Lung function impairment and cardiometabolic risks among rural adults: implication for an aging society

The Gender Gap in the Relationship between Metabolic Syndrome and Restrictive Ventilatory Defects

BACKGROUND

Given the fundamental physiological differences between the sexes, this study aimed to investigate the effect of metabolic syndrome on ventilatory defects stratified by sex.

METHODS

We conducted a nationwide, pooled, cross-sectional study. Data from 45,788 participants (men, n = 15,859; women, n = 29,929) aged 30 years or more were obtained from the Taiwan Biobank. Age-sex-adjusted and multivariate logistic regression models were used to estimate the risk of developing impaired pulmonary function (restrictive or obstructive ventilatory defects) in individuals with or without metabolic syndromes. Separate models were also used to estimate the effect of metabolic syndrome scores and the effect of individual metabolic abnormalities on the risk of restrictive ventilatory defects.

RESULTS

The overall prevalence of metabolic syndrome was estimated to be 15.9% in Taiwan, much higher in men than in women (18.6% versus 14.4%). A significant association was observed between metabolic syndromes and the risk of restrictive ventilatory defects. The risk of developing a restrictive ventilator defect was 35% higher in participants with metabolic syndromes (odds ratio, 1.35; 95% confidence interval, 1.26-1.45) than in those without metabolic syndromes. Elevated blood pressure and a triglycerides abnormality were important predictors of restrictive ventilator defects. Sex-stratified subgroup analyses of the individual metabolic abnormalities indicated that men with abdominal obesity and women with dysglycemia were more likely to develop restrictive ventilatory defects.

CONCLUSIONS

Our study's evidence suggested that metabolic syndromes were important predictors of impaired pulmonary function and an increased risk of developing restrictive ventilatory defects, and its risk increased with increasing numbers of metabolic abnormalities.

Coffee consumption was associated with a lower prevalence of airflow limitation in postmenopausal women

BACKGROUND

Several studies have suggested a potential correlation between menopause and airflow limitation. However, the presence of protective factors in postmenopausal women remains uncertain. Therefore, our study seeks to examine potential protective factors associated with a reduced prevalence of airflow limitation among postmenopausal women.

METHODS

Postmenopausal women were recruited from the Taiwan Biobank for this cross-sectional study. Airflow limitation was defined by a forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) ratio <0.7. The participants were categorized into two groups: non-coffee drinkers and coffee drinkers, and the association between coffee consumption and airflow limitation was examined using binary logistic regression models.

RESULTS

A total of 8149 women with available information were enrolled. Compared to the non-coffee drinkers, the coffee drinkers had a significantly lower prevalence of airflow limitation (7% vs. 5%). The odds ratio (OR) for airflow limitation was lower in the coffee drinkers than in the non-coffee drinkers (OR = 0.77; 95% confidence interval [CI] = 0.63 to 0.94) after adjusting for confounding factors. We also examined the association between daily coffee consumption in cups and airflow limitation. The women who consumed ≥2 cups of coffee per day had an OR of 0.74 (95% CI = 0.59 to 0.94) compared to those who did not consume coffee.

CONCLUSIONS

Our results suggest that habitual coffee consumption is associated with a reduction in the prevalence of airflow limitation in postmenopausal women, warranting further prospective studies to explore possible causal effects and mechanisms.

Cognition as mediator of pulmonary function and risk of sarcopenia among older adults

BACKGROUND

The relationship between lung function and sarcopenia remains ambiguous. The primary aim of this study was to investigate the potential association between lung function and sarcopenia in the older adults, as well as to examine the mediating role of cognitive function in this relationship.

METHODS

The participants were selected from a nationally representative population-based cohort in China. The peak expiratory flow (PEF) measurement was used to evaluate the lung function in older persons. The sarcopenia was diagnosed using the guidelines of the Asian Working Group for Sarcopenia (AWGS) in 2019. The Cox proportional hazard model was utilized to perform primary analyses of the relationship between PEF and sarcopenia. The mediating effect of cognitive function was evaluated using the counterfactual mediation method.

