Combined effect of lung function level and decline increases morbidity and mortality risks
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Combined effect of lung function level and decline increases morbidity and mortality risks. / Baughman, Penelope; Marott, Jacob Louis; Lange, Peter; Martin, Christopher J; Shankar, Anoop ; Petsonk, Edward L; Hnizdo, Eva .
I: European Journal of Epidemiology, Bind 27, 2012, s. 933–943.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Combined effect of lung function level and decline increases morbidity and mortality risks
AU - Baughman, Penelope
AU - Marott, Jacob Louis
AU - Lange, Peter
AU - Martin, Christopher J
AU - Shankar, Anoop
AU - Petsonk, Edward L
AU - Hnizdo, Eva
PY - 2012
Y1 - 2012
N2 - Abstract Lung function level and decline are each pre-dictive of morbidity and mortality. Evaluation of thecombined effect of these measurements may help furtheridentify high-risk groups. Using Copenhagen City HeartStudy longitudinal spirometry data (n = 10,457),16–21 year risks of chronic obstructive pulmonary disease(COPD) morbidity, COPD or coronary heart disease mor-tality, and all-cause mortality were estimated from com-bined effects of level and decline in forced expiratoryvolume in one second (FEV1). Risks were evaluated usingCox proportional hazards models for individuals groupedby combinations of baseline predicted FEV1 and quartilesof slope. Hazard ratios (HR) and 95 % con¿dence intervals(CI) were estimated using strati¿ed analysis by gender,smoking status, and baseline age (B45 and [45). ForCOPD morbidity, quartiles of increasing FEV1 declineincreased HRs (95 % CI) for individuals with FEV1 at orabove the lower limit of normal (LLN) but below 100 %predicted, reaching 5.11 (2.58–10.13) for males, 11.63(4.75–28.46) for females, and 3.09 (0.88–10.86) for neversmokers in the quartile of steepest decline. Signi¿cantincreasing trends were also observed for mortality and inindividuals with a baseline age B45. Groups with ‘normal’lung function (FEV1 at or above the LLN) but excessivedeclines (fourth quartile of FEV1 slope) had signi¿cantlyincreased mortality risks, including never smokers andindividuals with a baseline age B45.
AB - Abstract Lung function level and decline are each pre-dictive of morbidity and mortality. Evaluation of thecombined effect of these measurements may help furtheridentify high-risk groups. Using Copenhagen City HeartStudy longitudinal spirometry data (n = 10,457),16–21 year risks of chronic obstructive pulmonary disease(COPD) morbidity, COPD or coronary heart disease mor-tality, and all-cause mortality were estimated from com-bined effects of level and decline in forced expiratoryvolume in one second (FEV1). Risks were evaluated usingCox proportional hazards models for individuals groupedby combinations of baseline predicted FEV1 and quartilesof slope. Hazard ratios (HR) and 95 % con¿dence intervals(CI) were estimated using strati¿ed analysis by gender,smoking status, and baseline age (B45 and [45). ForCOPD morbidity, quartiles of increasing FEV1 declineincreased HRs (95 % CI) for individuals with FEV1 at orabove the lower limit of normal (LLN) but below 100 %predicted, reaching 5.11 (2.58–10.13) for males, 11.63(4.75–28.46) for females, and 3.09 (0.88–10.86) for neversmokers in the quartile of steepest decline. Signi¿cantincreasing trends were also observed for mortality and inindividuals with a baseline age B45. Groups with ‘normal’lung function (FEV1 at or above the LLN) but excessivedeclines (fourth quartile of FEV1 slope) had signi¿cantlyincreased mortality risks, including never smokers andindividuals with a baseline age B45.
U2 - 10.1007/s10654-012-9750-2
DO - 10.1007/s10654-012-9750-2
M3 - Journal article
C2 - 23238697
VL - 27
SP - 933
EP - 943
JO - European Journal of Epidemiology
JF - European Journal of Epidemiology
SN - 0393-2990
ER -
ID: 44325205