1
|
Ramos-Navarro C, Sánchez-Luna M, Pérez-Tarazona S, Sanz-López E, Maderuelo-Rodriguez E, Rueda-Esteban S, Sánchez-Torres A, Concheiro-Guisán A, Sánchez-Solís M. Pulmonary function and bronchopulmonary dysplasia classification: insights from the Spanish Registry. Eur J Pediatr 2024:10.1007/s00431-024-05629-w. [PMID: 38858227 DOI: 10.1007/s00431-024-05629-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/18/2024] [Accepted: 05/23/2024] [Indexed: 06/12/2024]
Abstract
In 2016, the Spanish Research Group on Bronchopulmonary Dysplasia (BPD) (GEIDIS) established a national registry with participation of 66 hospitals to collect information on clinical characteristics and long-term outcomes of BPD infants into adulthood. The aim of this observational study is to examine forced spirometry data in early childhood and to assess their correlation with the respiratory support required at 36 weeks postmenstrual age (PMA). The study analyzed data from preterm infants with BPD born between January 2016 and December 2017 who underwent forced spirometry at 5-7 years of age. Statistical analyses were conducted to investigate the relationships between spirometry results, perinatal factors, and the required respiratory support at 36 weeks PMA. The study involved 143 patients with a median gestational age (GA) of 27.3 weeks (range 25.7-28.7) and a median weight of 880 g (range 740-1135). Abnormal spirometry results were observed in 39.2% (56) of the patients. Among patients diagnosed with BPD type 3, those requiring over 30% oxygen at 36 weeks PMA exhibited an increased risk of abnormal spirometry results (OR 4.48; 95% CI 1.11-18.13) compared to those requiring positive pressure with less than 30% oxygen. In addition, this subgroup had a higher risk of developing a restrictive-mixed pattern compared to those with BPD type 1 (OR 10.65; 95% CI 2.06-54.98) and BPD type 2 (OR 6.76; 95% CI 1.09-42.06). No significant differences were found in the incidence of an obstructive pattern between BPD types. Conclusion: The requirement of more than 30% oxygen at 36 weeks PMA serves as a risk indicator for pulmonary function impairment in school-aged children with BPD. These findings suggest persistent airway and parenchymal injury in this specific patient population, and highlight the importance of careful monitoring to evaluate their long-term effects on lung function. What is Known: • Premature patients with bronchopulmonary dysplasia (BPD) may present abnormalities in pulmonary function tests during school age. However, the predictive accuracy of consensus BPD severity classification remains uncertain. What is New: • The requirement of more than 30% oxygen at 36 weeks postmenstrual age (PMA) indicates a potential risk of pulmonary function impairment in school-aged children with BPD. Additionally, a significant correlation has been observed between a restrictive-mixed pattern with exposure to mechanical ventilation and the development of severe forms of BPD.
Collapse
Affiliation(s)
- Cristina Ramos-Navarro
- Neonatologist at Neonatology Department, Gregorio Marañón University Hospital, Madrid, Spain.
| | - Manuel Sánchez-Luna
- Neonatologist at Neonatology Department, Gregorio Marañón University Hospital, Madrid, Spain
| | | | - Ester Sanz-López
- Neonatologist at Neonatology Department, Gregorio Marañón University Hospital, Madrid, Spain
| | | | - Santiago Rueda-Esteban
- Pediatric Pulmonologist at Pulmonology Department, San Carlos University Hospital, Madrid, Spain
| | - Ana Sánchez-Torres
- Neonatologist at Neonatology Department, La Paz University Hospital, Madrid, Spain
| | - Ana Concheiro-Guisán
- Neonatologist at Neonatology Department, Alvaro Cunqueiro University Hospital, Vigo, Spain
| | - Manuel Sánchez-Solís
- Pediatric Pulmonologist at Pulmonology Department, Virgen Arrixaca University Hospital Murcia, Murcia, Spain
| |
Collapse
|
2
|
Zhai J, Voraphani N, Imboden M, Keidel D, Liu C, Stern DA, Venker C, Petersen H, Bosco A, Sherrill DL, Morgan WJ, Tesfaigzi Y, Probst-Hensch NM, Martinez FD, Halonen M, Guerra S. Circulating biomarkers of airflow limitation across the life span. J Allergy Clin Immunol 2024; 153:1692-1703. [PMID: 38253260 PMCID: PMC11162345 DOI: 10.1016/j.jaci.2023.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 12/16/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND Airflow limitation is a hallmark of chronic obstructive pulmonary disease, which can develop through different lung function trajectories across the life span. There is a need for longitudinal studies aimed at identifying circulating biomarkers of airflow limitation across different stages of life. OBJECTIVES This study sought to identify a signature of serum proteins associated with airflow limitation and evaluate their relation to lung function longitudinally in adults and children. METHODS This study used data from 3 adult cohorts (TESAOD [Tucson Epidemiological Study of Airway Obstructive Disease], SAPALDIA [Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults], LSC [Lovelace Smoker Cohort]) and 1 birth cohort (TCRS [Tucson Children's Respiratory Study]) (N = 1940). In TESAOD, among 46 circulating proteins, we identified those associated with FEV1/forced vital capacity (FVC) percent (%) predicted levels and generated a score based on the sum of their z-scores. Cross-sectional analyses were used to test the score for association with concomitant lung function. Longitudinal analyses were used to test the score for association with subsequent lung function growth in childhood and decline in adult life. RESULTS After false discovery rate adjustment, serum levels of 5 proteins (HP, carcinoembryonic antigen, ICAM1, CRP, TIMP1) were associated with percent predicted levels of FEV1/FVC and FEV1 in TESAOD. In cross-sectional multivariate analyses the 5-biomarker score was associated with FEV1 % predicted in all adult cohorts (meta-analyzed FEV1 decrease for 1-SD score increase: -2.9%; 95% CI: -3.9%, -1.9%; P = 2.4 × 10-16). In multivariate longitudinal analyses, the biomarker score at 6 years of age was inversely associated with FEV1 and FEV1/FVC levels attained by young adult life (P = .02 and .005, respectively). In adults, persistently high levels of the biomarker score were associated with subsequent accelerated decline of FEV1 and FEV1/FVC (P = .01 and .001). CONCLUSIONS A signature of 5 circulating biomarkers of airflow limitation was associated with both impaired lung function growth in childhood and accelerated lung function decline in adult life, indicating that these proteins may be involved in multiple lung function trajectories leading to chronic obstructive pulmonary disease.
Collapse
Affiliation(s)
- Jing Zhai
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz
| | - Nipasiri Voraphani
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz
| | - Medea Imboden
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Dirk Keidel
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Congjian Liu
- Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
| | - Debra A Stern
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz
| | - Claire Venker
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz
| | - Hans Petersen
- Lovelace Respiratory Research Institute, Albuquerque, NM
| | - Anthony Bosco
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz
| | - Duane L Sherrill
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz
| | - Wayne J Morgan
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz
| | - Yohannes Tesfaigzi
- Brigham and Women's Hospital, Harvard Medical School, Boston, Mass; Lovelace Respiratory Research Institute, Albuquerque, NM
| | - Nicole M Probst-Hensch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Fernando D Martinez
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz
| | - Marilyn Halonen
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz
| | - Stefano Guerra
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz.
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
de la Hoz RE, Jeon Y, Doucette JT, Reeves AP, Estépar RSJ, Celedón JC. Cluster Analysis of World Trade Center Related Lower Airway Diseases. J Occup Environ Med 2024; 66:179-184. [PMID: 38305727 PMCID: PMC10842254 DOI: 10.1097/jom.0000000000003023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
ABSTRACT Introduction: Cluster analysis can classify without a priori assumptions the heterogeneous chronic lower airway diseases found in former workers at the World Trade Center (WTC) disaster site. Methods: We selected the first available chest computed tomography scan with quantitative computed tomography measurements on 311 former WTC workers with complete clinical, and spirometric data from their closest surveillance visit. We performed a nonhierarchical iterative algorithm K-prototype cluster analysis, using gap measure. Results: A five-cluster solution was most satisfactory. Cluster 5 had the healthiest individuals. In cluster 4, smoking was most prevalent and intense but there was scant evidence of respiratory disease. Cluster 3 had symptomatic subjects with reduced forced vital capacity impairment (low FVC). Clusters 1 and 2 had less dyspneic subjects, but more functional and quantitative computed tomography evidence of chronic obstructive pulmonary disease (COPD) in cluster 1, or low FVC in cluster 2. Clusters 1 and 4 had the highest proportion of rapid first-second forced expiratory volume decliners. Conclusions: Cluster analysis confirms low FVC and COPD/pre-COPD as distinctive chronic lower airway disease phenotypes on long-term surveillance of the WTC workers.
