The impact of lung function on extra-pulmonary diseases and all causes

Kai Yang,1,* Ying Wu,2,* Dandan Chen,1 Shengming Liu,3 Rongchang Chen1

1Shenzhen Institute of Respiratory Diseases, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, People’s Republic of China; 2Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, Guangdong, People’s Republic of China; 3Department of Respiratory Medicine, First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, People’s Republic of China

* These authors contributed equally to this work

Correspondence: Rongchang Chen
Shenzhen Institute of Respiratory Diseases, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518055, People’s Republic of China
Email chenrc@vip.163.com
Shengming Liu
Department of Respiratory Medicine, The First Affiliated Hospital, Jinan University, Guangzhou 510000, People’s Republic of China
Email tlsm@jnu.edu.cn

Objective: Spirometric lung function is usually used to assess respiratory health. However, the impact of lung function on extra-pulmonary disease and all-cause mortality has not been fully elucidated, especially in people without chronic obstructive pulmonary disease (COPD).
Patients and methods: In this study, participants aged ≥ 20 years and spirometry tested by the National Health and Nutrition Examination Surveys (NHANES) 2007-2012 of the United States were analyzed. Multivariate logistics and Cox regressions were used to evaluate the impact of forced expiratory volume in 1 second percent predicted (FEV1% predicted) and forced vital capacity percentage of predicted (% FVC predicted) out of 14 extra-pulmonary diseases and all-cause morbidity after adjustment for multiple confounding factors.
Results: During the 2007-2012 period, 1,800 COPD patients and 11,437 non-COPD subjects were included. The prevalence of hypertension, diabetes mellitus (DM), dyslipidemia, metabolic syndrome (MS), congestive heart failure (CHF), coronary heart disease, stroke, chronic kidney disease (CKD), arthritis, cancer, underweight, and osteoporosis in COPD patients was higher than that of the non-COPD population. After correcting for confounding factors, FEV decreases1% predicted and% predicted FVC correlated with increased odds of having hypertension, DM, obesity, MS, CHF, coronary heart disease, and depression (OR> 1, P.<0.05) in both the COPD and non-COPD populations. These 2 indices were also related to higher odds of dyslipidemia, CKD, arthritis and osteoporosis in the non-COPD population. The risk of stroke, anemia and cancer was not related to the decrease in lung function. Furthermore, decreased lung function was independent risk factors for increased all-cause mortality. These risks gradually increased as lung function decreased.
Conclusion: The decrease in FEV1The% predicted and% predicted FVC correlated with a higher risk of multiple extra-pulmonary disease and all-cause mortality in both the COPD and non-COPD populations.

Keyword: lung function, mortality, extra-pulmonary diseases, COPD

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