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Pulmonary Physiology |

Effect of Impaired Pulmonary Function on Mortality Among U.S. Adults With Metabolic Syndrome

Anindita Chowdhury*, MD; Dhaval Patel, MD
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Washington Hospital Center, Washington, DC


Chest. 2012;142(4_MeetingAbstracts):786A. doi:10.1378/chest.1390636
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Abstract

SESSION TYPE: Physiology/PFTs/ Rehabilitation I

PRESENTED ON: Sunday, October 21, 2012 at 01:15 PM - 02:45 PM

PURPOSE: Metabolic syndrome and its various components have been reported to be associated with impaired pulmonary function and systemic inflammation. Data on the effect of impaired pulmonary function on mortality among metabolic syndrome patients is inadequate. The purpose of our study was to determine the effect of impaired pulmonary function on all-cause, cardiovascular and respiratory cause related mortality among adults with metabolic syndrome.

METHODS: We selected adults with metabolic syndrome, age between 18 to 75 years who were non-smokers and had no cardiovascular or lung disease from the Third National Health and Nutrition Examination Survey. All adults with Metabolic syndrome were divided into 3 groups depending on spirometry results- normal , restrictive(FEV1/FVC>0.7 and predicted FVC<80%) or obstructive( FEV1/FVC<0.7) pulmonary impairment. Multivariate Logistic Regression analysis adjusted for age, sex, and ethnicity was used to compare various mortality rates among the 3 groups.

RESULTS: Among the patients with metabolic syndrome (n=2564) the prevalence of restrictive and obstructive lung impairment was estimated to be 10% and 11.1% respectively. Impaired lung function was more prevalent in older population. After adjusting for age, sex and ethnicity the restrictive pulmonary impairment was associated with higher all-cause mortality (33.0% vs 15.5%, OR= 2.08 CI: 1.52-2.84, P<0.0001), cardiovascular mortality (12.0% vs 4.7%, OR= 2.10 CI: 1.35-3.26, P<0.0001), respiratory cause related mortality (3.89% vs 1.0%, OR= 2.94 CI: 1.35-6.38, P=0.006) compared to adults with normal lung function. Obstructive lung function was found to be associated with higher all-cause mortality (42.1% vs 15.5%, OR= 1.29 CI: 1.11-1.49, P=0.0001) but not with cardiovascular mortality (13.5% vs 4.7%, OR=1.18 CI:0.95-1.46, P=0.11) and respiratory cause related mortality (2.4% vs 1.0%, OR= 0.94 CI: 0.59-1.48, P=0.79) after adjusting for age, sex and ethnicity.

CONCLUSIONS: Impaired pulmonary function particularly restrictive pattern was found to be associated with higher mortality among adults with metabolic syndrome.

CLINICAL IMPLICATIONS: In adults with metabolic syndrome screening pulmonary function tests should be encouraged and further research is needed to determine the efficacy of primary preventive strategies in adults with metabolic syndrome and impaired pulmonary function.

DISCLOSURE: The following authors have nothing to disclose: Anindita Chowdhury, Dhaval Patel

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Washington Hospital Center, Washington, DC

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