Collapse
Affiliation(s)
| | - Yunho Jeon
- Divisions of Occupational and Environmental Medicine, New York, NY, USA
| | - John T. Doucette
- Biostatistics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anthony P. Reeves
- School of Electrical and Computer Engineering, Cornell University, Ithaca, NY, USA
| | | | - Juan C. Celedón
- Division of Pediatric Pulmonary Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| |
Collapse
|
5
|
Carsin AE, Garcia-Aymerich J, Accordini S, Dharmage S, Leynaert B, de Las Heras M, Casas L, Caviezel S, Demoly P, Forsberg B, Gislason T, Corsico AG, Janson C, Jogi R, Martínez-Moratalla J, Nowak D, Gómez LP, Pin I, Probst-Hensch N, Raherison-Semjen C, Squillacioti G, Svanes C, Torén K, Urrutia I, Huerta I, Anto JM, Jarvis D, Guerra S. Spirometric patterns in young and middle-aged adults: a 20-year European study. Thorax 2024; 79:153-162. [PMID: 37758456 DOI: 10.1136/thorax-2022-219696] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 07/19/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Understanding the natural history of abnormal spirometric patterns at different stages of life is critical to identify and optimise preventive strategies. We aimed to describe characteristics and risk factors of restrictive and obstructive spirometric patterns occurring before 40 years (young onset) and between 40 and 61 years (mid-adult onset). METHODS We used data from the population-based cohort of the European Community Respiratory Health Survey (ECRHS). Prebronchodilator forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were assessed longitudinally at baseline (ECRHS1, 1993-1994) and again 20 years later (ECRHS3, 2010-2013). Spirometry patterns were defined as: restrictive if FEV1/FVC≥LLN and FVC<10th percentile, obstructive if FEV1/FVC RESULTS Among 3502 participants (mean age=30.4 (SD 5.4) at ECRHS1, 50.4 (SD 5.4) at ECRHS3), 2293 (65%) had a normal, 371 (11%) a young restrictive, 301 (9%) a young obstructive, 187 (5%) a mid-adult onset restrictive and 350 (10%) a mid-adult onset obstructive spirometric pattern. Being lean/underweight in childhood and young adult life was associated with the occurrence of the young spirometric restrictive pattern (relative risk ratio (RRR)=1.61 95% CI=1.21 to 2.14, and RRR=2.43 95% CI=1.80 to 3.29; respectively), so were respiratory infections before 5 years (RRR=1.48, 95% CI=1.05 to 2.08). The main determinants for young obstructive, mid-adult restrictive and mid-adult obstructive patterns were asthma, obesity and smoking, respectively. CONCLUSION Spirometric patterns with onset in young and mid-adult life were associated with distinct characteristics and risk factors.
Collapse
Affiliation(s)
- Anne-Elie Carsin
- ISGlobal, Campus mar, Barcelona, Catalunya, Spain
- Universita Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain, Spain
- Biometrics, RTI-Health Solutions, Barcelona, Spain
| | - Judith Garcia-Aymerich
- ISGlobal, Campus mar, Barcelona, Catalunya, Spain
- Universita Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain, Spain
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Shyamali Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Bénédicte Leynaert
- Université Paris-Saclay, UVSQ, Univ Paris-Sud, Inserm, INSERM, Paris, France
| | - Marti de Las Heras
- ISGlobal, Campus mar, Barcelona, Catalunya, Spain
- Universita Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain, Spain
| | - Lidia Casas
- Social Epidemiology and Health Policy, Department of Family Medicine and Population Health, University of Antwerp, Antwerpen, Belgium
- Institute for Environment and Sustainable Development (IMDO), University of Antwerp, Antwerpen, Belgium
| | - Seraina Caviezel
- Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Pascal Demoly
- Département de Pneumologie et Addictologie, University Hospital of Montpellier, Montpellier, France
- IDESP, University of Montpellier - Inserm UMR UA11, Montpellier, France
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Thorarinn Gislason
- Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland
- Medical Faculty, University of Iceland, Iceland, Iceland
| | - Angelo Guido Corsico
- Department of Internal Medicine and Therapeutics, University of Pavia, Italy, Italy
- Division of Respiratory Diseases, Fondazione IRCCS Policlinico San Matteo-University of Pavia, Pavia, Italy
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Rain Jogi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | | | - Dennis Nowak
- Institute and Clinic for Occupational and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Centre Munich, member DZL, German Centre for Lung Research, Munich, Germany
| | | | - Isabelle Pin
- Department of Pediatrics, CHU de Grenoble Alpes, Grenoble, France
- Inserm, UMR 1209, Institute for Advanced Biosciences, Grenoble, France
| | - Nicole Probst-Hensch
- Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Giulia Squillacioti
- Department of Public Health and Pediatrics, University of Turin, Torino, Piemonte, Italy
| | - Cecilie Svanes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Kjell Torén
- Department of Occupational and Environmental, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Isabel Urrutia
- Pulmonology Department, Galdakao Hospital, Biocruces Bizkaia, Spain
| | - Ismael Huerta
- Epidemiological Surveillance Section, Directorate General of Public Health, Oviedo, Spain
| | - Josep Maria Anto
- ISGlobal, Campus mar, Barcelona, Catalunya, Spain
- Universita Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain, Spain
| | - Debbie Jarvis
- National Heart and Lung Institute, Imperial College, London, UK
| | - Stefano Guerra
- ISGlobal, Campus mar, Barcelona, Catalunya, Spain
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona, USA
| |
Collapse
|
6
|
Alqarni AA, Badr OI, Aldhahir AM, Alqahtani JS, Siraj RA, Naser AY, Alghamdi AS, Majrshi M, Alghamdi SM, Alyami MM, Alghamdi SA, Alwafi H. Obesity Prevalence and Association with Spirometry Profiles, ICU Admission, and Comorbidities Among Patients with COPD: Retrospective Study in Two Tertiary Centres in Saudi Arabia. Int J Chron Obstruct Pulmon Dis 2024; 19:111-120. [PMID: 38249824 PMCID: PMC10799648 DOI: 10.2147/copd.s442851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
Background Obesity is common among chronic obstructive pulmonary disease (COPD) patients and is associated with an increase in acute exacerbation episodes. However, data on obesity's impact on and association with clinical outcomes among patients with COPD are limited. This study aimed to determine overweight and obesity prevalence and associations with spirometry profiles, intensive care unit (ICU) admission, and comorbidities in patients with COPD. Methods In this retrospective cohort study, we reviewed the electronic health records of adult individuals diagnosed with COPD who visited the studied pulmonary clinics between 1 January 2018 and 31 December 2022 and then collected key demographic variables and relevant clinical outcomes and comorbidities. Results A total of 474 patients with COPD were included in the final analysis, of whom 60% were male. The occurrences of overweight and obesity were 32.7% and 38.2%, respectively. The presence of comorbidities was high in obese patients (78.4%), followed by overweight patients (63.8%) with COPD. Obese and overweight patients had the highest ward admission rates (38.3% and 34.2%, respectively). ICU admissions were higher in obese and overweight patients (16% and 12%, respectively) compared with normal-weight patients (9%). Although no significant correlation was found between body mass index and spirometry parameters, comorbidities and ICU admission were linked to overweight and obesity in COPD patients (AOR: 1.82 95% CI: 1.15 to 2.86 and AOR: 3.34 95% CI 1.35 to 8.22, respectively). Conclusion Our findings imply that obesity in COPD is prevalent and is associated with adverse clinical outcomes including a greater number of comorbidities and higher rates of hospitalization and admission to ICUs although no associations were found between body weight and spirometry parameters. Further studies are needed to assess whether implementing and optimising obesity screening and management at an early stage in COPD can prevent further deterioration.
Collapse
Affiliation(s)
- Abdullah A Alqarni
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Respiratory Therapy Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Omaima I Badr
- Department of Chest Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Department of Pulmonary Medicine, Al Noor Specialist Hospital, Mecca, Saudi Arabia
| | - Abdulelah M Aldhahir
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Jaber S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Rayan A Siraj
- Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al Ahsa, Saudi Arabia
| | - Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Abdulrhman S Alghamdi
- Department of Rehabilitation Science, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mansour Majrshi
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton Hospital, London, UK
| | - Saeed M Alghamdi
- Clinical Technology Department, Respiratory Care Program, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohammed M Alyami
- Respiratory Therapy Department, Batterjee Medical College, Khamis Mushait, Saudi Arabia
| | - Sara A Alghamdi
- Respiratory Care Department, AlSalama Hospital, Jeddah, Saudi Arabia
| | - Hassan Alwafi
- Department of Clinical Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| |
Collapse
|
7
|
Kawayama T, Takahashi K, Ikeda T, Fukui K, Makita N, Tashiro N, Saito J, Shirai T, Inoue H. Exacerbation rates in Japanese patients with obstructive lung disease: A subanalysis of the prospective, observational NOVELTY study. Allergol Int 2024; 73:71-80. [PMID: 37661518 DOI: 10.1016/j.alit.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/11/2023] [Accepted: 07/24/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Although clinical trials including asthma and COPD patients have revealed much about exacerbation frequencies, most studies are limited in that they recruited patients only with a clear diagnosis of one disease or the other, based on conventional diagnostic criteria, which may exclude many real-world patients with mixed symptoms. METHODS NOVELTY is a global prospective observational study of patients with asthma and/or COPD from real-world practice. In this subanalysis, we compared patient characteristics of obstructive pulmonary diseases between the Japanese population (n = 820) and the overall population excluding Japanese patients (n = 10,406). RESULTS The Japanese population had fewer exacerbations than the overall population across most of the physician-assessed disease severities and all diagnoses. The difference in exacerbation frequencies was more prominent in patients with COPD and asthma + COPD. The Japanese population was older, had higher former smoking rates, lower BMI, fewer respiratory symptoms, and better health-related quality of life compared with the overall population across all diagnoses. CONCLUSIONS We clarified differences in patient characteristics among patients with asthma and/or COPD in Japan compared with non-Japanese patients. Importantly, we found that Japanese patients with asthma and/or COPD had significantly fewer exacerbations compared with patients overall. The results from our study may contribute to the development of precision medicine and guidelines specific to Japan.
