1.中山大学公共卫生学院营养学系,广东 广州 510080
2.广州市从化区卫生健康局,广东 广州 510900
曾伟锋,第一作者,研究方向:流行病与卫生统计学,E-mail: zengwf9@mail2.sysu.edu.cn
收稿:2025-05-30,
修回:2025-07-01,
录用:2025-07-03,
纸质出版:2025-09-20
移动端阅览
曾伟锋,叶炳琪,杨嘉璐等.广州乡村老年人肺功能现状及影响因素[J].中山大学学报(医学科学版),2025,46(05):851-860.
ZENG Weifeng,YE Bingqi,YANG Jialu,et al.Pulmonary Function and Its Influencing Factors in Rural Elderly Adults in Guangzhou[J].Journal of Sun Yat-sen University(Medical Sciences),2025,46(05):851-860.
曾伟锋,叶炳琪,杨嘉璐等.广州乡村老年人肺功能现状及影响因素[J].中山大学学报(医学科学版),2025,46(05):851-860. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2025.0515.
ZENG Weifeng,YE Bingqi,YANG Jialu,et al.Pulmonary Function and Its Influencing Factors in Rural Elderly Adults in Guangzhou[J].Journal of Sun Yat-sen University(Medical Sciences),2025,46(05):851-860. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2025.0515.
目的
2
了解广州乡村老年人的肺功能水平及相关的影响因素,确定肺功能不良的高危人群,并揭示肺功能影响因素之间的关系。
方法
2
研究对象为2023年广州市从化区60岁至94岁的1 500名居民,采用方便抽样的方法选取。通过面对面问卷调查和体格检查,获取人口学特征、身体测量数据、疾病史和生活方式等信息。同时,使用便携式肺活量计检测了受试者的呼气功能,包括一秒用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC,并观察气流阻塞(AFO)的患病率。研究按照5岁的年龄间隔报告了老年人的肺功能的年龄和性别分布,并运用多因素逻辑回归模型分析了AFO的影响因素。此外,进一步借助路径分析探究生活方式在其他影响因素与肺功能关联中所起的作用。
结果
2
纳入的1 500名研究对象年龄中位数和四分位数为71(67~75)岁,男性占44.2%。确定为AFO的受试者平均年龄更高、更多为男性、受教育程度更低,中高强度体力活动少于每周一次、或体形偏瘦的比例较高。FEV1/FVC的平均比值为(81.96±16.42)%。男性的FEV1/FVC为(79.80±17.58)%,女性为(83.66±15.22)%。高龄、低学历、男性和偏瘦与所有肺功能结局呈负相关(所有
P
值均<0.05)。路径分析显示,年龄、性别、婚姻状况、职业和收入可能通过生活方式与肺功能间接相关。
结论
2
广州乡村老年人肺功能水平较低,其中男性、非已婚、高龄、低学历、吸烟、缺乏中高强度体力活动、偏瘦与更差的肺功能相关。
Objective
2
To investigate pulmonary function levels and associated influencing factors among rural elderly in Guangzhou, to identify high-risk populations for poor pulmonary function, and to reveal the relationship between the influencing factors of pulmonary function.
Methods
2
We recruited 1 500 residents aged 60 to 94 years from rural area of Conghua District, Guangzhou City using convenience sampling in 2023. Data on demographics, body measurements, medical history and lifestyle were collected via face-to-face questionnaires and physical examination. Meanwhile, expiratory function parameters including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC, and the prevalence of airflow obstruction (AFO) were assessed using a portable spirometer. Age and sex distribution of pulmonary function in older adults at 5-year intervals was reported, and risk factors of AFO using multifactorial logistic regression models were analyzed. Furthermore, path analysis was further employed to explore the role of lifestyle in the association between other influencing factors and lung function.
Results
2
Among the 1 500 participants, the median age was 71 years (67-75), and 44.2% were male. Subjects identified as AFOs were generally older, more likely male, less educated, and had lower rates of moderate to vigorous physical activity (<1 time/week) and lower lean body mass. Mean FEV1/FVC ratio was (82.0±16.4) %. FEV1/FVC was (79.80±17.58) % in men and (83.66±15.22) % in women. Older age, lower education, male sex and leanness were negatively associated with all pulmonary function outcomes (all
P
values<0.05). Path analysis identified that age, gender, marital status, occupation and income may influence pulmonary function indirectly through lifestyle.
Conclusion
2
Rural elderly in Guangzhou exhibited lower pulmonary function levels, and male sex, non-married status, advanced age, lower education, smoking habits, insufficient engagement in moderate to vigorous physical activity, and lean body type were all associated with worse pulmonary function.
