Association between FEV₁/FVC levels and all-cause mortality in the general population.

IF 2.6 3区医学 Q2 RESPIRATORY SYSTEM BMC Pulmonary Medicine Pub Date : 2025-03-11 DOI:10.1186/s12890-025-03573-5

Leheng Tang, Fan Wu, Shiyu Zhang, Jie Ou, Juncheng Liang, Ranxi Peng, Siman Liao, Qiaorui Zhou, Yingtong Chen, Xiaozi Guo, Jingxian Chen, Qi Wan, Zihui Wang, Zhishan Deng, Yumin Zhou

{"title":"Association between FEV1/FVC levels and all-cause mortality in the general population.","authors":"Leheng Tang, Fan Wu, Shiyu Zhang, Jie Ou, Juncheng Liang, Ranxi Peng, Siman Liao, Qiaorui Zhou, Yingtong Chen, Xiaozi Guo, Jingxian Chen, Qi Wan, Zihui Wang, Zhishan Deng, Yumin Zhou","doi":"10.1186/s12890-025-03573-5","DOIUrl":null,"url":null,"abstract":"Background: The ratio of the forced expiratory volume in 1 s (FEV1) to the forced vital capacity (FVC) is an essential tool for the diagnosis of chronic obstructive pulmonary disease (COPD). However, the relationship between levels of FEV1/FVC and mortality in the general population remains unclear, particularly its non-linear relationship. Therefore, we aimed to explore the association between the FEV1/FVC and all-cause mortality in the general population.Methods: The data of participants included in the National Health and Nutrition Examination Survey (1988-1994 and 2007-2012 cycles) were analyzed. Participants aged ≥20 years, who were not pregnant, who underwent quality-controlled lung function tests, and with follow-up data on mortality status were enrolled. The study outcome was all-cause mortality. The participants were grouped by FEV1/FVC ratio in 0.10 increments. Cox proportional-hazards models were used to estimate the association between the FEV1/FVC ratio and all-cause mortality before and after confounder adjustment. Non-linear associations were explored using restricted cubic spline curves.Results: Overall, 25,501 participants were included. During the median follow up of 308 months, 6431 (25.2%) deaths were recorded. Among all participants, the mean age is 46.3 years, and 48.7% of which were male. In unadjusted model, individuals with an FEV1/FVC ratio < 0.90 had an increased risk of all-cause mortality compared to those with an FEV1/FVC ratio ≥ 0.90. After adjusting for age, sex, body mass index, race, and smoking status, participants in the 0.60 ≤ FEV1/FVC < 0.90 group had a lower all-cause mortality risk than those in the FEV1/FVC ≥ 0.90 group, while the mortality risk of individuals with an FEV1/FVC ratio < 0.50 was higher. Restricted cubic splines revealed a U-shaped association between the FEV1/FVC ratio and all-cause mortality. Below and above the inflection point, an inverse trend was observed.Conclusion: Our study first revealed a U-shaped association between the level of FEV1/FVC and all-cause mortality in general population.Clinical trial number: Not applicable.","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"108"},"PeriodicalIF":2.6000,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Pulmonary Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12890-025-03573-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The ratio of the forced expiratory volume in 1 s (FEV₁) to the forced vital capacity (FVC) is an essential tool for the diagnosis of chronic obstructive pulmonary disease (COPD). However, the relationship between levels of FEV₁/FVC and mortality in the general population remains unclear, particularly its non-linear relationship. Therefore, we aimed to explore the association between the FEV₁/FVC and all-cause mortality in the general population.

Methods: The data of participants included in the National Health and Nutrition Examination Survey (1988-1994 and 2007-2012 cycles) were analyzed. Participants aged ≥20 years, who were not pregnant, who underwent quality-controlled lung function tests, and with follow-up data on mortality status were enrolled. The study outcome was all-cause mortality. The participants were grouped by FEV₁/FVC ratio in 0.10 increments. Cox proportional-hazards models were used to estimate the association between the FEV₁/FVC ratio and all-cause mortality before and after confounder adjustment. Non-linear associations were explored using restricted cubic spline curves.

Results: Overall, 25,501 participants were included. During the median follow up of 308 months, 6431 (25.2%) deaths were recorded. Among all participants, the mean age is 46.3 years, and 48.7% of which were male. In unadjusted model, individuals with an FEV₁/FVC ratio < 0.90 had an increased risk of all-cause mortality compared to those with an FEV₁/FVC ratio ≥ 0.90. After adjusting for age, sex, body mass index, race, and smoking status, participants in the 0.60 ≤ FEV₁/FVC < 0.90 group had a lower all-cause mortality risk than those in the FEV₁/FVC ≥ 0.90 group, while the mortality risk of individuals with an FEV₁/FVC ratio < 0.50 was higher. Restricted cubic splines revealed a U-shaped association between the FEV₁/FVC ratio and all-cause mortality. Below and above the inflection point, an inverse trend was observed.

Conclusion: Our study first revealed a U-shaped association between the level of FEV₁/FVC and all-cause mortality in general population.

Clinical trial number: Not applicable.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

求助全文

约1分钟内获得全文去求助

来源期刊

BMC Pulmonary Medicine RESPIRATORY SYSTEM-

CiteScore

4.40

自引率

3.20%

发文量

423

审稿时长

6-12 weeks

期刊介绍： BMC Pulmonary Medicine is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of pulmonary and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.