Collapse
Affiliation(s)
- Tomotaka Kawayama
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
| | | | - Toshikazu Ikeda
- Department of Pulmonary Medicine, National Hospital Organization Matsue Medical Center, Matsue, Japan
| | | | | | | | - Junpei Saito
- Department of Pulmonary Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Toshihiro Shirai
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Hiromasa Inoue
- Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
| |
Collapse
|
8
|
Backman H, Sawalha S, Nilsson U, Hedman L, Stridsman C, Vanfleteren LEGW, Nwaru BI, Stenfors N, Rönmark E, Lindberg A. All-cause and cause-specific mortality by spirometric pattern and sex - a population-based cohort study. Ther Adv Respir Dis 2024; 18:17534666241232768. [PMID: 38465828 DOI: 10.1177/17534666241232768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Chronic airway obstruction (CAO) and restrictive spirometry pattern (RSP) are associated with mortality, but sex-specific patterns of all-cause and specific causes of death have hardly been evaluated. OBJECTIVES To study the possible sex-dependent differences of all-cause mortality and patterns of cause-specific mortality among men and women with CAO and RSP, respectively, to that of normal lung function (NLF). DESIGN Population-based prospective cohort study. METHODS Individuals with CAO [FEV1/vital capacity (VC) < 0.70], RSP [FEV1/VC ⩾ 0.70 and forced vital capacity (FVC) < 80% predicted] and NLF (FEV1/VC ⩾ 0.70 and FVC ⩾ 80% predicted) were identified within the Obstructive Lung Disease in Northern Sweden (OLIN) studies in 2002-2004. Mortality data were collected through April 2016, totally covering 19,000 patient-years. Cox regression and Fine-Gray regression accounting for competing risks were utilized to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) adjusted for age, body mass index, sex, smoking habits and pack-years. RESULTS The adjusted hazard for all-cause mortality was higher in CAO and RSP than in NLF (HR, 95% CI; 1.69, 1.31-2.02 and 1.24, 1.06-1.71), and the higher hazards were driven by males. CAO had a higher hazard of respiratory and cardiovascular death than NLF (2.68, 1.05-6.82 and 1.40, 1.04-1.90). The hazard of respiratory death was significant in women (3.41, 1.05-11.07) while the hazard of cardiovascular death was significant in men (1.49, 1.01-2.22). In RSP, the higher hazard for respiratory death remained after adjustment (2.68, 1.05-6.82) but not for cardiovascular death (1.11, 0.74-1.66), with a similar pattern in both sexes. CONCLUSION The higher hazard for all-cause mortality in CAO and RSP than in NLF was male driven. CAO was associated with respiratory death in women and cardiovascular death in men, while RSP is associated with respiratory death, similarly in both sexes.
Collapse
Affiliation(s)
- Helena Backman
- Section of Sustainable Health/The OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Sami Sawalha
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Ulf Nilsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Linnea Hedman
- Section of Sustainable Health/The OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Caroline Stridsman
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Lowie E G W Vanfleteren
- COPD Center, Sahlgrenska University Hospital, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Bright I Nwaru
- Krefting Research Center, Institution of Medicine, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Nikolai Stenfors
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Eva Rönmark
- Section of Sustainable Health/The OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Anne Lindberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| |
Collapse
|
9
|
Yang S, Liao G, Tse LA. Association of preserved ratio impaired spirometry with mortality: a systematic review and meta-analysis. Eur Respir Rev 2023; 32:230135. [PMID: 37914194 PMCID: PMC10618908 DOI: 10.1183/16000617.0135-2023] [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: 07/05/2023] [Accepted: 09/04/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Preserved ratio impaired spirometry (PRISm) is prevalent within the general population. Increased mortality has been reported among subjects with PRISm, but the evidence has never been summarised. This systematic review aims to synthesise evidence on the association between PRISm and the risk of all-cause, cardiovascular and respiratory-related mortality. METHODS We systematically searched MEDLINE, Embase and Web of Science for population-based cohort studies from inception to April 2023 using the terms related to impaired spirometry and mortality. Titles and abstracts were screened to identify eligible studies that reported mortality estimates for individuals with PRISm. We excluded studies that adopted other definitions of impaired spirometry, had a specific study setting (e.g. HIV patients), had an insufficient follow-up period (<1 year) or reported duplicated data. Random-effects meta-analysis was used to produce pooled hazard ratio (HR) with 95% confidence intervals. Between-study heterogeneity was assessed with I2. RESULTS Eight studies met the inclusion criteria involving 40 699 individuals with PRISm. All included studies reported increased risk of all-cause mortality among adults with PRISm. Meta-analysis showed that PRISm was associated with an increased risk of all-cause mortality (pooled HR 1.71, 95% CI 1.51-1.93; I2=64%), cardiovascular mortality (pooled HR 1.57, 95% CI 1.44-1.72; I2=35%) and respiratory-related mortality (pooled HR 1.97, 95% CI 1.55-2.49; I2=0%). CONCLUSIONS Individuals with PRISm have a significantly increased risk of mortality compared with those with normal spirometry.
Collapse
Affiliation(s)
- Shuyuan Yang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Gengze Liao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Lap Ah Tse
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| |
Collapse
|
10
|
Marott JL, Ingebrigtsen TS, Çolak Y, Kankaanranta H, Bakke PS, Vestbo J, Nordestgaard BG, Lange P. Impact of the metabolic syndrome on cardiopulmonary morbidity and mortality in individuals with lung function impairment: a prospective cohort study of the Danish general population. THE LANCET REGIONAL HEALTH. EUROPE 2023; 35:100759. [PMID: 38023334 PMCID: PMC10652137 DOI: 10.1016/j.lanepe.2023.100759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 10/06/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023]
Abstract
Background Whether the metabolic syndrome plays a role for the prognosis of individuals with lung function impairment (preserved ratio impaired spirometry (PRISm) or airflow limitation) is unclear. We hypothesised that the metabolic syndrome in individuals with lung function impairment is associated with increased cardiopulmonary morbidity and mortality. Methods The Copenhagen General Population Study was initiated in 2003 based on a random sample of white men and women aged 20-100 years drawn from the Danish general population. The risk of ischemic heart disease/heart failure, respiratory disease, and all-cause mortality was analysed with Cox models adjusted for age, sex, current smoking, and asthma during 15 years of follow-up. Findings Among 106,845 adults, 86,159 had normal lung function, 6126 had PRISm, and 14,560 had airflow limitation. We observed 10,448 hospital admissions for ischemic heart disease/heart failure, 21,140 for respiratory disease, and 11,125 deaths. Individuals with versus individuals without the metabolic syndrome generally had higher 5-year absolute risk of all outcomes, including within those with normal lung function, mild-moderate-severe PRISm, and very mild-mild-moderate-severe airflow limitation alike. Compared to individuals without the metabolic syndrome and with normal lung function, those with both the metabolic syndrome and severe PRISm had hazard ratios of 3.74 (95% CI: 2.53-5.55; p < 0.0001) for ischemic heart disease/heart failure, 5.02 (3.85-6.55; p < 0.0001) for respiratory disease, and 5.32 (3.76-7.54; p < 0.0001) for all-cause mortality. Corresponding hazard ratios in those with both the metabolic syndrome and severe airflow limitation were 2.89 (2.34-3.58; p < 0.0001) for ischemic heart disease/heart failure, 5.98 (5.28-6.78; p < 0.0001) for respiratory disease, and 4.16 (3.50-4.95; p < 0.0001) for all-cause mortality, respectively. The metabolic syndrome explained 13% and 27% of the influence of PRISm or airflow limitation on ischemic heart disease/heart failure and all-cause mortality. Interpretation The metabolic syndrome conferred increased risk of cardiopulmonary morbidity and mortality at all levels of lung function impairment. Funding Danish Lung Foundation, Danish Heart Foundation, Capital Region of Copenhagen, and Boehringer Ingelheim. JV is supported by the NIHR Manchester BRC.
Collapse
Affiliation(s)
- Jacob Louis Marott
- The Copenhagen City Heart Study, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
- The Copenhagen General Population Study, Copenhagen University Hospital – Herlev and Gentofte, Herlev, Denmark
| | - Truls Sylvan Ingebrigtsen
- The Copenhagen City Heart Study, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Yunus Çolak
- The Copenhagen City Heart Study, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
- The Copenhagen General Population Study, Copenhagen University Hospital – Herlev and Gentofte, Herlev, Denmark
- Department of Internal Medicine, Respiratory Section, Copenhagen University Hospital – Herlev and Gentofte, Herlev, Denmark
| | - Hannu Kankaanranta
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, United Kingdom
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Børge Grønne Nordestgaard
- The Copenhagen City Heart Study, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
- The Copenhagen General Population Study, Copenhagen University Hospital – Herlev and Gentofte, Herlev, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital – Herlev and Gentofte, Herlev, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter Lange
- The Copenhagen City Heart Study, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Internal Medicine, Respiratory Section, Copenhagen University Hospital – Herlev and Gentofte, Herlev, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
11
|
Li G, Jankowich MD, Wu L, Lu Y, Shao L, Lu X, Fan Y, Pan CW, Wu Y, Ke C. Preserved Ratio Impaired Spirometry and Risks of Macrovascular, Microvascular Complications and Mortality Among Individuals With Type 2 Diabetes. Chest 2023; 164:1268-1280. [PMID: 37356807 DOI: 10.1016/j.chest.2023.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND The prospective associations of preserved ratio impaired spirometry (PRISm) with new-onset macrovascular and microvascular complications and mortality among individuals with type 2 diabetes (T2D) and whether PRISm enhances the prediction ability of an established office-based risk score remain to be elucidated. RESEARCH QUESTION Can PRISm be used as a predictor of poor prognosis in individuals with T2D? STUDY DESIGN AND METHODS We included 20,047 study participants with T2D and complete data on spirometry at recruitment from the UK Biobank cohort. Multivariable Cox proportional hazards models were used to assess the associations of baseline PRISm (FEV1 to FVC ratio, ≥ 0.70; FEV1, < 80% predicted) with subsequent risks of incident stroke (any type), ischemic stroke, myocardial infarction, unstable angina, coronary heart disease, diabetic retinopathy, diabetic kidney disease, all-cause mortality, cardiovascular mortality, and respiratory mortality. RESULTS For this cohort analysis, 4,521 patients (22.55% of participants with T2D) showed comorbid PRISm at baseline. Over a median follow-up of 11.52 to 11.87 years, patients with T2D with PRISm at baseline showed higher risks than those with normal spirometry findings of various T2D complications developing and mortality; the adjusted hazard ratios for PRISm were 1.413 (95% CI, 1.187-1.681) for stroke (any type), 1.382 (95% CI, 1.129-1.690) for ischemic stroke, 1.253 (95% CI, 1.045-1.503) for myocardial infarction, 1.206 (95% CI, 1.086-1.339) for coronary heart disease, 1.311 (95% CI, 1.141-1.506) for diabetic retinopathy, 1.384 (95% CI, 1.190-1.610) for diabetic kidney disease, 1.337 (95% CI, 1.213-1.474) for all-cause mortality, 1.597 (95% CI, 1.296-1.967) for cardiovascular mortality, and 1.559 (95% CI, 1.189-2.044) for respiratory mortality, respectively. The addition of PRISm significantly improved the reclassification ability, based on the net reclassification index, of an office-based risk score by 15.53% (95% CI, 10.14%-19.63%) to 33.60% (95% CI, 20.90%-45.79%). INTERPRETATION Individuals with T2D with comorbid PRISm, accounting for a considerable proportion of the population with T2D, showed significantly increased risks of adverse macrovascular and microvascular complications and mortality.