佟赫 , 丛舒 , 方利文 , 等 . 2019-2020年中国40岁及以上人群肺功能检查状况分析 [J]. 中华流行病学杂志 , 2023 , 44 ( 5 ): 727 - 734 .
Tong H , Cong S , Fang LW , et al . Performance of pulmonary function test in people aged 40 years and above in China, 2019-2020 [J]. Chin J Epidemiol , 2023 , 44 ( 5 ): 727 - 734 .
杨亚蕊 , 郭旭君 , 魏巍 , 等 . 深圳市南山区≥40岁常住居民慢性阻塞性肺疾病知识知晓情况及患病率影响因素分析 [J]. 结核与肺部疾病杂志 , 2024 , 5 ( 6 ): 517 - 525 .
Yang YR , Guo XJ , Wei W , et al . Awareness and factors associated with chronic obstructive pulmonary disease among permanent residents age≥40 years old in Nanshan District, Shenzhen [J]. J Tubercul Lung Dis , 2024 , 5 ( 6 ): 517 - 525 .
Li X , Li L , Ji S , et al . Association between pulmonary ventilation function and cognitive function among middle-aged and older adults: an observational study from Southwest China [J]. BMC Pulm Med , 2024 , 24 ( 1 ): 626 .
Wang J , Du J , Gao Y , et al . Characteristics of lung function and prevalence of airflow obstruction among individuals aged 18-74 years-Beijing, China, 2017-2018 [J]. China CDC Wkly , 2022 , 4 ( 51 ): 1148 - 1153 .
Wang C , Xu J , Yang L , et al . Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China pulmonary health [CPH] study): a national cross-sectional study [J]. Lancet , 2018 , 391 ( 10131 ): 1706 - 1717 .
Venkatesan P . GOLD COPD report: 2024 update [J]. Lancet Respir Med , 2024 , 12 ( 1 ): 15 - 16 .
Murgia N , Gambelunghe A . Occupational COPD-The most under-recognized occupational lung disease? [J]. Respirology , 2022 , 27 ( 6 ): 399 - 410 .
Zou J , Sun T , Song X , et al . Distributions and trends of the global burden of COPD attributable to risk factors by SDI, age, and sex from 1990 to 2019: a systematic analysis of GBD 2019 data [J]. Respir Res , 2022 , 23 ( 1 ): 90 .
Hegewald MJ , Crapo RO . Socioeconomic status and lung function [J]. Chest , 2007 , 132 ( 5 ): 1608 - 1614 .
Gomez-Baya D , Salinas-Perez JA , Rodero-Cosano ML , et al . Socioeconomic inequalities in health through lifestyles: analysing gender and age differences in Andalusia, Spain [J]. J Community Health , 2020 , 45 ( 4 ): 836 - 845 .
Thomson B , Tapia-Conyer R , Lacey B , et al . Low-intensity daily smoking and cause-specific mortality in Mexico: prospective study of 150 000 adults [J]. Int J Epidemiol , 2021 , 50 ( 3 ): 955 - 964 .
樊萌语 , 吕筠 , 何平平 . 国际体力活动问卷中体力活动水平的计算方法 [J]. 中华流行病学杂志 , 2014 , 35 ( 8 ): 961 - 964 .
Fan MY , Lyu J , He PP . Chinese guidelines for data processing and analysis concerning the International Physical Activity Questionnaire [J]. Chin J Epidemiol , 2014 , 35 ( 8 ): 961 - 964 .
Zeng Q , Li N , Pan XF , et al . Clinical management and treatment of obesity in China [J]. Lancet Diabetes Endocrinol , 2021 , 9 ( 6 ): 393 - 405 .
Spiteri K , Xerri De Caro J , Grafton K , et al . Physical activity and sedentary behaviour with retirement in Maltese civil servants: a dialectical mixed-method study [J]. Int J Environ Res Public Health , 2022 , 19 ( 21 ): 14598 .
Rosseel Y . lavaan: an R package for structural equation modeling [J]. J Stat Softw , 2012 , 48 ( 2 ): 1 - 36 .
Harris JE , Gleason PM . Application of path analysis and structural equation modeling in nutrition and dietetics [J]. J Acad Nutr Diet , 2022 , 122 ( 11 ): 2023 - 2035 .
Agusti A , Faner R . Lung function trajectories in health and disease [J]. Lancet Respir Med , 2019 , 7 ( 4 ): 358 - 364 .
