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Huang J, Li W, Sun Y, Huang Z, Cong R, Yu C, Tao H. Preserved Ratio Impaired Spirometry (PRISm): A Global Epidemiological Overview, Radiographic Characteristics, Comorbid Associations, and Differentiation from Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2024; 19:753-764. [PMID: 38505581 PMCID: PMC10949882 DOI: 10.2147/copd.s453086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/12/2024] [Indexed: 03/21/2024] Open
Abstract
Preserved Ratio Impaired Spirometry (PRISm) manifests notable epidemiological disparities across the globe, with its prevalence and influential factors showcasing pronounced diversities among various geographical territories and demographics. The prevalence of PRISm fluctuates considerably among regions such as Latin America, the United States, and Asian nations, potentially correlating with a myriad of determinants, including socioeconomic status, environmental factors, and lifestyle modalities. Concurrently, the link between PRISm and health risks and other disorders, especially its distinction and interrelation with chronic obstructive pulmonary disease (COPD), has become a pivotal subject of scientific enquiry. Radiographic anomalies, such as perturbations in the pulmonary parenchyma and structural alterations, are posited as salient characteristics of PRISm. Furthermore, PRISm unveils intricate associations with multiple comorbidities, inclusive of hypertension and type 2 diabetes, thereby amplifying the intricacy in comprehending and managing this condition. In this review, we aim to holistically elucidate the epidemiological peculiarities of PRISm, its potential aetiological contributors, its nexus with COPD, and its association with radiographic aberrations and other comorbidities. An integrative understanding of these dimensions will provide pivotal insights for the formulation of more precise and personalised preventative and therapeutic strategies.
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Affiliation(s)
- Jia Huang
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730000, People’s Republic of China
| | - Wenjun Li
- Department of Respiratory, The Second Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
| | - Yecheng Sun
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730000, People’s Republic of China
| | - Zhutang Huang
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730000, People’s Republic of China
| | - Rong Cong
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730000, People’s Republic of China
| | - Chen Yu
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730000, People’s Republic of China
| | - Hongyan Tao
- Department of Respiratory, The Second Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
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Higbee DH, Lirio A, Hamilton F, Granell R, Wyss AB, London SJ, Bartz TM, Gharib SA, Cho MH, Wan E, Silverman E, Crapo JD, Lominchar JVT, Hansen T, Grarup N, Dantoft T, Kårhus L, Linneberg A, O'Connor GT, Dupuis J, Xu H, De Vries MM, Hu X, Rich SS, Barr RG, Manichaikul A, Wijnant SRA, Brusselle GG, Lahousse L, Li X, Hernández Cordero AI, Obeidat M, Sin DD, Harris SE, Redmond P, Taylor AM, Cox SR, Williams AT, Shrine N, John C, Guyatt AL, Hall IP, Davey Smith G, Tobin MD, Dodd JW. Genome-wide association study of preserved ratio impaired spirometry (PRISm). Eur Respir J 2024; 63:2300337. [PMID: 38097206 PMCID: PMC10765494 DOI: 10.1183/13993003.00337-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 10/29/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Preserved ratio impaired spirometry (PRISm) is defined as a forced expiratory volume in 1 s (FEV1) <80% predicted and FEV1/forced vital capacity ≥0.70. PRISm is associated with respiratory symptoms and comorbidities. Our objective was to discover novel genetic signals for PRISm and see if they provide insight into the pathogenesis of PRISm and associated comorbidities. METHODS We undertook a genome-wide association study (GWAS) of PRISm in UK Biobank participants (Stage 1), and selected single nucleotide polymorphisms (SNPs) reaching genome-wide significance for replication in 13 cohorts (Stage 2). A combined meta-analysis of Stage 1 and Stage 2 was done to determine top SNPs. We used cross-trait linkage disequilibrium score regression to estimate genome-wide genetic correlation between PRISm and pulmonary and extrapulmonary traits. Phenome-wide association studies of top SNPs were performed. RESULTS 22 signals reached significance in the joint meta-analysis, including four signals novel for lung function. A strong genome-wide genetic correlation (rg) between PRISm and spirometric COPD (rg=0.62, p<0.001) was observed, and genetic correlation with type 2 diabetes (rg=0.12, p=0.007). Phenome-wide association studies showed that 18 of 22 signals were associated with diabetic traits and seven with blood pressure traits. CONCLUSION This is the first GWAS to successfully identify SNPs associated with PRISm. Four of the signals, rs7652391 (nearest gene MECOM), rs9431040 (HLX), rs62018863 (TMEM114) and rs185937162 (HLA-B), have not been described in association with lung function before, demonstrating the utility of using different lung function phenotypes in GWAS. Genetic factors associated with PRISm are strongly correlated with risk of both other lung diseases and extrapulmonary comorbidity.
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Affiliation(s)
- Daniel H Higbee
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
- Academic Respiratory Unit, University of Bristol, Southmead Hospital, Bristol, UK
| | - Alvin Lirio
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Fergus Hamilton
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Raquel Granell
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Annah B Wyss
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Stephanie J London
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Departments of Biostatistics and Medicine, University of Washington, Seattle, WA, USA
| | - Sina A Gharib
- Computational Medicine Core, Center for Lung Biology, UW Medicine Sleep Center, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Michael H Cho
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Emily Wan
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Pulmonary and Critical Care Section, Department of Medicine, VA Boston Healthcare System, Boston, MA, USA
| | - Edwin Silverman
- Pulmonary and Critical Care Section, Department of Medicine, VA Boston Healthcare System, Boston, MA, USA
| | - James D Crapo
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO, USA
| | - Jesus V T Lominchar
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Dantoft
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Line Kårhus
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Allan Linneberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - George T O'Connor
- Pulmonary Center, School of Medicine, Boston University, Boston, MA, USA
- Division of Pulmonary, Allergy, Sleep, and Critical Care Medicine, Boston Medical Center, Boston, MA, USA
| | - Josée Dupuis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Hanfie Xu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Maaike M De Vries
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Xiaowei Hu
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - R Graham Barr
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Ani Manichaikul
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Sara R A Wijnant
- Department of Bioanalysis, Ghent University, Ghent, Belgium
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Guy G Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
- Department of Epidemiology, Department of Respiratory Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Lies Lahousse
- Department of Bioanalysis, Ghent University, Ghent, Belgium
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Xuan Li
- Centre for Heart Lung Innovation, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada
| | - Ana I Hernández Cordero
- Centre for Heart Lung Innovation, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada
| | - Ma'en Obeidat
- Centre for Heart Lung Innovation, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada
| | - Don D Sin
- Centre for Heart Lung Innovation, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada
- Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Sarah E Harris
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Paul Redmond
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Adele M Taylor
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Simon R Cox
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Alexander T Williams
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Nick Shrine
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Catherine John
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Anna L Guyatt
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Ian P Hall
- University of Nottingham and NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Martin D Tobin
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
- Joint senior authors
| | - James W Dodd
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
- Academic Respiratory Unit, University of Bristol, Southmead Hospital, Bristol, UK
- Joint senior authors
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