Collapse
Affiliation(s)
- Guochen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Matthew D Jankowich
- Providence VA Medical Center, Providence, RI; Division of Pulmonary, Critical Care, and Sleep Medicine, Alpert Medical School of Brown University, Providence, RI
| | - Luying Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yanqiang Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Liping Shao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xujia Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yulong Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Ying Wu
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China.
| |
Collapse
|
12
|
Cestelli L, Gulsvik A, Johannessen A, Stavem K, Nielsen R. Reduced lung function and cause-specific mortality: A population-based study of Norwegian men followed for 26 years. Respir Med 2023; 219:107421. [PMID: 37776914 DOI: 10.1016/j.rmed.2023.107421] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/06/2023] [Accepted: 09/28/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND AND AIM Reduced lung function is associated with increased mortality, but it is unclear how different spirometric patterns are related to specific deaths. Aim of this study was to investigate these associations in a large general population cohort. METHODS The study population consisted of 26,091 men aged 30-46 years from the Pneumoconiosis Survey of Western Norway conducted in 1988-1990 with follow-up on date and cause of death for 26 years. Cox proportional hazard models were used to estimate the association between baseline FEV1, FVC, obstructive (OSP) and restrictive spirometric pattern (RSP) (z-scores calculated according to GLI-2012 equations) and mortality (European 2012 shortlist classification (E-2012)), after adjustment for age, body mass index, smoking habits, and education. RESULTS In total, 2462 (9%) subjects died. A predominant reduction of FEV1 (and OSP) were associated with respiratory non-cancer (E-8) (HR for one unit FEV1 z-score decrease 2.29 (95% CI 1.90, 2.77) and lung cancer mortality (E-2.1.8) (1.27(1.12, 1.44)). A similar reduction of FEV1 and FVC (and RSP) were associated with diabetes (E-4.1) (FEV1 2.21(1.67, 2.92), FVC 2.41(1.75, 3.32)), cerebrovascular (E-7.3) (1.52(1.21, 1.91), 1.54(1.19, 1.98)), ischemic heart disease (E-7.1) (1.22(1.10, 1.35), 1.21(1.08, 1.36)), neurological (E-6.3) (1.56(1.21, 2.01), 1.61(1.22, 2.13)), suicide (E-17.2) (1.37(1.13, 1.65), 1.29(1.04, 1.59)) and hematological cancer mortality (E-2.1.19-21) (1.29(1.05, 1.58), (1.26(1.00, 1.58)). No association was found between reduced lung function and mortality due to accidents, alcohol abuse, digestive and genitourinary cancer. CONCLUSIONS Spirometric obstruction was mainly related to pulmonary mortality. Spirometric restriction was mainly related to extra-pulmonary mortality.
Collapse
Affiliation(s)
- Lucia Cestelli
- Department of Clinical Science, University of Bergen, Bergen, Norway.
| | - Amund Gulsvik
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Knut Stavem
- Pulmonary Department, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Rune Nielsen
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
13
|
Wade RC, Wells JM. Preserved Ratio With Impaired Spirometry: The Lung's Contribution to Metabolic Syndrome. Chest 2023; 164:1075-1076. [PMID: 37945187 DOI: 10.1016/j.chest.2023.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 06/22/2023] [Indexed: 11/12/2023] Open
Affiliation(s)
- R Chad Wade
- Department of Internal Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL; Lung Health Center, University of Alabama at Birmingham, Birmingham, AL; Acute Care Service, Birmingham VA Medical Center, Birmingham, AL.
| | - J Michael Wells
- Department of Internal Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL; Lung Health Center, University of Alabama at Birmingham, Birmingham, AL; Acute Care Service, Birmingham VA Medical Center, Birmingham, AL
| |
Collapse
|
14
|
Tan M, Liang Y, Lv W, Ren H, Cai Q. The effects of inspiratory muscle training on swimming performance: A study on the cohort of swimming specialization students. Physiol Behav 2023; 271:114347. [PMID: 37699450 DOI: 10.1016/j.physbeh.2023.114347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/29/2023] [Accepted: 09/09/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE Current evidence posits a strong correlation between respiratory muscle function and swimming performance. Despite this, few studies have explored the integration of inspiratory muscle training (IMT) into standard swimming training regimens, which remains an unexplored avenue for improving performance in swimmers. This study aims to evaluate the potential advantages of IMT for enhancing respiratory function and swimming performance and determine whether such training could induce beneficial physiological adaptations. METHODS We designed and conducted a randomized controlled trial involving 43 swimming specialization students aged 18-25 years. Participants were randomly allocated to two groups: a control group, which followed regular swimming training, and an experimental group, which complemented the standard training with IMT. The intervention lasted for six weeks. Key outcomes measured included swimming performance metrics (time of 50 m freestyle, number of breaths in 50 m freestyle, distance before first breath in freestyle, time of 100 m freestyle) and various inspiratory muscle function parameters such as vital capacity (VC), maximum inspiratory pressure (MIP), maximum inspiratory flow (MIF), and maximum inspiratory capacity (MIC). We also assessed certain biochemical parameters, including hemoglobin, creatine kinase (CK), blood urea nitrogen (BUN), testosterone, and cortisol concentrations. RESULTS Following the training period, the experimental group exhibited significant improvements in swimming performance and respiratory function parameters. We also noted an increase in hemoglobin levels and a reduction in testosterone concentrations in this group, suggesting beneficial physiological adaptations in response to the combined IMT and swimming training. CONCLUSION Our findings underline the potential of IMT as a supplementary training modality for enhancing respiratory function and improving swimming performance. The changes in biochemical parameters suggest physiological adaptations that might contribute to these observed improvements. This study opens the door for future research on the benefits of integrating IMT into training regimens for competitive swimmers. Further investigation is warranted to fully elucidate the mechanisms behind the observed benefits and to validate these findings in a larger cohort and other athlete populations.
Collapse
Affiliation(s)
| | - Yuxi Liang
- Guangzhou Sport University, Guangzhou, China
| | - Wenting Lv
- Guangzhou Sport University, Guangzhou, China
| | - Hao Ren
- Institute for Healthcare Artificial Intelligence, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Qijun Cai
- Guangzhou Sport University, Guangzhou, China
| |
Collapse
|
15
|
Declercq PL, Fournel I, Demeyere M, Berraies A, Ksiazek E, Nyunga M, Daubin C, Ampere A, Sauneuf B, Badie J, Delbove A, Nseir S, Artaud-Macari E, Bironneau V, Ramakers M, Maizel J, Miailhe AF, Lacombe B, Delberghe N, Oulehri W, Georges H, Tchenio X, Clarot C, Redureau E, Bourdin G, Federici L, Adda M, Schnell D, Bousta M, Salmon-Gandonnière C, Vanderlinden T, Plantefeve G, Delacour D, Delpierre C, Le Bouar G, Sedillot N, Beduneau G, Rivière A, Meunier-Beillard N, Gélinotte S, Rigaud JP, Labruyère M, Georges M, Binquet C, Quenot JP. Influence of socio-economic status on functional recovery after ARDS caused by SARS-CoV-2: the multicentre, observational RECOVIDS study. Intensive Care Med 2023; 49:1168-1180. [PMID: 37620561 PMCID: PMC10556111 DOI: 10.1007/s00134-023-07180-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE Survivors after acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19) are at high risk of developing respiratory sequelae and functional impairment. The healthcare crisis caused by the pandemic hit socially disadvantaged populations. We aimed to evaluate the influence of socio-economic status on respiratory sequelae after COVID-19 ARDS. METHODS We carried out a prospective multicenter study in 30 French intensive care units (ICUs), where ARDS survivors were pre-enrolled if they fulfilled the Berlin ARDS criteria. For patients receiving high flow oxygen therapy, a flow ≥ 50 l/min and an FiO2 ≥ 50% were required for enrollment. Socio-economic deprivation was defined by an EPICES (Evaluation de la Précarité et des Inégalités de santé dans les Centres d'Examens de Santé - Evaluation of Deprivation and Inequalities in Health Examination Centres) score ≥ 30.17 and patients were included if they performed the 6-month evaluation. The primary outcome was respiratory sequelae 6 months after ICU discharge, defined by at least one of the following criteria: forced vital capacity < 80% of theoretical value, diffusing capacity of the lung for carbon monoxide < 80% of theoretical value, oxygen desaturation during a 6-min walk test and fibrotic-like findings on chest computed tomography. RESULTS Among 401 analyzable patients, 160 (40%) were socio-economically deprived and 241 (60%) non-deprived; 319 (80%) patients had respiratory sequelae 6 months after ICU discharge (81% vs 78%, deprived vs non-deprived, respectively). No significant effect of socio-economic status was identified on lung sequelae (odds ratio (OR), 1.19 [95% confidence interval (CI), 0.72-1.97]), even after adjustment for age, sex, most invasive respiratory support, obesity, most severe P/F ratio (adjusted OR, 1.02 [95% CI 0.57-1.83]). CONCLUSIONS In COVID-19 ARDS survivors, socio-economic status had no significant influence on respiratory sequelae 6 months after ICU discharge.
