Objective  To explore the association between FEV1%pred, FVC%pred, and the presence of carotid intima-media thickening and plaque.

Methods  Participants who underwent both pulmonary function testing and carotid ultrasound examination as part of the Kailuan Group health checkups between 2014 and 2023 were selected as the study population. A total of 5 488 individuals with complete data on FEV1%pred, FVC%pred, and carotid intimal atherosclerosis were included in the analysis. Participants were divided into three groups based on tertiles of FEV1%pred and FVC%pred. Multivariable logistic regression was performed to examine the associations between lung function categories and carotid intimal thickening and plaque after adjusting for confounding factors.

Results  The detection rate of carotid intima thickening and plaque in the third tertile of FEV1% pred is higher than that in the first tertile (34.3% vs 12.9%, χ² = 240.93, P＜0.01; 25.1% vs 8.2%, χ² = 197.42, P＜0.01). Multivariate logistic regression analysis showed that after adjusting for traditional cardiovascular risk factors, the odds ratios (ORs) for carotid intima-media thickening and plaques in the third FEV1%pred tertile group were 2.15 (95%CI: 1.78 to 2.58) and 2.29 (95%CI: 1.85 to 2.84), respectively, while in the third FVC%pred tertile group, the ORs were 1.61 (95%CI: 1.34 to 1.93) and 1.67 (95%CI: 1.36 to 2.06). Additionally, the association between lung function decline and carotid plaques was more pronounced in individuals aged ＜45 years, with a 1-standard-deviation (16.25%) decrease in FEV1%pred corresponding to an OR of 1.88 (95%CI: 1.47 to 2.41) for carotid plaques.

Conclusion  lung function is associated with carotid atherosclerosis, and those with decreased pulmonary function have an increased risk of carotid atherosclerosis.