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Abstract：
BACKGROUND: The prevalence, Medicaid use and mortality risk associated with low forced expiratory volume in 1 s (FEV1) among young adults aged 20-35 years are not well understood, despite its potential implications for the development of chronic pulmonary disease and overall prognosis.
METHODS: A retrospective cohort study was conducted among young adults aged 20-35 years old, using data from the National Health and Nutrition Examination Survey, National Death Index and Centers for Medicare & Medicaid Services. Participants were categorised into a low FEV1 group (pre-bronchodilator FEV1%pred <80%) and a normal FEV1 group (FEV1%pred ≥80%). Weighted logistic regression analysis was employed to identify the risk factors associated with low FEV1, while Cox proportional hazard models were used to calculate the hazard ratio (HR) for Medicaid use and the all-cause mortality between the two groups.
RESULTS: A total of 5346 participants aged 20-35 were included in the study, with 329 in the low FEV1 group and 5017 in the normal group. The weighted prevalence of low FEV1 among young adults was 7.1% (95% CI 6.0 to 8.2). Low body mass index (OR=3.06, 95% CI 1.79 to 5.24), doctor-diagnosed asthma (OR=2.25, 1.28 to 3.93), and wheezing or whistling (OR=1.57, 1.06 to 2.33) were identified as independent risk factors for low FEV1. Over a 15-year follow-up, individuals in the low FEV1 group exhibited a higher likelihood of Medicaid use compared with those in the normal group (HR=1.73, 1.07 to 2.79). However, there was no statistically significant increase in the risk of all-cause mortality over a 30-year follow-up period (HR=1.48, 1.00 to 2.19).
CONCLUSIONS: A considerable portion of young adults demonstrated low FEV1 levels, a characteristic that was associated with a higher risk of Medicaid use over a long-term follow-up, yet not linked to an augmented risk of all-cause mortality.
METHODS: A retrospective cohort study was conducted among young adults aged 20-35 years old, using data from the National Health and Nutrition Examination Survey, National Death Index and Centers for Medicare & Medicaid Services. Participants were categorised into a low FEV1 group (pre-bronchodilator FEV1%pred <80%) and a normal FEV1 group (FEV1%pred ≥80%). Weighted logistic regression analysis was employed to identify the risk factors associated with low FEV1, while Cox proportional hazard models were used to calculate the hazard ratio (HR) for Medicaid use and the all-cause mortality between the two groups.
RESULTS: A total of 5346 participants aged 20-35 were included in the study, with 329 in the low FEV1 group and 5017 in the normal group. The weighted prevalence of low FEV1 among young adults was 7.1% (95% CI 6.0 to 8.2). Low body mass index (OR=3.06, 95% CI 1.79 to 5.24), doctor-diagnosed asthma (OR=2.25, 1.28 to 3.93), and wheezing or whistling (OR=1.57, 1.06 to 2.33) were identified as independent risk factors for low FEV1. Over a 15-year follow-up, individuals in the low FEV1 group exhibited a higher likelihood of Medicaid use compared with those in the normal group (HR=1.73, 1.07 to 2.79). However, there was no statistically significant increase in the risk of all-cause mortality over a 30-year follow-up period (HR=1.48, 1.00 to 2.19).
CONCLUSIONS: A considerable portion of young adults demonstrated low FEV1 levels, a characteristic that was associated with a higher risk of Medicaid use over a long-term follow-up, yet not linked to an augmented risk of all-cause mortality.
摘要：
背景：患病率，在20-35岁的年轻人中，与1s内低用力呼气量（FEV1）相关的医疗补助使用和死亡风险尚不清楚。尽管它对慢性肺疾病的发展和总体预后有潜在的影响。
方法：在20-35岁的年轻人中进行了一项回顾性队列研究，使用国家健康和营养调查的数据，国家死亡指数和医疗保险和医疗补助服务中心。参与者被分为低FEV1组（支气管扩张剂前FEV1％pred<80％）和正常FEV1组（FEV1％pred≥80％）。采用加权逻辑回归分析来确定与低FEV1相关的危险因素，而Cox比例风险模型用于计算医疗补助使用的风险比（HR）和两组之间的全因死亡率。
结果：共有5346名20-35岁的参与者被纳入研究，低FEV1组329,正常组5017。年轻人中低FEV1的加权患病率为7.1％（95％CI6.0至8.2）。低体重指数（OR=3.06，95％CI1.79至5.24），医生诊断的哮喘（OR=2.25，1.28至3.93），喘息或吹口哨（OR=1.57，1.06至2.33）是低FEV1的独立危险因素。经过15年的随访，与正常组相比,低FEV1组患者使用Medicaid的可能性更高(HR=1.73,1.07~2.79).然而,在30年随访期间,全因死亡率的风险无统计学显著增加(HR=1.48,1.00~2.19).
结论：相当一部分年轻人表现出低FEV1水平，一个与长期随访中使用医疗补助的风险较高相关的特征，但与全因死亡率风险增加无关。
方法：在20-35岁的年轻人中进行了一项回顾性队列研究，使用国家健康和营养调查的数据，国家死亡指数和医疗保险和医疗补助服务中心。参与者被分为低FEV1组（支气管扩张剂前FEV1％pred<80％）和正常FEV1组（FEV1％pred≥80％）。采用加权逻辑回归分析来确定与低FEV1相关的危险因素，而Cox比例风险模型用于计算医疗补助使用的风险比（HR）和两组之间的全因死亡率。
结果：共有5346名20-35岁的参与者被纳入研究，低FEV1组329,正常组5017。年轻人中低FEV1的加权患病率为7.1％（95％CI6.0至8.2）。低体重指数（OR=3.06，95％CI1.79至5.24），医生诊断的哮喘（OR=2.25，1.28至3.93），喘息或吹口哨（OR=1.57，1.06至2.33）是低FEV1的独立危险因素。经过15年的随访，与正常组相比,低FEV1组患者使用Medicaid的可能性更高(HR=1.73,1.07~2.79).然而,在30年随访期间,全因死亡率的风险无统计学显著增加(HR=1.48,1.00~2.19).
结论：相当一部分年轻人表现出低FEV1水平，一个与长期随访中使用医疗补助的风险较高相关的特征，但与全因死亡率风险增加无关。
