Lung function and onset of cardiometabolic diseases in the longitudinal Burden of Obstructive Lung Disease study

• Published in: BMJ open respiratory research 2025-01, Vol.12 (1), p.e002442
• Main Authors: Potts, James, Malinovschi, Andrei, Agarwal, Dhiraj, Juvekar, Sanjay K, Koul, Parvaiz, Nielsen, Rune, Mahesh, Padukudru Anand, Paraguas, Stefanni Nonna M, Sooronbaev, Talant, Amaral, Andre F S, Hafizi, Hasan, Bardhi, Donika, Thanasi, Natasha, Nikolla, Jolanda, Kazasi, Rezarta, Haddad, Tabarek, Zgaoula, Ibtissem, Marks, Guy, Bird, Tessa, Hardaker, Kate, Dawes, Torkil, Lamprecht, Bernd, Islam, Qazi Shafayetul, Rahman, Mizanur, Lawin, Herve, Kpangon, Arsene, Kpossou, Karl, Agodokpessi, Gildas, Tan, Wan C, Liu, Shengming, Lu, Jiachun, Zheng, Jin-ping, Zhou, Yumin, Laja, Hendrik, Ulst, Katrin, Adegnika, Ayola Akim, Malik, Sajjad, Raphael, Jonelle, Tawde, Mahesh, Katkar, Sunil, Dhanawade, Rupesh, Ghurup, Umesh, Chaidhary, Bharat, Umap, Arati, Walke, Savita, Sapkal, Anil, Londhe, Jyoti, Aquart-Stewart, Althea, Aikman, Akosua Francia, Sooronbaev, Talant M., Estebesova, Bermet M., Bostonova, Eliza, Emilov, Berik, Mwangoka, Ernest, Nejjari, Chakib, Rhazi, Karima El, Wesseling, GJ, Endresen, Tina, Svendsen, Lene, Fatmi, Zafar, Guia, Teresita S de, Tan, Daniel T, Banal-Yang, Sylvia, Dantes, Renato B, Frey, Jakub, Harat, Rafal, Nastalek, Pawel, Szczeklik, Andrzej, Twardowska, Magda, Barbara, Cristina, Dias, Herminia, Cardoso, Joao, Matos, Maria Joao, Simão, Paula, Al Hajjaj, M, Hashi, A, Fanuncio, R, Doloriel, E, Bateman, Eric, Adams, Desiree, Barnes, Edward, Freeman, Jasper, Ryck, Johanna, Storbeck, Janita, Gunasekera, Kirthi, Mohamed, Monjda Awad, Osman, Hasab Alrasoul Akasha Ahmed, Zain, Abdel Mu’is El, Elhadi, Mahmoud, Abdelmonam, Dalia, Janson, Christer, Lutchmansingh, Fallon, Conyette, Liane, Hanta, Ismail, Turkyilmaz, Ahmet Sinan, Gnatiuc, Louisa, Tumilty, Michael, Sonia Buist, A, Cain, John
• Format: Article
• Language: English
• Subjects: Adult; Aged; Body mass index; Cardiometabolic Risk Factors; Cardiovascular disease; Cardiovascular Diseases - epidemiology; Chronic obstructive pulmonary disease; Clinical Epidemiology; COPD epidemiology; Diabetes; Diabetes Mellitus - epidemiology; Female; Forced Expiratory Volume; Gender differences; Heart; Heart Diseases - epidemiology; Heart Diseases - physiopathology; Humans; Hypertension; Industrialized nations; Longitudinal Studies; Lung - physiopathology; Lung diseases; Lung Diseases, Obstructive - epidemiology; Lung Diseases, Obstructive - physiopathology; Lung Physiology; Male; Middle Aged; Original Research; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - physiopathology; Questionnaires; Regression analysis; Respiratory Epidemiology; Risk Factors; Spirometry; Stroke; Vital Capacity; Womens health
• ISSN: 2052-4439; 2052-4439
• DOI: 10.1136/bmjresp-2024-002442

IntroductionPrevious population-based studies, mainly from high-income countries, have shown that a higher forced vital capacity (FVC) is associated with a lower risk of developing cardiometabolic diseases. The aim of this study was to assess the longitudinal association between spirometry measures and the onset of cardiometabolic diseases across sites in low-income, middle-income and high-income countries.MethodsThe study population comprised 5916 individuals from 15 countries participating in the Burden of Obstructive Lung Disease baseline and follow-up assessments. Postbronchodilator forced expiratory volume in 1 s (FEV1), FVC and FEV1/FVC were measured at baseline. Participants who reported having doctor-diagnosed hypertension, diabetes, heart disease and stroke at follow-up but not at baseline were considered new cases of these diseases. The association between lung function and the onset of participant-reported cardiometabolic diseases was assessed in each site using regression models, and estimates were combined using random effects meta-analysis. Models were adjusted for sex, age, smoking, body mass index and educational level.ResultsParticipants with greater per cent predicted FVC were less likely to have new-onset diabetes (OR per 10%=0.91, 95% CI 0.84 to 0.99), heart disease (OR per 10%=0.86, 95% CI 0.80 to 0.92) and stroke (OR per 10%=0.81, 95% CI 0.73 to 0.89) during the follow-up period (mean±SD 9.5±3.6 years). A greater percentage of FEV1 was associated with a lower risk of onset of heart disease and stroke. No significant association was found between FEV1/FVC and onset of reported cardiometabolic diseases, except for a higher risk of diabetes (OR per 10%=1.21, 95% CI 1.08 to 1.35) in participants with higher FEV1/FVC.ConclusionsThe findings of this study suggest that a low FVC is more important than a low FEV1/FVC as a risk factor for developing cardiometabolic diseases. The value of including FVC in risk score models to improve their precision in predicting the onset of cardiometabolic diseases should be explored.