Collapse
Affiliation(s)
| | - Isabelle Fournel
- Centre d’Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | | | | | - Eléa Ksiazek
- Centre d’Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | - Martine Nyunga
- Service de Médecine Intensive Réanimation, CH de Roubaix, Roubaix, France
| | - Cédric Daubin
- Department of Medical Intensive Care, CHU de Caen Normandie, Caen, France
| | | | - Bertrand Sauneuf
- Service de Médecine Intensive Réanimation, CH Public du Cotentin, Cherbourg-en-Cotentin, France
| | - Julio Badie
- Service de Médecine Intensive Réanimation, Hopital Nord Franche-Comte, Trevenans, France
| | - Agathe Delbove
- Service de Réanimation Polyvalente, CHBA Vannes, Vannes, France
| | - Saad Nseir
- Service de Médecine Intensive Réanimation, CHRU Roger Salengro, Lille, France
- Inserm U1285, Univ. Lille, CNRS, UMR 8576-UGSF-Unité de Glycobiologie Structurale et Fonctionnelle, Lille, France
| | - Elise Artaud-Macari
- University of Normandie, UNIROUEN, EA3830, CHU Rouen, Department of Pneumology, Thoracic Oncology and Respiratory Intensive Care Unit, Rouen, France
| | - Vanessa Bironneau
- Service de Pneumologie, CHU Poitiers, Poitiers, France
- INSERM CIC 1402, ALIVES Research Group, Université de Poitiers, Poitiers, France
| | - Michel Ramakers
- Service de Médecine Intensive Réanimation, Centre Hospitalier Mémorial de Saint-Lô, Saint-Lô, France
| | - Julien Maizel
- Service de Médecine Intensive Réanimation, CHU d’Amiens, Amiens, France
| | | | - Béatrice Lacombe
- Service de Réanimation Polyvalente, Groupe Hospitalier Bretagne Sud, Lorient, France
| | | | - Walid Oulehri
- Service de Réanimation Chirurgicale, CHRU Strasbourg, Strasbourg, France
| | - Hugues Georges
- Service de Médecine Intensive Réanimation, CH de Tourcoing, Tourcoing, France
| | - Xavier Tchenio
- Service de Réanimation Polyvalente, Centre Hospitalier Fleyriat, Bourg en Bresse, France
| | | | - Elise Redureau
- Service de Pneumologie, CHD Vendée, La Roche-sur-Yon, France
| | - Gaël Bourdin
- Service de Réanimation Polyvalente, CH Saint Joseph Saint Luc, Lyon, France
| | - Laura Federici
- Service de Médecine Intensive Réanimation, AP-HP, Hôpital Louis Mourier, Colombes, France
| | - Mélanie Adda
- Service de Médecine Intensive Réanimation, Hôpitaux de Marseille, Hôpital Nord, Marseille, France
| | - David Schnell
- Service de Réanimation Polyvalente et USC, CH d’Angoulême, Angoulême, France
| | - Mehdi Bousta
- Service de Réanimation Médico-Chirugicale, Groupe Hospitalier du Havre, Le Havre, France
| | | | - Thierry Vanderlinden
- Intensive Care Unit, St Philibert hospital, ETHICS EA 7446, Lille Catholic University, Lille, France
| | - Gaëtan Plantefeve
- Service de Médecine Intensive Réanimation, CH d’Argenteuil, Argenteuil, France
| | - David Delacour
- Service de radiologie, Clinique du Cèdre, Bois-Guillaume, France
| | | | - Gurvan Le Bouar
- Service de Médecine Intensive Réanimation, CHES Evreux, Evreux, France
| | - Nicholas Sedillot
- Service de Réanimation Polyvalente, Centre Hospitalier Fleyriat, Bourg en Bresse, France
| | - Gaëtan Beduneau
- Normandie Univ, UNIROUEN, UR3830, CHU Rouen, Department of Medical Intensive Care, 76000 Rouen, France
| | - Antoine Rivière
- Service de Réanimation Polyvalente, CH d’Abbeville, Abbeville, France
| | - Nicolas Meunier-Beillard
- Centre d’Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | | | - Jean-Philippe Rigaud
- Service de Médecine Intensive Réanimation, CH de Dieppe, Dieppe, France
- Espace de Réflexion Ethique de Normandie, CHU Caen, Caen, France
| | - Marie Labruyère
- Department of Intensive Care, Burgundy University Hospital, 14 rue Paul Gaffarel, B.P 77908, 21079 Dijon Cedex, France
- Lipness Team, INSERM Research Center LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
- INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France
| | - Marjolaine Georges
- Department of Pulmonary Medicine and Intensive Care Unit, University Hospital, Dijon, France
| | - Christine Binquet
- Centre d’Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | - Jean-Pierre Quenot
- Department of Intensive Care, Burgundy University Hospital, 14 rue Paul Gaffarel, B.P 77908, 21079 Dijon Cedex, France
- Lipness Team, INSERM Research Center LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
- INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France
| |
Collapse
|
16
|
Yang S, Chan CK, Wang MH, Leung CC, Tai LB, Tse LA. Association of spirometric restriction with mortality in the silicotics: a cohort study. BMC Pulm Med 2023; 23:327. [PMID: 37667228 PMCID: PMC10478203 DOI: 10.1186/s12890-023-02622-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/30/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Restrictive spirometry pattern (RSP), defined as reduced forced vital capacity (FVC) in absence of airflow obstruction (AFO), is associated with increased risk of mortality in general population. However, evidence in the patients with silicosis is limited. This study was aimed to investigate the relationship between RSP and the risk of death in a silicotic cohort. METHOD This retrospective cohort study used data from the Pneumoconiosis Clinic, Hong Kong Department of Health that containing 4315 patients aged 18-80 years and diagnosed with silicosis during 1981-2019, with a follow-up till 31 December 2019. Spirometry was carried out at the diagnostic examination of silicosis. Lung function categories were classified as normal spirometry (FEV1/FVC ≥ 0.7, FVC ≥ 80% predicted), RSP only (FEV1/FVC ≥ 0.7, FVC < 80% predicted), AFO only (FEV1/FVC < 0.7, FVC ≥ 80% predicted), and RSP&AFO mixed (FEV1/FVC < 0.7, FVC < 80% predicted). The hazard ratio (HR) and 95% confidence intervals (95% CI) were computed using a Cox proportional hazards model adjusting for age, body mass index, history of tuberculosis, smoking status, pack-years, and radiographic characteristics of silicotic nodules. RESULTS Among the 4315 patients enrolled in the study, the prevalence of RSP was 24.1% (n = 1038), including 11.0% (n = 473) with RSP only and 13.1% (n = 565) with mixed RSP and AFO. During the follow-up period, a total of 2399 (55.6%) deaths were observed. Compared with the silicotics with normal spirometry, those with RSP only had significantly increased risk of all-cause mortality (HR = 1.63, 95% CI 1.44-1.85) and respiratory-related mortality (HR = 1.56, 95% CI 1.31-1.85). Notably, a higher risk of mortality was observed in silicotics with mixed ventilatory defects of both RSP and AFO (all-cause mortality: HR = 2.22, 95% CI 1.95-2.52; respiratory-related mortality: HR = 2.59, 95% CI 2.18-3.07) than in those with RSP only. CONCLUSION RSP is significantly associated with increased risk of all-cause and respiratory-related mortality in the silicotics, and patients with mixed restrictive and obstructive ventilatory defect have higher risk of mortality than those with single RSP or AFO. These findings emphasize the importance of recognizing RSP in the occupational settings, especially for the silicotic patients with mixed ventilatory defect.
Collapse
Affiliation(s)
- Shuyuan Yang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Kuen Chan
- Tuberculosis and Chest Service, Department of Health, Hong Kong SAR, China
| | - Maggie Haitian Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Chiu Leung
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lai Bun Tai
- Tuberculosis and Chest Service, Department of Health, Hong Kong SAR, China
| | - Lap Ah Tse
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
17
|
Li G, Jankowich MD, Lu Y, Wu L, Shao L, Ke C. Preserved Ratio Impaired Spirometry, Metabolomics, and the Risk of Type 2 Diabetes. J Clin Endocrinol Metab 2023; 108:e769-e778. [PMID: 36897159 DOI: 10.1210/clinem/dgad140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/28/2023] [Accepted: 03/08/2023] [Indexed: 03/11/2023]
Abstract
CONTEXT Whether baseline preserved ratio impaired spirometry (PRISm) is associated with the risk of developing type 2 diabetes (T2D) and if this association could be mediated by circulating metabolites remains to be elucidated. OBJECTIVE To measure the prospective association of PRISm with T2D and potential metabolic mediators thereof. METHODS This study used data from the UK Biobank and included 72 683 individuals without diabetes at baseline. PRISm was defined as the predicted forced expiratory volume in 1 second (FEV1) <80% and the FEV1/forced vital capacity ratio ≥0.70. Cox proportional hazards modeling was performed to assess the longitudinal relation between baseline PRISm and incident T2D. Mediation analysis was used to explore the mediation effects of circulating metabolites in the path from PRISm to T2D. RESULTS During a median follow-up of 12.06 years, 2513 participants developed T2D. Individuals who had PRISm (N = 8394) were 47% (95% CI, 33%-63%) more likely to develop T2D compared with those who had normal spirometry (N = 64 289). A total of 121 metabolites showed statistically significant mediation effects in the path from PRISm to T2D (false discovery rate <0.05). Glycoprotein acetyls, cholesteryl esters in large high-density lipoprotein (HDL), degree of unsaturation, cholesterol in large HDL, and cholesteryl esters in very large HDL were the top 5 metabolic markers, with mediation proportions (95% CI) being 11.91% (8.76%-16.58%), 11.04% (7.34%-15.55%), 10.36% (7.34%-14.71%), 9.87% (6.78%-14.09%), and 9.51% (6.33%-14.05%), respectively. A total of 11 principal components that explained 95% variance of the metabolic signatures accounted for 25.47% (20.83%-32.19%) of the relation between PRISm and T2D. CONCLUSIONS Our study revealed the association of PRISm with T2D risk and the potential roles of circulating metabolites in mediating this association.
