TY - JOUR
T1 - Airflow Obstruction and Cardio-metabolic Comorbidities
AU - Triest, Filip J. J.
AU - Studnicka, Michael
AU - Franssen, Frits M. E.
AU - Vollmer, William M.
AU - Lamprecht, Bernd
AU - Wouters, Emiel F. M.
AU - Burney, Peter G. J.
AU - Vanfleteren, Lowie E. G. W.
N1 - Funding Information:
The BOLD Study is currently funded by a grant from The Wellcome Trust (085790/Z/08/Z) which supports the London, UK Co-ordinating Center. The initial BOLD program was funded in part by unrestricted educational grants to the Co-ordinating Center in Portland, USA from Aventis, AstraZeneca, Boehringer-Ingelheim, Chiesi, GlaxoSmithKline, Merck, Novartis, Pfizer, Schering-Plough, Sepracor and University of Kentucky. BOLD wishes to acknowledge the contributions of Georg Harnoncourt of the ndd Corporation, Paul Enright, and Bob Jensen for their assistance with spirometry training and quality control during the study. A full list of funders can be found at: http:// www.boldstudy.org/sponsors.html. Dr. Filip J.J. Triest, Dr. Michael Studnicka, Dr. Frits M.E. Franssen, Dr. Bernd Lamprecht, and Dr. Lowie E.G.W. Vanfleteren report no other conflicts of interest. Dr. William M. Vollmer reports unrestricted educational grants to the Center for Health Research received unrestricted educational grants from a variety of pharmaceutical companies while serving as Operations Center for the first 15 BOLD sites. These funds were used for training and to pay staff salaries, during the conduct of the study. These are included in the general statement above. Dr. Peter G.J. Burney reports grants from Wellcome Trust, during the conduct of the study. This is included in the general statement above. Dr. Wouters reports personal fees from board membership (Nycomed, Boehringer), grants (AstraZeneca, GSK), personal fees from payment for lectures (AstraZeneca, GSK, Novartis, Chiesi), outside the submitted work.
Funding Information:
The BOLD Study is currently funded by a grant from The Wellcome Trust (085790/Z/08/Z) which supports the London, UK Co-ordinating Center. The initial BOLD program was funded in part by unrestricted educational grants to the Co-ordinating Center in Portland, USA from Aventis, AstraZeneca, Boehringer-Ingelheim, Chiesi, GlaxoSmithKline, Merck, Novartis, Pfizer, Schering-Plough, Sepracor and University of Kentucky. BOLD wishes to acknowledge the contributions of Georg Harnoncourt of the ndd Corporation, Paul Enright, and Bob Jensen for their assistance with spirometry training and quality control during the study. A full list of funders can be found at: http://www.boldstudy.org/sponsors.html. Dr. Filip J.J. Triest, Dr. Michael Studnicka, Dr. Frits M.E. Franssen, Dr. Bernd Lamprecht, and Dr. Lowie E.G.W. Vanfleteren report no other conflicts of interest. Dr. William M. Vollmer reports unrestricted educational grants to the Center for Health Research received unrestricted educational grants from a variety of pharmaceutical companies while serving as Operations Center for the first 15 BOLD sites. These funds were used for training and to pay staff salaries, during the conduct of the study. These are included in the general statement above. Dr. Peter G.J. Burney reports grants from Wellcome Trust, during the conduct of the study. This is included in the general statement above. Dr. Wouters reports personal fees from board membership (Nycomed, Boehringer), grants (AstraZeneca, GSK), personal fees from payment for lectures (AstraZeneca, GSK, Novartis, Chiesi), outside the submitted work.
Publisher Copyright:
© 2019, © 2019 Taylor & Francis Group, LLC.
