• Guochen Li, Yanqiang Lu, Yanan Qiao, Die Hu, and Chaofu Ke.
• Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China.
• Chest. 2022 Aug 1; 162 (2): 421-432.

BackgroundAlthough pulmonary function has been studied in relationship to individual cardiometabolic diseases, uncertainty persists about the difference in risk magnitudes of pulmonary function for these diseases and its association with cardiometabolic multimorbidity (CM).Research QuestionDoes pulmonary function have different risk magnitudes for cardiometabolic diseases and CM?Study Design And MethodsThis study used data from the UK Biobank, including 357,433 individuals with no cardiometabolic diseases at baseline (stage I) and 35,034 individuals with one cardiometabolic disease at baseline (stage II). Pulmonary function was measured by FVC or FEV1. We defined CM as the coexistence of at least two cardiometabolic diseases: type 2 diabetes (T2D), coronary heart disease (CHD), and stroke. Multinomial logistic regression models and Cox proportional hazards models were performed to estimate ORs or hazard ratios (HRs) and their 95% CIs for the longitudinal relationship between baseline pulmonary function and incident cardiometabolic outcomes.ResultsIn stage I, FVC showed the most pronounced associations with new-onset CM and T2D among the four mutually exclusive end points. Compared with the lowest quartile (quartile 1), the adjusted ORs of quartile 4 of FVC were 0.525 (95% CI, 0.468-0.589) for CM, 0.534 (95% CI, 0.498-0.572) for T2D alone, 0.817 (95% CI, 0.751-0.888) for stroke alone, and 0.800 (95% CI, 0.764-0.837) for CHD alone. In stage II, FVC also was associated with the risk of CM in patients with T2D (HR of quartile 4, 0.727; 95% CI, 0.649-0.814), patients with CHD (HR, 0.635; 95% CI, 0.555-0.727), and patients who experienced stroke (HR, 0.783, 95% CI, 0.642-0.955). Similar results were observed for FEV1 in both stages.InterpretationThis study revealed the different risk associations of pulmonary function with individual cardiometabolic diseases and CM. Tailor-made screening and monitoring through pulmonary function may be applicable for the precise prevention and control of these conditions.Copyright © 2022 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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