1. Chest. 2009 Jul;136(1):171-6. Epub 2009 May 8.

Association of FVC and total mortality in US adults with metabolic syndrome and

Lee HM, Chung SJ, Lopez VA, Wong ND.

Division of Cardiology, School of Medicine, University of California, Irvine, CA 
92697-4101, USA. hwamuleemd@sbcglobal.net

BACKGROUND: Reduced pulmonary function is an independent predictor of metabolic
syndrome (MetS) and diabetes mellitus (DM), conditions associated with increased 
mortality. We investigated whether reduced pulmonary function is associated with 
increased mortality in persons with these conditions. METHODS: We examined 5,633 
(projected, 62.4 million) US adults (age range, 18 to 79 years) in the Third
National Health and Nutrition Examination Survey, who were never-smokers and were
without known cardiovascular or obstructive lung disease. Cox regression
(adjusted for age, sex, and ethnicity) was used to examine all-cause mortality
risk across FVC categories (FVC: low, <or= 85% predicted; intermediate, 86 to 94%
predicted; and high, >or= 95% predicted) among those with MetS, DM, or neither
disease. RESULTS: The prevalence of DM and MetS significantly increased as
predicted FVC decreased (p < 0.01). Age- and sex-adjusted mortality rates (per
1,000 person-years) increased in a stepwise manner as predicted FVC decreased in 
those patients with neither MetS nor DM (3.5 to 8.0), MetS (4.1 to 8.1), and DM
(9.9 to 13.3). Compared to those with high FVC, those with low FVC had more than 
a fourfold increase in mortality among those with MetS (hazard ratio [HR], 4.27; 
95% confidence interval [CI], 1.59 to 11.45; p < 0.01) and more than a twofold
increase among those with neither disease (HR, 2.40; 95% CI, 1.06 to 5.43; p <
0.05). Also, every 10% reduction in FVC was associated with a 77% higher
mortality (HR, 1.77; 95% CI, 1.33 to 2.37; p < 0.05) among persons with MetS.
However, in those with DM, FVC did not contribute further to mortality risk.
CONCLUSION: In persons with MetS, a reduced FVC is associated with further
increases in mortality, suggesting that the evaluation of lung function may be
useful for risk stratification in those with MetS.

PMID: 19429724 [PubMed - indexed for MEDLINE]