Background Interstitial lung abnormalities (ILAs) are associated with increased mortality. It is unclear whether multimorbidity accounts for the mortality association or how strongly ILA is associated with mortality relative to other common age-associated diseases. We determined the association of ILA with all-cause mortality adjusted for multimorbidity, compared mortality associated with ILA and prevalent cardiovascular disease (CVD), diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease and cancer and also determined the association between ILA and these diseases. Methods We measured ILA (none, indeterminant, definite) using blinded reads of CT images, prevalent chronic diseases and potential confounders in two observational cohorts, the Framingham Heart Study (FHS) (n=2449) and Age, Gene/Environment Susceptibility - Reykjavik Study (AGES-Reykjavik) (n=5180). We determined associations with mortality using Cox proportional hazards models and between ILA and diseases with multinomial logistic regression. Results Over a median (IQR) follow-up of 8.8 (1.4) years in FHS and 12.0 (7.7) years in AGES-Reykjavik, in adjusted models, ILAs were significantly associated with increased mortality (HR, 95% CI 1.95, 1.23 to 3.08, p=0.0042, in FHS; HR 1.60, 1.41 to 1.82, p<0.0001, in AGES-Reykjavik) adjusted for multimorbidity. In both cohorts, the association of ILA with mortality was of similar magnitude to the association of most other diseases. In adjusted models, ILAs were associated only with prevalent kidney disease (OR, 95% CI 1.90, 1.01 to 3.57, p=0.0452) in FHS and with prevalent CVD (OR 1.42, 1.12 to 1.81, p=0.0040) in AGES-Reykjavik. Conclusions ILAs were associated with mortality adjusted for multimorbidity and were similarly associated with increased mortality compared with several common chronic diseases. ILAs were not consistently associated with the prevalence of these diseases themselves. Data are available upon reasonable request.

中文翻译：

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间质性肺异常、死亡率和合并症之间的关系：一项队列研究

背景 间质性肺异常 (ILA) 与死亡率增加有关。目前尚不清楚多病症是否是死亡率关联的原因，也不清楚相对于其他常见的年龄相关疾病，ILA 与死亡率的相关性有多强。我们确定了 ILA 与针对多种疾病调整后的全因死亡率的关联，比较了 ILA 与流行的心血管疾病 (CVD)、糖尿病、慢性肾病、慢性阻塞性肺病和癌症相关的死亡率，还确定了 ILA 与这些因素之间的关联疾病。方法 我们使用盲读 CT 图像、流行的慢性疾病和潜在的混杂因素在两个观察队列 Framingham 心脏研究 (FHS) (n=2449) 和年龄、基因/环境易感性 - 雷克雅未克研究 (AGES-Reykjavik) (n=5180)。我们使用 Cox 比例风险模型确定了与死亡率的关联，并使用多项逻辑回归确定了 ILA 与疾病之间的关联。结果 在 FHS 中 8.8 (1.4) 年和 AGES-Reykjavik 中 12.0 (7.7) 年的中位 (IQR) 随访中，在调整后的模型中，ILA 与死亡率增加显着相关（HR，95% CI 1.95，1.23 至3.08，p=0.0042，在 FHS 中；HR 1.60，1.41 至 1.82，p<0.0001，在 AGES-Reykjavik 中）针对多重病症进行了调整。在这两个队列中，ILA 与死亡率的相关性与大多数其他疾病的相关性相似。在调整后的模型中，ILAs 仅与 FHS 中普遍存在的肾脏疾病（OR，95% CI 1.90，1.01 至 3.57，p=0.0452）和普遍存在的 CVD（OR 1.42，1.12 至 1.81，p=0. 0040) 在 AGES-雷克雅未克。结论 ILAs 与针对多种疾病调整后的死亡率相关，并且与几种常见慢性病相比，ILAs 与死亡率增加相关。ILAs 并不总是与这些疾病本身的流行有关。可根据合理要求提供数据。