RESULTS

This cohort study included 4,011 older adults (average age, 66.6 years; 53.3% males). During a follow-up period of 3.86 years, 349 individuals were diagnosed with sarcopenia. After adjusting for potential confounders, each one-standard-deviation increase in PEF was associated with a 28% reduction in the risk of sarcopenia (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.63, 0.80). There was a significant mediation of cognition for the association between PEF and incident sarcopenia, and the proportion mediated was 12.2% (95% CI: 4.5%, 23.1%).

CONCLUSIONS

Older adults with impaired lung function are more likely to develop sarcopenia. Nevertheless, cognition can explain only a small portion of this association. Thus, other potential pathways between lung function and sarcopenia must be elucidated.

Associations between different body mass index and lung function impairment in Chinese people aged over 40 years: a multicenter cross-sectional study

OBJECTIVE

The aim of this study was to explore the associations between different body mass index (BMI) levels and different lung function impairment (LFI) in Chinese people aged over 40 years.

METHODS

We used a multi-stage stratified cluster random sampling method to investigate 3000 residents aged over 40 years from 5 areas in Hubei province of China in 2019-20. The data on questionnaire, physical measurements, and spirometry of the participants were collected. The associations of different BMI levels with different LFI were analyzed using multivariate logistic regressions after complex weighting. The spirometry data were analyzed using one-factor analysis of variance (ANOVA), and post-hoc was performed using the least significance difference (LSD)-t test.

RESULTS

A total of 2860 subjects were included. The prevalence (95%CI) of obstructive lung disease (OLD), restrictive lung disease (RLD), mixed lung disease (MLD), chronic obstructive pulmonary disease (COPD), COPD mild, and COPD moderate/severe/very severe were 24.1% (95% CI: 22.2-26.2), 11.6% (95% CI: 10.3-12.9), 4.0% (95% CI: 3.3-4.8), 12.6% (95% CI: 11.0-14.1), 7.2% (95% CI: 6.0-8.4), and 5.3% (95% CI: 4.3-6.4) respectively. After multivariate adjustment, the risk of OLD, COPD, and COPD mild decreased with the increment of BMI levels (both P for trend < 0.05). When compared to the normal weight group, the overweight group and obese group were at lower risk of experiencing OLD than normal group, the ORs were 0.77 (95% CI: 0.59-0.99) and 0.59 (95% CI: 0.40-0.86) respectively. The obese group was at lower risk for people with COPD mild (OR: 0.42, 95%CI: 0.21-0.85). Participants in underweight group were more likely to experience COPD and COPD moderate/severe/very severe, the ORs were 2.82 (95% CI: 1.07-7.39) and 3.89 (95% CI: 1.28-11.87) respectively.

CONCLUSION

Higher BMI levels were associated with an decreased risk of OLD and COPD. Obesity had a protective effect on lung function in OLD patients and COPD patients. However, there was no significant difference in RLD and MLD prevalence between different BMI groups.

Application of Anderson model to analyze the influencing factors of lung function test behavior in middle-aged and elderly people in China

Introduction

Lung function tests are valuable in assessing respiratory health and disease, and the Healthy China Initiative clearly states that people over 40 years of age should have a lung function test once a year. To explore the influence of propensity factors, ability factors, and need factors on lung function detection behaviors of middle-aged and elderly Chinese, the following studies are conducted.

Method

A questionnaire was designed using Anderson's model, and multi-stage sampling was used to conduct a nationwide questionnaire survey based on geographical subdivisions and population distribution. Frequency and percentages were used for descriptive statistical analysis of lung function testing among middle-aged and elderly people in China, and chi-square tests and binary logistic regression analyses were used to investigate the factors influencing lung function testing behavior among middle-aged and elderly people in China.

Result

A total of 404 study participants were included in this study. Education level (relative to primary school and below, middle school and high school and secondary school OR = 2.652, P = 0.018; college and above OR = 4.566, P = 0.002), mode of health care affordability (relative to those who paid for the test, non-payers OR = 2.205, P = 0.004), dimensions of the European Five Dimensional Health Scale (mobility OR = 4.571, P = 0.006; pain or discomfort OR = 0.397, P = 0.003; anxiety or depression OR = 0.511, P = 0.028), and self-efficacy (medium group 0R = 0.294, P < 0.001; low group OR = 0.162, P = 0.003) had a significant impact on lung function testing behavior in our middle-aged and older adults.