Collapse
Affiliation(s)
- Guochen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, 215123, P. R. China
| | - Matthew D Jankowich
- Section of Pulmonary and Critical Care Medicine, Medical Service, Providence VA Medical Center, Providence, RI 02908, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Yanqiang Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, 215123, P. R. China
| | - Luying Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, 215123, P. R. China
| | - Liping Shao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, 215123, P. R. China
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, 215123, P. R. China
| |
Collapse
|
18
|
de la Hoz RE, Shapiro M, Nolan A, Sood A, Lucchini RG, Cone JE, Celedón JC. Association of World Trade Center (WTC) Occupational Exposure Intensity with Chronic Obstructive Pulmonary Disease (COPD) and Asthma COPD Overlap (ACO). Lung 2023; 201:325-334. [PMID: 37468611 PMCID: PMC10763856 DOI: 10.1007/s00408-023-00636-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/04/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION Reported associations between World Trade Center (WTC) occupational exposure and chronic obstructive pulmonary disease (COPD) or asthma COPD overlap (ACO) have been inconsistent. Using spirometric case definitions, we examined that association in the largest WTC occupational surveillance cohort. METHODS We examined the relation between early arrival at the 2001 WTC disaster site (when dust and fumes exposures were most intense) and COPD and ACO in workers with at least one good quality spirometry with bronchodilator response testing between 2002 and 2019, and no physician-diagnosed COPD before 9/11/2001. COPD was defined spirometrically as fixed airflow obstruction and ACO as airflow obstruction plus an increase of ≥ 400 ml in FEV1 after bronchodilator administration. We used a nested 1:4 case-control design matching on age, sex and height using incidence density sampling. RESULTS Of the 17,928 study participants, most were male (85.3%) and overweight or obese (84.9%). Further, 504 (2.8%) and 244 (1.4%) study participants met the COPD and ACO spirometric case definitions, respectively. In multivariable analyses adjusted for smoking, occupation, cohort entry period, high peripheral blood eosinophil count and other covariates, early arrival at the WTC site was associated with both COPD (adjusted odds ratio [ORadj] = 1.34, 95% confidence interval [CI] 1.01-1.78) and ACO (ORadj = 1.55, 95%CI 1.04-2.32). CONCLUSION In this cohort of WTC workers, WTC exposure intensity was associated with spirometrically defined COPD and ACO. Our findings suggest that early arrival to the WTC site is a risk factor for the development of COPD or of fixed airway obstruction in workers with pre-existing asthma.
Collapse
Affiliation(s)
- Rafael E de la Hoz
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Division of Occupational and Environmental Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, WTC HP CCE Box 1059, New York, NY, 10029, USA.
| | - Moshe Shapiro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anna Nolan
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Akshay Sood
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Roberto G Lucchini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James E Cone
- New York City Department of Health and Mental Hygiene, WTC Health Registry, New York, NY, USA
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
19
|
Lim HS, Kim DK, Gil HI, Lee MY, Lee HS, Lee YT, Yoon KJ, Park CH. Association of Pulmonary Function with Osteosarcopenic Obesity in Older Adults Aged over 50 Years. Nutrients 2023; 15:2933. [PMID: 37447259 DOI: 10.3390/nu15132933] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Osteosarcopenic obesity (OSO) is a newly described coexistence of osteopenia/osteoporosis, sarcopenia, and obesity. We examined the association between pulmonary function, OSO, and its composition in adults aged ≥ 50 years. A total of 26,343 participants (8640 men; 17,703 women) were classified into four groups based on the number of abnormal body compositions (osteopenia/osteoporosis, sarcopenia, and obesity): 0 (control), 1+, 2+, and 3+ (OSO) abnormal body compositions. The values of forced volume vital capacity (FVC)%, forced expiratory volume in 1 s (FEV1%), and FEV1/FVC% were significantly decreased by increasing the number of adverse body compositions (p < 0.0001). Although the prevalence of restrictive spirometry pattern (RSP) was positively associated with a higher number of abnormal body composition parameters (p < 0.001), obstructive spirometry pattern (OSP) had no association with adverse body composition. In multivariate analyses, the adjusted odds ratios (ORs) for RSP compared to the control group were 1.36 in 1+, 1.47 in 2+, and 1.64 in 3+ abnormal body compositions (p for trend < 0.001). Multiple abnormal body composition, especially osteosarcopenic obesity, was independently associated with poor lung function showing RSP in older adults over 50 years. The coexistence of these abnormal body compositions may be a predisposing factor for pulmonary function deterioration.
Collapse
Affiliation(s)
- Han-Sol Lim
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Dong-Kun Kim
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Hyun-Il Gil
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Mi-Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Hyun-Seung Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Yong-Taek Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Kyung Jae Yoon
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Chul-Hyun Park
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| |
Collapse
|
20
|
Sin S, Lee EJ, Won S, Kim WJ. Longitudinal mortality of preserved ratio impaired spirometry in a middle-aged Asian cohort. BMC Pulm Med 2023; 23:155. [PMID: 37138264 PMCID: PMC10157957 DOI: 10.1186/s12890-023-02451-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/24/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Although preserved ratio impaired spirometry (PRISm) has been determined to have poor prognosis, it is a heterogeneous state, and studies regarding its prognosis in Asians are limited. This study investigated the long-term all-cause and cardiovascular mortality of patients with PRISm compared with those of patients with chronic obstructive pulmonary disease (COPD) and normal individuals in the Korean middle-aged general population. METHODS Participants were recruited between 2001 and 2002 from a community-based prospective cohort in South Korea. Mortality data were collected over a 16.5-year mean follow-up period. The all-cause and cardiovascular mortality risks of PRISm were compared between patients with COPD and healthy controls. RESULTS The PRISm group had a mean age of 53.4 years and mean body mass index of 24.9 kg/m2; furthermore, 55.2% of the PRISm patients had never smoked, and the prevalence of comorbidities was not higher than that in the other groups. Compared with normal individuals, PRISm patients did not show increased all-cause mortality, whereas COPD patients showed increased all-cause mortality (PRISm: adjusted hazard ratio [aHR], 1.19; 95% confidence interval [CI], 0.85-1.65; COPD: aHR, 1.34, 95% CI, 1.07-1.69). Furthermore, the PRISm patients did not show increased cardiovascular mortality compared with normal individuals (PRISm: aHR, 1.65; 95% CI, 0.92-2.95; COPD: aHR, 1.83; 95% CI, 1.09-3.07). CONCLUSION In our population-based cohort, all-cause and cardiovascular mortality risk did not increase in individuals with PRISm compared with normal individuals. Further studies are needed to distinguish a lower-risk subgroup of PRISm with certain characteristics, such as middle-aged, light-smoking Asians without additional cardiovascular risk.
Collapse
Affiliation(s)
- Sooim Sin
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea
| | - Eun Ju Lee
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Sungho Won
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, Republic of Korea.
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.
- Department of Internal Medicine, School of Medicine, Kangwon National University, Kangwon National University Hospital, Chuncheon, 24341, Republic of Korea.
| |
Collapse
|
21
|
Schiffers C, Ofenheimer A, Breyer MK, Mraz T, Lamprecht B, Burghuber OC, Hartl S, Wouters EFM, Breyer-Kohansal R. Prevalence of restrictive lung function in children and adults in the general population. Respir Med 2023; 210:107156. [PMID: 36870424 DOI: 10.1016/j.rmed.2023.107156] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/09/2023] [Accepted: 02/14/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Restrictive lung function (RLF) is characterized by a reduced lung expansion and size. In the absence of lung volume measurements, restriction can be indirectly assessed with restrictive spirometric patterns (RSP) by spirometry. Prevalence data on RLF by the golden standard body plethysmography in the general population are scarce. Therefore, we aimed to evaluate the prevalence of RLF and RSP in the general population by body plethysmography and to determine factors influencing RLF and RSP. METHODS Pre-bronchodilation lung function data of 8891 subjects (48.0% male, age 6-82 years) have been collected in the LEAD Study, a single-centered, longitudinal, population-based study from Vienna, Austria. The cohort was categorized in the following groups based on the Global Lung Initiative reference equations: normal subjects, RLF (TLC < lower limit of normal (LLN)), RSP (FEV1/FVC ≥ LLN and a FVC < LLN), RSP only (RSP with TLC ≥ LLN). Normal subjects were considered those with FEV1, FVC, FEV1/FVC and TLC between LLN and ULN (upper limit of normal). RESULTS The prevalence of RLF and RSP in the Austrian general population is 1.1% and 4.4%. Spirometry has a positive and negative predictive value of 18.0% and 99.6% to predict a restrictive lung function. Central obesity was associated with RLF. RSP was related to smoking and underweight. CONCLUSIONS The prevalence of true restrictive lung function and RSP in the Austrian general population is lower than previously estimated. Our data confirm the need for direct lung volume measurement to diagnose true restrictive lung function.
