Glomerular hyperfiltration may be a novel risk factor of restrictive spirometry pattern: Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2015

Abstract

Background and objectivesThere have been limited studies regarding the association between glomerular hyperfiltration (GHF) and restrictive spirometry pattern (RSP) in Korean adults.MethodsWe used data of 23,189 adults from the Korea National Health and Nutritional Examination Survey 2009–2015 with a complete data set including spirometry, serum creatinine, and anthropometric measurements. Spirometry data included the forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). We defined GHF as the >90th percentile of age & sex adjusted estimated glomerular filtration rate (eGFR), and RSP was defined as an FVC <80%-predicted value and an FEV1/FVC ratio ≥0.7.ResultsParticipants with RSP showed higher blood pressure, fasting glucose, and triglyceride, reduced high density lipoprotein cholesterol, and central obesity, which resulted in a higher prevalence of metabolic syndrome (MetS) compared to those without RSP. Multivariate logistic regression revealed that the odds for RSP were significantly increased with an increased number of MetS components. In addition, increased eGFR was associated with decreased FVC, showing an inverted J-shaped relationship in a multivariate generalized additive model analysis. In the multivariate logistic regression analysis, the adjusted odds ratio and 95% confidence interval of GHF for RSP was 1.184 (1.026–1.368, P = 0.021), which was evident in groups without metabolic disorders.ConclusionsWe concluded that GHF was associated with increased odds for RSP, particularly in groups without metabolic disorders. Further prospective studies are needed to confirm our study results.

Determinants of Longitudinal Change of Lung Function in Different Gender in a Large Taiwanese Population Follow-Up Study Categories: Original Investigation

“…Another important finding of this study is that a low eGFR was significantly associated with a fast decrease in FEV1/FVC in both the male and female participants. Lim et al reported that glomerular hyperfiltration was associated with a restrictive pattern of spirometry after adjusting for blood pressure and metabolic indices, but that confounders, such as reduced muscle mass, low serum creatinine and an inflammatory effect still existed [47]. In addition, Kim et al [40] performed an analysis of the Korean National Health and Nutrition Examination Survey, which represents the general Korean population from 2010 to 2012, and found that both restrictive and obstructive impaired pulmonary function was associated with a decline in the eGFR in both male and female participants.…”

Glomerular Hyperfiltration Interacts With Abnormal Metabolism to Enhance Arterial Stiffness in Middle-Aged and Elderly People

“…GHF was defined as an eGFR over the 90th percentile in different age (40-49, 50-59, and ≥60 years) and sex categories (14) at baseline, the 90th percentile cut-off points (15)(16)(17) of the Modification of Diet in Renal study (MDRD) eGFR were from 124.65 to 149.58 mL/min per 1.73 m 2 .…”