Why does lung function predict mortality? Results from the Whitehall II Cohort Study

Am J Epidemiol. 2010 Dec 15;172(12):1415-23. doi: 10.1093/aje/kwq294. Epub 2010 Oct 20.

Abstract

The authors examined the extent to which socioeconomic position, behavior-related factors, cardiovascular risk factors, inflammatory markers, and chronic diseases explain the association between poor lung function and mortality in 4,817 participants (68.9% men) from the Whitehall II Study aged 60.8 years (standard deviation, 5.9), on average. Forced expiratory volume in 1 second (FEV(1)) was used to measure lung function in 2002-2004. A total of 139 participants died during a mean follow-up period of 6.4 years (standard deviation, 0.8). In a model adjusted for age and sex, being in the lowest tertile of FEV(1)/height(2) was associated with a 1.92-fold (95% confidence interval: 1.35, 2.73) increased risk of mortality compared with being in the top 2 tertiles. Once age, sex, and smoking history were taken into account, the most important explanatory factors for this association were inflammatory markers (21.3% reduction in the FEV(1)/height(2)-mortality association), coronary heart disease, stroke, and diabetes (11.7% reduction), and alcohol consumption, diet, physical activity, and body mass index (9.8% reduction). The contribution of socioeconomic position and cardiovascular risk factors was small (≤ 3.5% reduction). Taken together, these factors explained 32.5% of the association. Multiple pathways link lung function to mortality; these results show inflammatory markers to be particularly important.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / mortality*
  • Cardiovascular Diseases / psychology
  • Chronic Disease
  • Cohort Studies
  • Female
  • Health Behavior
  • Humans
  • Inflammation / blood
  • Lung / physiopathology*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Respiratory Function Tests*
  • Retrospective Studies
  • Risk Factors
  • Socioeconomic Factors
  • Survival Rate
  • United Kingdom

Substances

  • Biomarkers