Lung function and metabolic syndrome: Findings of National Health and Nutrition Examination Survey 2007-2010 肺功能与代谢综合征：2007-2010全国健康与营养调查研究结果

• Published in: Journal of diabetes Vol. 6; no. 6; pp. 603 - 613
• Main Authors: Ford, Earl S., Cunningham, Timothy J., Mercado, Carla I.
• Format: Journal Article
• Language: English
• Published: Blackwell Publishing Ltd 01.11.2014
• Subjects: chronic obstructive pulmonary disease; cross-sectional studies; metabolic syndrome; spirometry; 关键词：慢性阻塞性肺病，横断面研究，代谢综合征，肺活量测定法
• ISSN: 1753-0393; 1753-0407
• DOI: 10.1111/1753-0407.12136

Background Considerable uncertainty remains about obstructive lung function (OLF) in adults with metabolic syndrome (MetS). The aim of the present study was to examine pulmonary function status in adults with and without MetS. Methods We used data from 3109 participants aged ≥20 years of the National Health and Nutrition Examination Survey 2007–2010. Subjects' MetS status was established on the basis of the 2009 harmonizing definition. Participants received spirometry. Results After age adjustment, 79.3% (SE 1.1) of participants with MetS had normal lung function, 8.7% (0.9) had restrictive lung function (RLF), 7.1% (0.8) had mild OLF, and 4.8% (0.6) had moderate OLF or worse. Among participants without MetS, these estimates were 78.7% (1.2), 3.9% (0.6), 10.9% (1.1), and 6.4% (0.8), respectively. After multiple adjustment, participants with MetS were more likely to have RLF (adjusted prevalence ratio [aPR] 2.20; 95% confidence interval [CI] 1.67, 2.90) and less likely to have any OLF (aPR 0.73; 95% CI 0.62, 0.86) than those without MetS. Furthermore, participants with MetS had lower mean levels of forced expiratory volume in one second (FEV1), FEV1 % predicted, forced vital capacity (FVC), and FVC % predicted, but a higher FEV1/FVC ratio than participants without MetS. Mean levels of FEV1, FEV1 % predicted, FVC, and FVC % predicted declined significantly, but not the FEV1/FVC ratio, as the number of components increased. Conclusions Compared with adults without MetS, spirometry is more likely to show a restrictive pattern and less likely to show an obstructive pattern among adults with MetS. 摘要 背景：目前还不十分明确合并代谢综合征（metabolic syndrome，MetS）的成年人的阻塞性肺功能（obstructive lung function，OLF）状态。当前这项研究的目的是在合并以及不合并MetS的成年人中调查肺功能状态。 方法：我们使用的3109名年龄≥ 20岁的参与者的数据来自2007–2010全国健康与营养调查研究。受试者的MetS状态根据2009年达成一致的定义来确定。参与者接受了肺活量的测定。 结果：经过年龄的校正之后，发现79.3%（标准误为1.1）合并MetS的参与者肺功能是正常的，8.7%（0.9）为限制性肺功能（RLF），7.1%（0.8）为轻度OLF，4.8%（0.6）为中度或者重度OLF。在不合并MetS的参与者中，估计这些相应的比例分别为78.7%（1.2）、3.9%（0.6）、10.9%（1.1）以及6.4%（0.8）。经过多重校正之后，发现与不合并MetS的参与者相比，合并MetS的参与者的肺功能状态更可能为RLF（校正过的患病率比[aPR]为2.20；95%置信区间[CI]为1.67，2.90），并且可能为任何程度的OLF的几率更低（aPR为0.73；95%CI为0.62，0.86）。此外，与不合并MetS的参与者相比较，合并MetS的参与者一秒钟用力呼气量（forced expiratory volume in one second，FEV1）、FEV1%预测值、用力肺活量（forced vital capacity，FVC）以及FVC%预测值的平均水平都更低，但是FEV1/FVC比值却更高。FEV1、FEV1%预测值、FVC以及FVC%预测值的平均水平都在显著下降，但是FEV1/FVC的比值却没有下降，因为组成的数量增加了。 结论：与不合并MetS的成年人相比，在合并MetS的成年人中使用肺活量测定法更有可能发现限制性肺功能状态，而发现阻塞性肺功能状态的可能性却更低。