Collapse
Affiliation(s)
| | - Alina Ofenheimer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Medical Center, Maastricht, the Netherlands
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, Vienna, Austria
| | - Tobias Mraz
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, Vienna, Austria
| | - Bernd Lamprecht
- Department of Pulmonology and Faculty of Medicine, Kepler University Hospital, Linz, Austria
| | - Otto Chris Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Sigmund Freud University, Faculty of Medicine, Vienna, Austria
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, Vienna, Austria; Sigmund Freud University, Faculty of Medicine, Vienna, Austria
| | - Emiel F M Wouters
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Medical Center, Maastricht, the Netherlands
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Pulmonary Diseases, Clinic Hietzing, Vienna Healthcare Group, Vienna, Austria
| |
Collapse
|
22
|
Hines SE, Dement J, Cloeren M, Cranford K, Quinn PS, Ringen K. Restrictive spirometry pattern among construction trade workers. Am J Ind Med 2023; 66:484-499. [PMID: 36942569 DOI: 10.1002/ajim.23474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/22/2023] [Accepted: 03/07/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Spirometry-based studies of occupational lung disease have mostly focused on obstructive or mixed obstructive/restrictive outcomes. We wanted to determine if restrictive spirometry pattern (RSP) is associated with occupation and increased mortality. METHODS Study participants included 18,145 workers with demographic and smoking data and repeatable spirometry. The mortality analysis cohort included 15,445 workers with known vital status and cause of death through December 31, 2016. Stratified analyses explored RSP prevalence by demographic and clinical variables and trade. Log-binomial regression models explored RSP risk factors while controlling for important confounders such as smoking, obesity, and comorbidities. Cox regression models explored mortality risk by spirometry category. RESULTS Prevalence of RSP was very high (28.6%). Mortality hazard ratios for RSP were 1.50 for all causes, 1.86 for cardiovascular diseases, 2.31 for respiratory diseases, and 1.66 for lung cancer. All construction trades except painters, machinists, and roofers had significantly elevated risk for RSP compared to our internal reference group. RSP was significantly associated with both parenchymal and pleural changes seen by chest X-ray. CONCLUSIONS Construction trade workers are at significantly increased risk for RSP independent of obesity. Individuals with RSP are at increased risk for all-cause mortality as well as mortality attributable to respiratory diseases, cardiovascular diseases, and lung cancer. RSP deserves greater attention in occupational medicine and epidemiology.
Collapse
Affiliation(s)
- Stella E Hines
- Division of Occupational and Environmental Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - John Dement
- Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Marianne Cloeren
- Division of Occupational and Environmental Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kim Cranford
- Zenith American Solutions, Covina, California, USA
| | - Patricia S Quinn
- Energy Employees Department, CPWR Center for Construction Research and Training, Silver Spring, Maryland, USA
| | - Knut Ringen
- Energy Employees Department, CPWR Center for Construction Research and Training, Silver Spring, Maryland, USA
| |
Collapse
|
23
|
Dharmage SC, Bui DS, Walters EH, Lowe AJ, Thompson B, Bowatte G, Thomas P, Garcia-Aymerich J, Jarvis D, Hamilton GS, Johns DP, Frith P, Senaratna CV, Idrose NS, Wood-Baker RR, Hopper J, Gurrin L, Erbas B, Washko GR, Faner R, Agusti A, Abramson MJ, Lodge CJ, Perret JL. Lifetime spirometry patterns of obstruction and restriction, and their risk factors and outcomes: a prospective cohort study. THE LANCET. RESPIRATORY MEDICINE 2023; 11:273-282. [PMID: 36244396 DOI: 10.1016/s2213-2600(22)00364-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Interest in lifetime lung function trajectories has increased in the context of emerging evidence that chronic obstructive pulmonary disease (COPD) can arise from multiple disadvantaged lung function pathways, including those that stem from poor lung function in childhood. To our knowledge, no previous study has investigated both obstructive and restrictive lifetime patterns concurrently, while accounting for potential overlaps between them. We aimed to investigate lifetime trajectories of the FEV1/forced vital capacity (FVC) ratio, FVC, and their combinations, relate these combined trajectory groups to static lung volume and gas transfer measurements, and investigate both risk factors for and consequences of these combined trajectory groups. METHODS Using z scores from spirometry measured at ages 7, 13, 18, 45, 50, and 53 years in the Tasmanian Longitudinal Health Study (n=2422), we identified six FEV1/FVC ratio trajectories and five FVC trajectories via group-based trajectory modelling. Based on whether trajectories of the FEV1/FVC ratio and FVC were low (ie, low from childhood or adulthood) or normal, four patterns of lifetime spirometry obstruction or restriction were identified and compared against static lung volumes and gas transfer. Childhood and adulthood characteristics and morbidities of these patterns were investigated. FINDINGS The prevalence of the four lifetime spirometry patterns was as follows: low FEV1/FVC ratio only, labelled as obstructive-only, 25·8%; low FVC only, labelled as restrictive-only, 10·5%; both low FEV1/FVC ratio and low FVC, labelled as mixed, 3·5%; and neither low FEV1/FVC ratio nor low FVC, labelled as reference, 60·2%. The prevalence of COPD at age 53 years was highest in the mixed pattern (31 [37%] of 84 individuals) followed by the obstructive-only pattern (135 [22%] of 626 individuals). Individuals with the mixed pattern also had the highest prevalence of parental asthma, childhood respiratory illnesses, adult asthma, and depression. Individuals with the restrictive-only pattern had lower total lung capacity and residual volume, and had the highest prevalence of childhood underweight, adult obesity, diabetes, cardiovascular conditions, hypertension, and obstructive sleep apnoea. INTERPRETATION To our knowledge, this is the first study to characterise lifetime phenotypes of obstruction and restriction simultaneously using objective data-driven techniques and unique life course spirometry measures of FEV1/FVC ratio and FVC from childhood to middle age. Mixed and obstructive-only patterns indicate those who might benefit from early COPD interventions. Those with the restrictive-only pattern had evidence of true lung restriction and were at increased risk of multimorbidity by middle age. FUNDING National Health and Medical Research Council of Australia, The University of Melbourne, Clifford Craig Medical Research Trust of Tasmania, The Victorian, Queensland & Tasmanian Asthma Foundations, The Royal Hobart Hospital, Helen MacPherson Smith Trust, and GlaxoSmithKline.
Collapse
Affiliation(s)
- Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
| | - Dinh S Bui
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Eugene H Walters
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Bruce Thompson
- School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Gayan Bowatte
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Paul Thomas
- Inflammation and Infection Research, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain; Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Debbie Jarvis
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Garun S Hamilton
- School of Clinical Sciences, Monash University, Melbourne, VIC, Australia; Lung, Sleep, Allergy and Immunology Department at Monash Health, Melbourne, VIC, Australia
| | - David P Johns
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Peter Frith
- College of Medicine and Public Health, Flinders University, Adelaide, SA Australia
| | - Chamara V Senaratna
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Nur S Idrose
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - John Hopper
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Lyle Gurrin
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Bircan Erbas
- School of Psychology and Public Heath, La Trobe University, Bundoora, VIC, Australia
| | - George R Washko
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA; Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
| | - Rosa Faner
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
| | - Alvar Agusti
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain; Respiratory Institute, Hospital Clinic, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Jennifer L Perret
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
24
|
Tandra M, Walters EH, Perret J, Lowe AJ, Lodge CJ, Johns DP, Thomas PS, Bowatte G, Davis PG, Abramson MJ, Dharmage SC, Bui DS. Small for gestational age is associated with reduced lung function in middle age: A prospective study from first to fifth decade of life. Respirology 2023; 28:159-165. [PMID: 36197802 PMCID: PMC10947040 DOI: 10.1111/resp.14379] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 09/05/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE The association between birth weight, particularly relative to gestational age, and adult lung function is uncertain. We investigated the associations between birth weight relative to gestational age and measures of lung function in middle age, and mediation of these associations by adult height. METHODS Participants in the Tasmanian Longitudinal Health Study who had both known birth weight and lung function assessment at age 45 years were included (n = 849). Linear regression models were fitted to investigate the association between small for gestational age and birth weight with post-bronchodilator lung function measures (forced expiratory volume in 1 second [FEV1 ], forced vital capacity [FVC], FEV1 /FVC, diffusing capacity for carbon monoxide [DL co], residual volume [RV] and total lung capacity [TLC]), adjusting for potential confounders. The contribution of adult height as a mediator of these associations was investigated. RESULTS Compared with infants born with normal weight for gestational age, those born small for gestational age had reduced FEV1 (coefficient: -191 ml [95%CI: -296, -87]), FVC (-205 ml [-330, -81]), TLC (-292 ml [-492, -92]), RV (-126 ml [-253, 0]) and DL co (-0.42 mmol/min/kPa [-0.79, -0.041]) at age 45 years. However, they had comparable FEV1 /FVC. For every 1 kg increase in birth weight, lung function indices increased by an average of 117 ml (95%CI: 40, 196) for FEV1 , 124 ml (30, 218) for FVC, 215 ml (66, 365) for TLC and 0.36 mmol/min/kPa (0.11, 0.62) for DL co, independent of gestational age, but again not for FEV1 /FVC. These associations were significantly mediated by adult height (56%-90%). CONCLUSION Small for gestational age was associated with reduced lung function that is likely due to smaller lungs with little evidence of any specific parenchymal impairment.
