美国人群限制性肺损伤患病率的变化及相关危险因素:1988-1994年和2007-2010年国家健康与营养调查(NHANES)

IF 2.3 Multidisciplinary Respiratory Medicine Pub Date : 2015-02-28 eCollection Date: 2015-01-01 DOI:10.1186/s40248-015-0003-6
Laura Kurth, Eva Hnizdo
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引用次数: 40

摘要

背景:来自美国国家健康与营养调查(NHANES)的成年人数据被用于评估肺活量测定法限制性模式的危险因素,并估计1988-1994年至2007-2010年采样期间肺活量测定法患病率的变化。先前的一些流行病学研究使用了全球慢性阻塞性肺疾病计划固定1秒用力呼气量(FEV1)/用力肺活量(FVC) > 0.70的限制性模式分类标准,而不是年龄定义的美国胸科学会(ATS)/欧洲呼吸学会(ERS)正常下限(LLN)标准,这可能导致分类错误。方法:分析1988-1994年和2007-2010年期间NHANES数据中的肺活量测量值,以估计肺活量测量限制性模式的年龄标准化患病率以及20-79岁成年人患病率随时间的变化。基于ATS/ERS LLN标准的限制性模式定义为FEV1/FVC > LLN和FVC。结果:限制性模式的总体年龄标准化患病率从7.2%(1988-1994)下降到5.4% (2007-2010)(p = 0.0013)。中度至重度限制性模式的患病率也从2.0%显著下降至1.4% (p = 0.023)。与肺活量测定法限制性模式呈正相关的因素包括年龄、女性、白人、低教育程度、曾经和现在吸烟,以及合并症,包括医生诊断的心血管疾病、医生诊断的糖尿病和腹部肥胖。结论:在1988-1994年和2007-2010年的调查期间,尽管与限制性模式相关的合并症(即糖尿病和腹部肥胖)的比例有所增加,但限制性模式和中度至重度限制性模式的总体患病率有所下降。这表明限制模式的个体风险因素有所下降,需要进一步研究。
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Change in prevalence of restrictive lung impairment in the U.S. population and associated risk factors: the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 2007-2010.

Background: Data for the U.S adult population from the National Health and Nutrition Examination Survey (NHANES) were used to evaluate risk factors for a restrictive pattern on spirometry and estimate the change in its prevalence from the 1988-1994 to 2007-2010 sampling periods. Several previous epidemiologic studies used the Global Initiative for Chronic Obstructive Lung Disease fixed forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) > 0.70 criteria for classifying restrictive pattern rather than the age-defined American Thoracic Society (ATS)/European Respiratory Society (ERS) lower limit of normal (LLN) criteria, which may lead to misclassification.

Methods: Spirometry measurements from NHANES data for the 1988-1994 and 2007-2010 periods were analyzed to estimate the age-standardized prevalence of a restrictive pattern on spirometry and the change in prevalence over time for adults aged 20-79. A restrictive pattern was defined based on ATS/ERS LLN criteria as FEV1/FVC > LLN and FVC < LLN, and a moderate to more severe restrictive pattern was further evaluated using FEV1 < 70% predicted. The associations between demographic and other individual risk factors for restrictive lung impairment were examined using multivariable logistic regression models for the two consecutive time periods.

Results: The overall age-standardized prevalence of restrictive pattern decreased significantly from 7.2% (1988-1994) to 5.4% (2007-2010) (p = 0.0013). The prevalence of moderate to more severe restrictive pattern also decreased significantly from 2.0% to 1.4% (p = 0.023). Factors positively associated with restrictive pattern on spirometry included age, female sex, white race, lower education, former and current smoking, and comorbidities including doctor-diagnosed cardiovascular disease, doctor-diagnosed diabetes, and abdominal obesity.

Conclusions: The overall prevalence of restrictive pattern and moderate to more severe restrictive pattern decreased between the 1988-1994 and 2007-2010 survey periods despite a population increase in the proportion of comorbidities associated with restrictive pattern (i.e. diabetes and abdominal obesity). This suggests a decline in individual risk factors for restrictive pattern and a need for future research.

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来源期刊
Multidisciplinary Respiratory Medicine
Multidisciplinary Respiratory Medicine Medicine-Pulmonary and Respiratory Medicine
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0.00%
发文量
23
期刊介绍: Multidisciplinary Respiratory Medicine is the official journal of the Italian Respiratory Society - Società Italiana di Pneumologia (IRS/SIP). The journal publishes on all aspects of respiratory medicine and related fields, with a particular focus on interdisciplinary and translational research. The interdisciplinary nature of the journal provides a unique opportunity for researchers, clinicians and healthcare professionals across specialties to collaborate and exchange information. The journal provides a high visibility platform for the publication and dissemination of top quality original scientific articles, reviews and important position papers documenting clinical and experimental advances.
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