The prevalence and mortality risks of PRISm and COPD in the United States from NHANES 2007–2012

IF 4.7 2区医学 Q1 RESPIRATORY SYSTEM

Respiratory Research Pub Date : 2024-05-15 DOI:10.1186/s12931-024-02841-y

Christopher J. Cadham, Hayoung Oh, MeiLan K. Han, David Mannino, Steven Cook, Rafael Meza, David T. Levy, Luz María Sánchez-Romero

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Abstract

We estimated the prevalence and mortality risks of preserved ratio impaired spirometry (PRISm) and chronic obstructive pulmonary disease (COPD) in the US adult population. We linked three waves of pre-bronchodilator spirometry data from the US National Health and Nutritional Examination Survey (2007–2012) with the National Death Index. The analytic sample included adults ages 20 to 79 without missing data on age, sex, height, BMI, race/ethnicity, and smoking status. We defined COPD (GOLD 1, 2, and 3–4) and PRISm using FEV1/FVC cut points by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). We compared the prevalence of GOLD stages and PRISm by covariates across the three waves. We estimated adjusted all-cause and cause-specific mortality risks by COPD stage and PRISm using all three waves combined. Prevalence of COPD and PRISm from 2007–2012 ranged from 13.1%-14.3% and 9.6%-10.2%, respectively. We found significant differences in prevalence by sex, age, smoking status, and race/ethnicity. Males had higher rates of COPD regardless of stage, while females had higher rates of PRISm. COPD prevalence increased with age, but not PRISm, which was highest among middle-aged individuals. Compared to current and never smokers, former smokers showed lower rates of PRISm but higher rates of GOLD 1. COPD prevalence was highest among non-Hispanic White individuals, and PRISm was notably higher among non-Hispanic Black individuals (range 31.4%-37.4%). We found associations between PRISm and all-cause mortality (hazard ratio [HR]: 2.3 95% CI: 1.9—2.9) and various cause-specific deaths (HR ranges: 2.0–5.3). We also found associations between GOLD 2 (HR: 2.1, 95% CI: 1.7–2.6) or higher (HR: 4.2, 95% CI: 2.7–6.5) and all-cause mortality. Cause-specific mortality risk varied within COPD stages but typically increased with higher GOLD stage. The prevalence of COPD and PRISm remained stable from 2007–2012. Greater attention should be paid to the potential impacts of PRISm due to its higher prevalence in minority groups and its associations with mortality across various causes including cancer.

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2007-2012 年美国 NHANES 调查显示的 PRISm 和 COPD 患病率和死亡风险

我们估算了美国成年人群中肺活量保留比值受损（PRISm）和慢性阻塞性肺病（COPD）的患病率和死亡风险。我们将美国国家健康与营养调查（2007-2012 年）中的三波支气管扩张前肺活量数据与国家死亡指数联系起来。分析样本包括年龄在 20 岁至 79 岁之间的成年人，没有缺失年龄、性别、身高、体重指数、种族/人种和吸烟状况的数据。我们使用慢性阻塞性肺病全球倡议（GOLD）的 FEV1/FVC 切点来定义慢性阻塞性肺病（GOLD 1、2 和 3-4）和 PRISm。我们根据协变量比较了三个波次中 GOLD 阶段和 PRISm 的患病率。我们使用所有三个波次的合并数据，按慢性阻塞性肺病分期和 PRISm 估算了调整后的全因和特因死亡率风险。2007-2012年期间，慢性阻塞性肺病和PRISm的患病率分别为13.1%-14.3%和9.6%-10.2%。我们发现，不同性别、年龄、吸烟状况和种族/民族的患病率存在明显差异。无论处于哪个阶段，男性的慢性阻塞性肺病患病率都较高，而女性的 PRISm 患病率较高。慢性阻塞性肺病的患病率随年龄增长而增加，但 PRISm 的患病率并不随年龄增长而增加，中年人的 PRISm 患病率最高。与目前吸烟和从不吸烟者相比，曾经吸烟者的 PRISm 患病率较低，但 GOLD 1 患病率较高。慢性阻塞性肺病在非西班牙裔白人中发病率最高，而 PRISm 在非西班牙裔黑人中明显较高（范围为 31.4%-37.4%）。我们发现 PRISm 与全因死亡率（危险比 [HR]：2.3 95% CI：1.9-2.9）和各种特定原因死亡（HR 范围：2.0-5.3）之间存在关联。我们还发现 GOLD 2（HR：2.1，95% CI：1.7-2.6）或更高（HR：4.2，95% CI：2.7-6.5）与全因死亡率之间存在关联。慢性阻塞性肺病各分期的病因特异性死亡风险各不相同，但通常随着 GOLD 分期的升高而增加。2007-2012年期间，慢性阻塞性肺病和PRISm的患病率保持稳定。由于 PRISm 在少数群体中的发病率较高，而且与包括癌症在内的各种病因的死亡率都有关联，因此应更加关注 PRISm 的潜在影响。

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来源期刊

Respiratory Research 医学-呼吸系统

自引率

1.70%

发文量

314

期刊介绍： Respiratory Research publishes high-quality clinical and basic research, review and commentary articles on all aspects of respiratory medicine and related diseases. As the leading fully open access journal in the field, Respiratory Research provides an essential resource for pulmonologists, allergists, immunologists and other physicians, researchers, healthcare workers and medical students with worldwide dissemination of articles resulting in high visibility and generating international discussion. Topics of specific interest include asthma, chronic obstructive pulmonary disease, cystic fibrosis, genetics, infectious diseases, interstitial lung diseases, lung development, lung tumors, occupational and environmental factors, pulmonary circulation, pulmonary pharmacology and therapeutics, respiratory immunology, respiratory physiology, and sleep-related respiratory problems.