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

Abstract

Background Early detection and prevention of cardiometabolic risk factors in an increasingly aging society are a global public health concern. Maintaining adequate lung function is important for healthy aging. Few studies exist on lung function impairment and decline in primary healthcare settings, especially among rural adults with cardiometabolic risks. This study aimed to explore the prevalence of impaired lung function and its association with cardiometabolic risks among rural adults. Methods A community-based, cross-sectional study was conducted between March and December 2019 in western coastal Yunlin County, Taiwan. The lung function test was measured by spirometry, based on the American Thoracic Society recommendations. Three lung function parameters were obstructive lung impairment, restrictive lung impairment, and mixed lung impairment. Restrictive, obstructive, and mixed type lung function was categorized as impaired. Cardiometabolic risk factors and metabolic syndrome were based on the national standard and include five abnormal biomarkers, including abdominal obesity, blood pressure, fasting plasma glucose, triglycerides, and decreased high-density cholesterol levels. Results The median age of the 1653 (92.9%) participants with complete data was 66 years (interquartile range: 55 to 75 years). The prevalence of impaired lung function was 37%, including 31.7% restrictive, 2.5% obstructive, and 2.7% mixed type. Adults with impaired lung function (86% restrictive type) engaged more in smoking and betel nut chewing, ate fewer vegetables and fruit, and drank less water compared to the normal lung function group. After adjusting for potential confounding variables, multivariate logistic regression analysis showed that cardiometabolic risk factors were independently associated with restrictive lung impairment, while cigarette smoking (OR = 2.27, 95% CI = 1.14–4.53) and betel nut chewing (OR = 2.33, 95% CI = 1.09–5.01) were significantly associated with the obstructive type of lung impairment. Conclusions A high prevalence of restrictive lung impairment, cardiometabolic risks, and unhealthy lifestyles among rural adults were found in this study. For adults with cardiometabolic risks in rural areas, initiating lifestyle modifications with culture-tailored programs to improve lung function should be an important issue for clinicians and primary healthcare providers.

The gender gap in the relationship between Metabolic Syndrome and Restrictive Ventilatory Defect

“…In contrast, only men with abdominal obesity (or increasing WC) and women with dysglycemia (elevating fasting blood glucose) were more likely to develop RVD. Many studies demonstrated that the risk of developing RVD was associated with MetS [7,[19][20][21][22][23][24]. We observed an increased risk of RVD with increasing numbers of metabolic abnormalities, which was consistent with those reported by other researchers [7], [19,25].…”

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

“…In addition to asthma, betel nuts also associate with COPD, another common type of lung disease caused by chronic inflammation. Lin et al conducted a cross-sectional study of 1653 participants, and their results were the first to suggest a positive correlation between betel nut chewing and obstructive lung disease [10]. The mechanism underlying the association between betel nut chewing and COPD may also be related to arecoline, which can lead to tracheobronchial hypersecretion, tracheal smooth muscle contraction, and inflammation.…”

“…In 2004, betel nut was recognized by the International Agency for Research on Cancer as a group 1 human carcinogen [7]. In addition, betel nut chewing has been associated with metabolic syndrome, cardiovascular abnormities such as arterial stiffness and coronary artery disease, and the growth of colorectal polyps [8][9][10]. Although many studies have investigated the relationships between betel nut and extrapulmonary abnormalities, little is known about the effects of betel nuts on lung function.…”

“…Wang et al reported that betel nut chewing caused the release of eotaxin-1 induced by arecoline, a major alkaloid in betel nuts, which can cause asthma [11]. In addition, Lin et al suggested that betel nut chewing and smoking were both associated with obstructive lung disease [10]. Possible pathological mechanisms of betel nut chewing include dysregulation of proinflammatory cytokines and excessive deposition in connective tissue [12].…”

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

“…As part of a health module in the 2014-2015 wave of the NLSY, participants were asked if they were ever diagnosed with the following cardiovascular and related health problems: (1) stroke, (2) heart problems, (3) high blood pressure, and (4) lung problems. Though lung problems are not technically a CVD, research shows the strong interrelationship between lung impairment and cardiovascular disease (e.g., Lin et al, 2021). Therefore, we also consider lung problems as a related health problem in our analyses.…”