黄丽霞 , 张静 , 陈莉娟 , 等 . 甘肃省慢性阻塞性肺疾病流行特征及其高危因素调查 [J]. 现代预防医学 , 2024 , 51 ( 15 ): 2726 - 2730 ; + 2747 .
Huang LX , Zhang J , Chen LJ , et al . Epidemiological characteristics and risk factors of chronic obstructive pulmonary disease (COPD) in Gansu Province [J]. Mod Prev Med , 2024 , 51 ( 15 ): 2726 - 2730 ; + 2747 .
Tian XY , Liu CH , Wang DX , et al . Spirometric reference equations for elderly Chinese in Jinan aged 60-84 years [J]. Chin Med J (Engl) , 2018 , 131 ( 9 ): 1016 - 1022 .
Liu C , Cheng W , Zeng Y , et al . Different characteristics of ex-smokers and current smokers with COPD: a cross-sectional study in China [J]. Int J Chron Obstruct Pulmon Dis , 2020 , 15 : 1613 - 1619 .
赖招霞 , 陈繁 , 谢荷荫 . 龙岩市新罗区2020年粉尘作业人员肺功能检查结果分析 [J]. 海峡预防医学杂志 , 2022 , 28 ( 1 ): 109 - 110 .
Lai ZX , Chen F , Xie HY . Analysis of lung function examination results of dust operators in 2020 in Xinluo District, Longyan City [J]. Strait J Prev Med , 2022 , 28 ( 1 ): 109 - 110 .
李慧茹 , 周林琼 , 段春磊 , 等 . 早期慢性阻塞性肺疾病危险因素及诊断和管理的国际研究进展 [J]. 中华危重病急救医学 , 2023 , 35 ( 12 ): 1340 - 1344 .
Li HR , Zhou LQ , Duan CL , et al . International research progress of risk factors, diagnosis and management in early chronic obstructive pulmonary disease [J]. Chin Crit Care Med , 2023 , 35 ( 12 ): 1340 - 1344 .
Hua Y , Fan X , Yang M , et al . Association between socioeconomic status and risk of chronic obstructive pulmonary disease in China: a prospective cohort study [J]. BMC Public Health , 2024 , 24 ( 1 ): 2077 .
Poureslami I , Fitzgerald JM , Tregobov N , et al . Health literacy in asthma and chronic obstructive pulmonary disease (COPD) care: a narrative review and future directions [J]. Respir Res , 23 ( 1 ): 361 .
Zhang DD , Liu JN , Ye Q , et al . Association between socioeconomic status and chronic obstructive pulmonary disease in Jiangsu province, China: a population-based study [J]. Chin Med J (Engl) , 2021 , 134 ( 13 ): 1552 - 1560 .
Quispe-Haro C , Szabó D , Kordas K , et al . The mediating role of air pollutants in the association between education and lung function among the elderly, the HAPIEE study [J]. Sci Total Environ , 2024 , 947 : 174556 .
Collaud S , Touilloux B , Von Garnier C , et al . Physical activity and lung function association in a healthy community-dwelling European population [J]. BMC Pulm Med , 2024 , 24 ( 1 ): 169 .
O'donovan G , Hamer M . The association between leisure-time physical activity and lung function in older adults: the English longitudinal study of ageing [J]. Prev Med , 2018 , 106 : 145 - 149 .
Burtscher J , Millet GP , Gatterer H , et al . Does regular physical activity mitigate the age-associated decline in pulmonary function? [J]. Sports Med , 2022 , 52 ( 5 ): 963 - 970 .
Li LSK , Cassim R , Perret JL , et al . The longitudinal association between physical activity, strength and fitness, and lung function: a UK biobank cohort study [J]. Respir Med , 2023 , 220 : 107476 .
Glasson L , Panter J , Ogilvie D , et al . The physical activity implications of retirement across occupational activity groups [J]. Prev Med , 2023 , 173 : 107570 .
Vogiatzis I , Zakynthinos G , Andrianopoulos V . Mechanisms of physical activity limitation in chronic lung diseases [J]. Pulm Med , 2012 , 2012 : 634761 .
Rawashdeh A , Alnawaiseh N . The effect of high-intensity aerobic exercise on the pulmonary function among inactive male individuals [J]. Biomed Pharmacol J , 2018 , 11 : 735 - 741 .
Huang K , Han X , Pan Z , et al . Impact of using pre- and postbronchodilator spirometry reference values in a Chinese population [J]. Am J Respir Crit Care Med , 2024 , 210 ( 7 ): 881 - 889 .
0
浏览量
284
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621
