Association between FEV1/FVC levels and all-cause mortality in the general population
Abstract Background The ratio of the forced expiratory volume in 1 s (FEV1) to the forced vital capacity (FVC) is an essential tool for the diagnosis of chronic obstructive pulmonary disease (COPD). However, the relationship between levels of FEV1/FVC and mortality in the general population remains...
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BMC
2025-03-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | https://doi.org/10.1186/s12890-025-03573-5 |
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| author | Leheng Tang Fan Wu Shiyu Zhang Jie Ou Juncheng Liang Ranxi Peng Siman Liao Qiaorui Zhou Yingtong Chen Xiaozi Guo Jingxian Chen Qi Wan Zihui Wang Zhishan Deng Yumin Zhou |
| author_facet | Leheng Tang Fan Wu Shiyu Zhang Jie Ou Juncheng Liang Ranxi Peng Siman Liao Qiaorui Zhou Yingtong Chen Xiaozi Guo Jingxian Chen Qi Wan Zihui Wang Zhishan Deng Yumin Zhou |
| author_sort | Leheng Tang |
| collection | DOAJ |
| description | Abstract Background The ratio of the forced expiratory volume in 1 s (FEV1) to the forced vital capacity (FVC) is an essential tool for the diagnosis of chronic obstructive pulmonary disease (COPD). However, the relationship between levels of FEV1/FVC and mortality in the general population remains unclear, particularly its non-linear relationship. Therefore, we aimed to explore the association between the FEV1/FVC and all-cause mortality in the general population. Methods The data of participants included in the National Health and Nutrition Examination Survey (1988–1994 and 2007–2012 cycles) were analyzed. Participants aged ≥20 years, who were not pregnant, who underwent quality-controlled lung function tests, and with follow-up data on mortality status were enrolled. The study outcome was all-cause mortality. The participants were grouped by FEV1/FVC ratio in 0.10 increments. Cox proportional-hazards models were used to estimate the association between the FEV1/FVC ratio and all-cause mortality before and after confounder adjustment. Non-linear associations were explored using restricted cubic spline curves. Results Overall, 25,501 participants were included. During the median follow up of 308 months, 6431 (25.2%) deaths were recorded. Among all participants, the mean age is 46.3 years, and 48.7% of which were male. In unadjusted model, individuals with an FEV1/FVC ratio < 0.90 had an increased risk of all-cause mortality compared to those with an FEV1/FVC ratio ≥ 0.90. After adjusting for age, sex, body mass index, race, and smoking status, participants in the 0.60 ≤ FEV1/FVC < 0.90 group had a lower all-cause mortality risk than those in the FEV1/FVC ≥ 0.90 group, while the mortality risk of individuals with an FEV1/FVC ratio < 0.50 was higher. Restricted cubic splines revealed a U-shaped association between the FEV1/FVC ratio and all-cause mortality. Below and above the inflection point, an inverse trend was observed. Conclusion Our study first revealed a U-shaped association between the level of FEV1/FVC and all-cause mortality in general population. Clinical trial number Not applicable. |
| format | Article |
| id | doaj-art-a72f2aa7a77e4a0e95ccb690c12ebb2a |
| institution | DOAJ |
| issn | 1471-2466 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj-art-a72f2aa7a77e4a0e95ccb690c12ebb2a2025-08-20T03:01:34ZengBMCBMC Pulmonary Medicine1471-24662025-03-012511910.1186/s12890-025-03573-5Association between FEV1/FVC levels and all-cause mortality in the general populationLeheng Tang0Fan Wu1Shiyu Zhang2Jie Ou3Juncheng Liang4Ranxi Peng5Siman Liao6Qiaorui Zhou7Yingtong Chen8Xiaozi Guo9Jingxian Chen10Qi Wan11Zihui Wang12Zhishan Deng13Yumin Zhou14The First Clinical College, Guangzhou Medical UniversityState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityThe First Clinical College, Guangzhou Medical UniversityState Key Laboratory of Respiratory Disease, Guangzhou Chest HospitalThe Second Clinical College, Guangzhou Medical UniversityThe Third Clinical College, Guangzhou Medical UniversityThe Second Clinical College, Guangzhou Medical UniversityThe First Clinical College, Guangzhou Medical UniversityThe First Clinical College, Guangzhou Medical UniversityThe Second Clinical College, Guangzhou Medical UniversityThe Second Clinical College, Guangzhou Medical UniversityState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityAbstract Background The ratio of the forced expiratory volume in 1 s (FEV1) to the forced vital capacity (FVC) is an essential tool for the diagnosis of chronic obstructive pulmonary disease (COPD). However, the relationship between levels of FEV1/FVC and mortality in the general population remains unclear, particularly its non-linear relationship. Therefore, we aimed to explore the association between the FEV1/FVC and all-cause mortality in the general population. Methods The data of participants included in the National Health and Nutrition Examination Survey (1988–1994 and 2007–2012 cycles) were analyzed. Participants aged ≥20 years, who were not pregnant, who underwent quality-controlled lung function tests, and with follow-up data on mortality status were enrolled. The study outcome was all-cause mortality. The participants were grouped by FEV1/FVC ratio in 0.10 increments. Cox proportional-hazards models were used to estimate the association between the FEV1/FVC ratio and all-cause mortality before and after confounder adjustment. Non-linear associations were explored using restricted cubic spline curves. Results Overall, 25,501 participants were included. During the median follow up of 308 months, 6431 (25.2%) deaths were recorded. Among all participants, the mean age is 46.3 years, and 48.7% of which were male. In unadjusted model, individuals with an FEV1/FVC ratio < 0.90 had an increased risk of all-cause mortality compared to those with an FEV1/FVC ratio ≥ 0.90. After adjusting for age, sex, body mass index, race, and smoking status, participants in the 0.60 ≤ FEV1/FVC < 0.90 group had a lower all-cause mortality risk than those in the FEV1/FVC ≥ 0.90 group, while the mortality risk of individuals with an FEV1/FVC ratio < 0.50 was higher. Restricted cubic splines revealed a U-shaped association between the FEV1/FVC ratio and all-cause mortality. Below and above the inflection point, an inverse trend was observed. Conclusion Our study first revealed a U-shaped association between the level of FEV1/FVC and all-cause mortality in general population. Clinical trial number Not applicable.https://doi.org/10.1186/s12890-025-03573-5Forced expiratory volume in 1 sForced vital capacityGeneral populationAll-cause mortalityNon-linear relationship |
| spellingShingle | Leheng Tang Fan Wu Shiyu Zhang Jie Ou Juncheng Liang Ranxi Peng Siman Liao Qiaorui Zhou Yingtong Chen Xiaozi Guo Jingxian Chen Qi Wan Zihui Wang Zhishan Deng Yumin Zhou Association between FEV1/FVC levels and all-cause mortality in the general population BMC Pulmonary Medicine Forced expiratory volume in 1 s Forced vital capacity General population All-cause mortality Non-linear relationship |
| title | Association between FEV1/FVC levels and all-cause mortality in the general population |
| title_full | Association between FEV1/FVC levels and all-cause mortality in the general population |
| title_fullStr | Association between FEV1/FVC levels and all-cause mortality in the general population |
| title_full_unstemmed | Association between FEV1/FVC levels and all-cause mortality in the general population |
| title_short | Association between FEV1/FVC levels and all-cause mortality in the general population |
| title_sort | association between fev1 fvc levels and all cause mortality in the general population |
| topic | Forced expiratory volume in 1 s Forced vital capacity General population All-cause mortality Non-linear relationship |
| url | https://doi.org/10.1186/s12890-025-03573-5 |
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