Key result
Restricted spirometry was significantly associated with higher adjusted odds of cardiovascular disease (OR 1.54), hypertension (OR 1.50), and diabetes (OR 1.86).
Why the study?
Whether restricted spirometry, defined as low forced vital capacity, predicts chronic cardiometabolic disease was not definitely known.
Is restricted spirometry associated with increased odds of cardiovascular disease, hypertension, and diabetes in a general population?
Cross-Sectional (n=23,623)
Yes
Is restricted spirometry associated with increased odds of cardiovascular disease, hypertension, and diabetes in a general population?
Restricted spirometry is independently associated with a higher prevalence of cardiometabolic diseases including cardiovascular disease, hypertension, and diabetes.
Restricted spirometry signals higher cardiometabolic comorbidity odds independent of BMI/smoking; leaves open prospective prediction and causal pathways.
BACKGROUND: Whether restricted spirometry, i.e. low Forced Vital Capacity (FVC), predicts chronic cardiometabolic disease is not definitely known. In this international population-based study, we assessed the relationship between restricted spirometry and cardiometabolic comorbidities. METHODS: A total of 23,623 subjects (47.5% males, 19.0% current smokers, age: 55.1 ± 10.8 years) from five continents (33 sites in 29 countries) participating in the Burden of Obstructive Lung Disease (BOLD) study were included. Restricted spirometry was defined as post-bronchodilator FVC < 5th percentile of reference values. Self-reports of physician-diagnosed cardiovascular disease (CVD; heart disease or stroke), hypertension, and diabetes were obtained through questionnaires. RESULTS: Overall 31.7% of participants had restricted spirometry. However, prevalence of restricted spirometry varied approximately ten-fold, and was lowest (8.5%) in Vancouver (Canada) and highest in Sri Lanka (81.3%). Crude odds ratios for the association with restricted spirometry were 1.60 (95% CI 1.37-1.86) for CVD, 1.53 (95% CI 1.40-1.66) for hypertension, and 1.98 (95% CI 1.71-2.29) for diabetes. After adjustment for age, sex, education, Body Mass Index (BMI) and smoking, the odds ratios were 1.54 (95% CI 1.33-1.79) for CVD, 1.50 (95% CI 1.39-1.63) for hypertension, and 1.86 (95% CI 1.59-2.17) for diabetes. CONCLUSION: In this population-based, international, multi-site study, restricted spirometry associates with cardiometabolic diseases. The magnitude of these associations appears unattenuated when cardiometabolic risk factors are taken into account.
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Kulbacka-Ortiz et al. (2022) conducted a cross-sectional in Cardiometabolic comorbidities (Cardiovascular disease, Hypertension, Diabetes) (n=23,623). Restricted spirometry vs. Unrestricted spirometry was evaluated on Cardiovascular disease (CVD) (OR 1.54, 95% CI 1.33-1.79, p=<0.001). Restricted spirometry was significantly associated with higher adjusted odds of cardiovascular disease (OR 1.54), hypertension (OR 1.50), and diabetes (OR 1.86).
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