. The value of including FVC in risk score models to improve their precision in predicting the onset of cardiometabolic diseases should be explored.

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阻塞性肺疾病纵向负担研究中的肺功能和心脏代谢疾病的发病

先前主要来自高收入国家的基于人群的研究表明，较高的用力肺活量（FVC）与较低的发生心脏代谢疾病的风险相关。本研究的目的是评估在低收入、中等收入和高收入国家不同地区肺活量测定与心脏代谢疾病发病之间的纵向关联。方法：研究人群包括来自15个国家的5916名参与阻塞性肺疾病负担基线和随访评估的个体。在基线时测量支气管扩张剂后1 s用力呼气量（FEV1）、FVC和FEV1/FVC。在随访中报告患有医生诊断的高血压、糖尿病、心脏病和中风，但在基线时未报告的参与者被视为这些疾病的新病例。使用回归模型评估肺功能与参与者报告的心脏代谢疾病发病之间的关联，并使用随机效应荟萃分析将估计值结合起来。模型根据性别、年龄、吸烟、体重指数和教育水平进行了调整。结果：预测FVC百分比较高的参与者在随访期间（平均±SD 9.5±3.6年）发生新发糖尿病（OR / 10%=0.91, 95% CI 0.84至0.99）、心脏病（OR / 10%=0.86, 95% CI 0.80至0.92）和中风（OR / 10%=0.81, 95% CI 0.73至0.89）的可能性较低。FEV1的比例越大，心脏病和中风发作的风险就越低。除FEV1/FVC较高的参与者患糖尿病的风险较高（OR / 10%=1.21, 95% CI 1.08至1.35）外，FEV1/FVC与报告的心脏代谢疾病发病之间没有显著关联。结论：本研究的结果表明，低FEV1/FVC比低FEV1/FVC更重要，是发生心脏代谢疾病的危险因素。应探讨将FVC纳入风险评分模型以提高其预测心脏代谢疾病发病的精度的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMJ Open Respiratory Research RESPIRATORY SYSTEM-

CiteScore

6.60

自引率

2.40%

发文量

审稿时长

12 weeks

期刊介绍： BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.