PY - 2019/3/4
Y1 - 2019/3/4
N2 - Chronic obstructive pulmonary disease (COPD) is characterized by airflow obstruction and often co-exists with cardiovascular disease (CVD), hypertension and diabetes. This international study assessed the association between airflow obstruction and these comorbidities. 23,623 participants (47.5% males, 19.0% current smokers, age: 55.1 +/- 10.8 years) in 33 centers in the Burden of Obstructive Lung Disease (BOLD) initiative were included. 10.4% of subjects had airflow obstruction. Self-reports of physician-diagnosed CVD (heart disease or stroke), hypertension and diabetes were regressed against airflow obstruction (post-bronchodilator FEV1/FVC <5th percentile of reference values), adjusting for age, sex, smoking (including pack-years), body mass index and education. Analyses were undertaken within center and meta-analyzed across centers checking heterogeneity using the I-2-statistic. Crude odds ratios for the association with airflow obstruction were 1.42 (95% CI: 1.20-1.69) for CVD, 1.24 (1.02-1.51) for hypertension, and 0.93 (0.76-1.15) for diabetes. After adjustment these were 1.00 (0.86-1.16) (I-2:6%) for CVD, 1.14 (0.99-1.31) (I-2:53%) for hypertension, and 0.76 (0.64-0.89) (I-2:1%) for diabetes with similar results for men and women, smokers and nonsmokers, in richer and poorer centers. Alternatively defining airflow obstruction by FEV1/FVC <2.5th percentile or 0.70, did not yield significant other results. In conclusion, the associations of CVD and hypertension with airflow obstruction in the general population are largely explained by age and smoking habits. The adjusted risk for diabetes is lower in subjects with airflow obstruction. These findings emphasize the role of common risk factors in explaining the coexistence of cardio-metabolic comorbidities and COPD.
AB - Chronic obstructive pulmonary disease (COPD) is characterized by airflow obstruction and often co-exists with cardiovascular disease (CVD), hypertension and diabetes. This international study assessed the association between airflow obstruction and these comorbidities. 23,623 participants (47.5% males, 19.0% current smokers, age: 55.1 +/- 10.8 years) in 33 centers in the Burden of Obstructive Lung Disease (BOLD) initiative were included. 10.4% of subjects had airflow obstruction. Self-reports of physician-diagnosed CVD (heart disease or stroke), hypertension and diabetes were regressed against airflow obstruction (post-bronchodilator FEV1/FVC <5th percentile of reference values), adjusting for age, sex, smoking (including pack-years), body mass index and education. Analyses were undertaken within center and meta-analyzed across centers checking heterogeneity using the I-2-statistic. Crude odds ratios for the association with airflow obstruction were 1.42 (95% CI: 1.20-1.69) for CVD, 1.24 (1.02-1.51) for hypertension, and 0.93 (0.76-1.15) for diabetes. After adjustment these were 1.00 (0.86-1.16) (I-2:6%) for CVD, 1.14 (0.99-1.31) (I-2:53%) for hypertension, and 0.76 (0.64-0.89) (I-2:1%) for diabetes with similar results for men and women, smokers and nonsmokers, in richer and poorer centers. Alternatively defining airflow obstruction by FEV1/FVC <2.5th percentile or 0.70, did not yield significant other results. In conclusion, the associations of CVD and hypertension with airflow obstruction in the general population are largely explained by age and smoking habits. The adjusted risk for diabetes is lower in subjects with airflow obstruction. These findings emphasize the role of common risk factors in explaining the coexistence of cardio-metabolic comorbidities and COPD.
KW - Airflow obstruction
KW - COPD
KW - comorbidity
KW - cardiovascular
KW - hypertension
KW - diabetes
KW - CORONARY-HEART-DISEASE
KW - CARDIOVASCULAR RISK-FACTORS
KW - BLOOD-PRESSURE
KW - PREVALENCE
KW - MORBIDITY
KW - SMOKING
U2 - 10.1080/15412555.2019.1614550
DO - 10.1080/15412555.2019.1614550
M3 - Article
C2 - 31131642
SN - 1541-2555
VL - 16
SP - 109
EP - 117
JO - Copd-Journal of Chronic Obstructive Pulmonary Disease
JF - Copd-Journal of Chronic Obstructive Pulmonary Disease
IS - 2
ER -