Conclusion

This study found that there is still room for improvement in the participation of middle-aged and elderly people in lung function testing. Among the propensity factors, the factor that affects the rate of lung function tests is the highest degree of education, which determines the degree of patients' attention to lung function tests. Among the need factors, the factors affecting the rate of lung function detection are the physical conditions of middle-aged and elderly people, and those with poor physical conditions need medical detection. Among the ability factors, the factor that affects the rate of lung function tests is the way of bearing medical expenses, and economic status is the key factor that determines whether patients can accept lung function tests.

Effects of transplantation of umbilical cord blood mononuclear cells into the scrotum on sexual function in elderly mice

Aim: This study investigated the effect of allografting umbilical cord blood mononuclear cells (UCBMCs) into the scrotum on sexual function in male elderly mice. Methods: UCBMCs were injected once into the scrotal sheath cavity of elderly mice. Results: The transplanted UCBMCs survived in the scrotal sheath cavity for 1 month. The mice had significantly increased blood testosterone concentrations, cyclic guanosine monophosphate (cGMP) levels and total nitric oxide synthase (T-NOS) activity in the corpus cavernosum and an increase in the number of mouse matings within 30 min (all p = 0.000). Conclusion: Scrotum-implanted UCBMCs improve the sexual function of male elderly mice through testosterone production and the NOS/cGMP pathway, which may provide an innovative transplantation approach for the treatment of erectile dysfunction.

Matters of the Heart: Childhood Maltreatment, Religious Transitions, and Cardiovascular-Related Problems over the Life Course

Objectives:

Childhood maltreatment is associated with a higher risk of cardiovascular-related problems, the leading cause of death in the United States. Drawing from cumulative inequality theory, this study considers whether transitions in religious attendance moderate the deleterious impact of childhood maltreatment on long-term cardiovascular risk.

Methods:

We utilize over 35 years of prospective panel data from the National Longitudinal Study of Youth from the United States (1979–2015).

Results:

Our findings suggest that decreases in religious attendance between adolescence and adulthood (from high to low, and high to moderate attendance) were associated with elevated cardiovascular-related risk for those abused as children. Neither stable high attendance nor increases in attendance buffered against the impact of childhood abuse on cardiovascular-related problems.

Discussion:

We illustrate the importance of incorporating the role of stability and change in religious attendance across the life course and suggest directions for future research.

Betel Nut Chewing Was Associated with Obstructive Lung Disease in a Large Taiwanese Population Study

The prevalence of betel nut chewing in Taiwan is high at approximately 7%, however, few studies have evaluated the relationship between betel nut chewing and lung disease. Therefore, the aim of this study was to investigate associations between betel nut chewing and lung function in 80,877 participants in the Taiwan Biobank (TWB). We further investigated correlations between betel nut chewing characteristics such as years of use, frequency, daily amount, and accumulative dose, with obstructive lung disease. We used data from the TWB. Lung function was assessed using spirometry measurements of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). The participants were classified into normal lung function and obstructive lung function (FEV1/FVC < 70%) groups. The participants were asked questions about betel nut chewing, including years of use, frequency, and daily amount. After multivariable analysis, betel nut chewing (odds ratio [OR] = 1.159; p < 0.001) was significantly associated with FEV1/FVC < 70% in all participants (n = 80,877). Further, in the participants who chewed betel nut (n = 5135), a long duration of betel nut chewing (per 1 year; OR = 1.008; p = 0.012), betel nut use every day (vs. 1–3 days/month; OR = 1.793; p = 0.036), 10–20 quids a day (vs. <10 quids; OR = 1.404; p = 0.019), 21–30 quids a day (vs. <10 quids; OR = 1.662; p = 0.010), ≥31 quids a day (vs. <10 quids; OR = 1.717; p = 0.003), and high cumulative dose (per 1 year × frequency × daily score; OR = 1.001; p = 0.002) were significantly associated with FEV1/FVC < 70%. In this large population-based cohort study, chewing betel nut was associated with obstructive lung disease. Furthermore, a long duration of betel nut chewing, more frequent use, higher daily amount, and high cumulative dose were associated with obstructive lung disease. This suggests that preventing betel nut chewing should be considered to reduce obstructive lung disease in Taiwan.