Association between lung function and future risks of diabetes, asthma, myocardial infarction, hypertension and all-cause mortality

Abstract

BackgroundWhile forced expiratory volume in 1 s (FEV1) is a hallmark of disease progression in chronic obstructive lung diseases, little is known about the relationship between baseline FEV1 and future risks of other medical conditions.ObjectiveThe aim of this study was to investigate the association between baseline FEV1 and future risks of diabetes, asthma, myocardial infarction, hypertension and all-cause mortality.MethodsWe used data from the National Health and Nutrition Examination Survey and its Epidemiological Follow-Up Study. Our data provided longitudinal follow-up of the original cohort for up to 12 years. We used two competing risks approaches, the cause-specific hazard model and the Fine–Gray sub-distribution hazard model, to measure the associations between baseline FEV1 and future risks of the outcomes of interest. All models were adjusted for major confounding factors.ResultsThe final sample included 3020 participants (mean±sd baseline age 44.64±13.44 years). In the cause-specific hazard model, for every per cent increase in the baseline per cent predicted FEV1, the hazard of the event reduced by 2.5% (HR 0.975; 95% CI 0.958–0.994) for diabetes, 4.3% (HR 0.957; 95% CI 0.932–0.983) for asthma and 1.8% (HR 0.982; 95% CI 0.971–0.992) for all-cause mortality. There was no statistically significant association between baseline per cent predicted FEV1 and future risks of myocardial infarction (HR 0.987; 95% CI 0.970–1.004) and hypertension (HR 0.998; 95% CI 0.992–1.005). Consistent results were observed for the Fine–Gray sub-distribution hazard model.ConclusionOur data suggest that lower per cent predicted FEV1 values at baseline were significantly associated with higher future risks of diabetes, asthma and all-cause mortality.