Abstract
Background and objectivesThere have been limited studies regarding the association between glomerular hyperfiltration (GHF) and restrictive spirometry pattern (RSP) in Korean adults.MethodsWe used data of 23,189 adults from the Korea National Health and Nutritional Examination Survey 2009–2015 with a complete data set including spirometry, serum creatinine, and anthropometric measurements. Spirometry data included the forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). We defined GHF as the >90th percentile of age & sex adjusted estimated glomerular filtration rate (eGFR), and RSP was defined as an FVC <80%-predicted value and an FEV1/FVC ratio ≥0.7.ResultsParticipants with RSP showed higher blood pressure, fasting glucose, and triglyceride, reduced high density lipoprotein cholesterol, and central obesity, which resulted in a higher prevalence of metabolic syndrome (MetS) compared to those without RSP. Multivariate logistic regression revealed that the odds for RSP were significantly increased with an increased number of MetS components. In addition, increased eGFR was associated with decreased FVC, showing an inverted J-shaped relationship in a multivariate generalized additive model analysis. In the multivariate logistic regression analysis, the adjusted odds ratio and 95% confidence interval of GHF for RSP was 1.184 (1.026–1.368, P = 0.021), which was evident in groups without metabolic disorders.ConclusionsWe concluded that GHF was associated with increased odds for RSP, particularly in groups without metabolic disorders. Further prospective studies are needed to confirm our study results.
Highlights
In ordinary practice, spirometry is commonly used to measure the pulmonary function [1]
In the multivariate logistic regression analysis, the adjusted odds ratio and 95% confidence interval of glomerular hyperfiltration (GHF) for restrictive spirometry pattern (RSP) was 1.184 (1.026–1.368, P = 0.021), which was evident in groups without metabolic disorders
We concluded that GHF was associated with increased odds for RSP, in groups without metabolic disorders
Summary
Spirometry is commonly used to measure the pulmonary function [1]. The clinical interpretation of corresponding reductions in FVC and FEV1, leading to a preserved FEV1/FVC ratio, has to be deferred until a reduced lung volume is confirmed by volumetric measurements This abnormal spirometry phenotype, which is referred to as restrictive spirometry pattern (RSP) [5], has been consistently reported to be associated with an increased risk of insulin resistance (IR) [6, 7], metabolic syndrome (MetS) [8,9,10,11], diabetes [12,13,14,15,16], cardiovascular disease [6, 15, 17, 18], and allcause death [11].This suggests that RSP may be a metabolic marker and not just a simple surrogate of lung restriction. There have been limited studies regarding the association between glomerular hyperfiltration (GHF) and restrictive spirometry pattern (RSP) in Korean adults
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