Collapse
Affiliation(s)
- Melvin Tandra
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - E. Haydn Walters
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
- School of Medicine and Menzies InstituteUniversity of TasmaniaHobartTasmaniaAustralia
| | - Jennifer Perret
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - Adrian J. Lowe
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - Caroline J. Lodge
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - David P. Johns
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
- School of Medicine and Menzies InstituteUniversity of TasmaniaHobartTasmaniaAustralia
| | - Paul S. Thomas
- Inflammation and Infection Research, Faculty of MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Gayan Bowatte
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
- Department of Basic Sciences, Faculty of Allied Health SciencesUniversity of PeradeniyaPeradeniyaSri Lanka
| | - Peter G. Davis
- Department of Obstetrics and GynaecologyUniversity of MelbourneMelbourneVictoriaAustralia
- Department of Newborn ResearchThe Royal Women's HospitalMelbourneVictoriaAustralia
| | - Michael J. Abramson
- School of Public Health & Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Shyamali C. Dharmage
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - Dinh S. Bui
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| |
Collapse
|
25
|
Significance of Preoperative Pulmonary Function on Short- and Long-Term Outcomes Following Gastrectomy for Gastric Cancer. J Gastrointest Surg 2023; 27:866-877. [PMID: 36658384 PMCID: PMC9851588 DOI: 10.1007/s11605-023-05582-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/25/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Preoperative pulmonary function assessment is useful for selecting surgical candidates and operative methods and assessing the risk of postoperative pulmonary complications. However, few studies have investigated the relationship between preoperative pulmonary function and short- and long-term outcomes in patients who underwent gastrectomy for gastric cancer. METHODS Of the 1040 patients with gastric cancer (stages I-III) who had undergone R0 gastrectomy between 2009 and 2020, 750 who underwent preoperative spirometry were included. Restrictive ventilatory impairment was defined as a vital capacity of the predicted value (%VC) < 80%, while obstructive ventilatory impairment was defined as forced expiratory volume in one second (FEV1%) < 70%. Postoperative complications were assessed using the Clavien-Dindo (CD) classification. The relationship between clinical factors, including %VC, FEV1%, severe postoperative complications (CD ≥ 3b), overall survival (OS), and relapse-free survival, were assessed. RESULTS The mean age of the 750 patients was 68 ± 10.5 years. Severe postoperative complications were observed in 25 (3.3%) patients and were significantly associated with FEV1% < 70% in the univariate analysis. The 5-year OS was 72.5%. Multivariate analysis showed that the cancer stage, age > 75 years, preoperative comorbidities, %VC < 80%, total gastrectomy, severe postoperative complications, and postoperative adjuvant chemotherapy were the significant independent factors affecting OS. Pneumonia was significantly associated with %VC < 80%. CONCLUSIONS FEV1% < 70%was associated with the development of severe postoperative complications, while %VC < 80% was associated with poor OS independent of the cancer stage because of death from pneumonia. Spirometry helps surgeons and patients discuss the risks and benefits of surgery.
Collapse
|
26
|
Dhahri R, Mejri I, Ghram A, Dghaies A, Slouma M, Boussaid S, Metoui L, Gharsallah I, Ayed K, Moatemri Z, Farahat RA, AlHamdani A, Dergaa I. Assessment Tools for Pulmonary Involvement in Patients with Ankylosing Spondylitis: Is Diaphragmatic Ultrasonography Correlated to Spirometry? J Multidiscip Healthc 2023; 16:51-61. [PMID: 36660040 PMCID: PMC9843477 DOI: 10.2147/jmdh.s393061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/23/2022] [Indexed: 01/12/2023] Open
Abstract
Objective Spondyloarthritis (SpA) is a chronic inflammatory rheumatic disease that can lead to spinal ankylosis and consequently, restrictive pulmonary dysfunction. Thus, the present study aimed to assess the accuracy of diaphragm ultrasound compared to spirometry in the screening of restrictive pulmonary disorders in radiographic SpA patients. Methods We conducted a cross-sectional study of 50 patients with radiographic SpA, over six months. Sociodemographic data, clinical characteristics of the disease, as well as biological, radiological, and therapeutic data, were collected. Spirometry and diaphragm ultrasound were performed. Results The mean age of the study participants (N= 50) was 42.7±11 years [range: 25-66] with male predominance (N= 41). Spirometry showed a restrictive disorder in 32% of cases. The mean chest expansion (CE) value was 3.9±1.81cm [range: 1-9] with a median of 4 cm. A pathological value (<5cm) was observed in 72% of cases. A significant positive correlation was found between the right inspiratory diaphragmatic thickness and forced vital capacity (FVC) (r= 0.36; p = 0.02) and the supine FVC (r=0.29; p = 0.04). The left inspiratory diaphragmatic thickness was correlated with the percentage of the FVC decrease (r= 0.35; p = 0.01) defined as the percentage of difference between FVC and supine FVC. The right expiratory diaphragmatic thickness was associated with the FVC (r=0.32; p = 0.02). A significant positive correlation was found between the CE and the presence of B lines (r=0.32; p = 0.02), but not between the CE and the FVC. Conclusion The present study showed that diaphragm ultrasonography is correlated with spirometric findings in radiographic SpA patients. Further studies are required to assess its reliability, specificity, and sensitivity in this pathology.
Collapse
Affiliation(s)
- Rim Dhahri
- Department of Rheumatology, Military Hospital of Instruction, Tunis, Tunisia,University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Islam Mejri
- University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia,Department of Pneumology, Military Hospital of instruction, Tunis, Tunisia
| | - Amine Ghram
- Department of Pneumology, Military Hospital of instruction, Tunis, Tunisia,Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA,Research Laboratory “Heart Failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia
| | - Abir Dghaies
- Department of Rheumatology, Military Hospital of Instruction, Tunis, Tunisia,University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Marwa Slouma
- Department of Rheumatology, Military Hospital of Instruction, Tunis, Tunisia,University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Soumaya Boussaid
- University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia,Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA,Department of Rheumatology, Rabta Hospital, Tunis, Tunisia
| | - Leila Metoui
- Department of Rheumatology, Military Hospital of Instruction, Tunis, Tunisia,University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Imen Gharsallah
- Department of Rheumatology, Military Hospital of Instruction, Tunis, Tunisia,University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Khadija Ayed
- University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia,Aviation Medicine Center of Expertise, Tunis, Tunisia
| | - Zied Moatemri
- University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia,Department of Pneumology, Military Hospital of instruction, Tunis, Tunisia
| | | | | | - Ismail Dergaa
- Primary Health Care Corporation (PHCC), Doha, Qatar,Research Unit Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia,High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia,Correspondence: Ismail Dergaa, Primary Health Care Corporation (PHCC), Doha, Qatar, Email ;
| |
Collapse
|
27
|
Saavedra JM, Brellenthin AG, Song BK, Lee DC, Sui X, Blair SN. Associations of cardiorespiratory fitness and body mass index with incident restrictive spirometry pattern. Br J Sports Med 2023:bjsports-2022-106136. [PMID: 36609350 PMCID: PMC10323034 DOI: 10.1136/bjsports-2022-106136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Restrictive spirometry pattern (RSP) suggests an impairment of lung function associated with a significantly increased risk of premature mortality. We evaluated the independent and joint associations of cardiorespiratory fitness (CRF) and body mass index with incident RSP. METHODS Data from the Aerobics Centre Longitudinal Study included 12 360 participants (18-82 years). CRF was assessed by maximal treadmill test and categorised into five groups. Body mass index was categorised into normal weight (<25.0 kg/m2), overweight (25.0-29.9 kg/m2) or obesity (≥30.0 kg/m2). RSP was defined as the simultaneous occurrence of forced expiratory volume in 1 s/force vital capacity ≥lower limit of normal and forced vital capacity <lower limit of normal. RESULTS There were 900 (7.3%) cases of RSP (mean follow-up: 6.9 years). Compared with category 1 ('least fit'), HRs (95% CIs) of RSP were 0.78 (0.63 to 0.96), 0.68 (0.54 to 0.86), 0.70 (0.55 to 0.88) and 0.59 (0.45 to 0.77) in categories 2, 3, 4 and 5 (most fit), respectively, after adjusting for confounders including body mass index. Compared with normal weight, HRs (95% CIs) of RSP were 1.06 (0.91 to 1.23) and 1.30 (1.03 to 1.64) in overweight and obese, respectively. However, the association between obesity and RSP was attenuated when additionally adjusting for CRF (HR 1.08, 95% CI 0.84 to 1.39). Compared with the 'unfit and overweight/obese' group, HRs (95% CIs) for RSP were 1.35 (0.98 to 1.85), 0.77 (0.63 to 0.96) and 0.70 (0.56 to 0.87) in the 'unfit and normal weight,' 'fit and overweight/obese' and 'fit and normal weight' groups, respectively. CONCLUSIONS Low CRF was associated with a greater incidence of RSP, irrespective of body mass index. Future studies are needed to explore potential underlying mechanisms of this association and to prospectively evaluate if improving CRF reduces the risk of developing RSP.
Collapse
Affiliation(s)
- Joey M Saavedra
- Department of Kinesiology, Iowa State University, Ames, Iowa, USA
| | | | - Bong Kil Song
- Department of Kinesiology, Iowa State University, Ames, Iowa, USA
| | - Duck-Chul Lee
- Department of Kinesiology, Iowa State University, Ames, Iowa, USA
| | - Xuemei Sui
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Steven N Blair
- Departments of Exercise Science and Epidemiology & Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| |
Collapse
|
28
|
Jang H, Kwon S, Lee B, Kim G, Chae W, Jang SI. Association between Breastfeeding and Restrictive Spirometric Pattern in Women Aged over 40 Years: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16291. [PMID: 36498359 PMCID: PMC9738453 DOI: 10.3390/ijerph192316291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/30/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
Objectives: Restrictive spirometric pattern (RSP) has a prevalence of 5.4−9.2% and is associated with various respiratory symptoms, comorbidities, and increased mortality. Breastfeeding has important effects on maternal health; however, the effects of breastfeeding on pulmonary function remain unclear. This study aimed to investigate the effects of breastfeeding on maternal pulmonary function, particularly the risk of RSP. Methods: Retrospective, cross-sectional observational study enrolling parous women aged >40 years who participated in the Korea National Health and Nutrition Examination Survey from 2013−2018. RSP was defined using the FEV1/FVC ratio and FVC outcomes of the pulmonary function test. The adjusted odds ratios (OR) for RSP were calculated using multivariate logistic regression. Results: Of 9261 parous women, 913 (9.9%) had RSP. Breastfeeding (≥1 month) was associated with a reduced risk of RSP (OR: 0.75 [0.60−0.92]) when adjusted for age, body mass index, smoking status, other diseases, socioeconomic status, and maternal risk factors. The adjusted ORs for RSP for women decreased further with increasing duration of breastfeeding (p for trend: 0.0004). The FEV1, FVC, and FVC% were higher in women who breastfed than in those who did not breastfeed (by 0.0390 L, 0.0521 L, 0.9540% p, respectively). Conclusions: There is an association between breastfeeding and pulmonary function in parous women. Breastfeeding was associated with a lower prevalence of RSP in parous women aged >40 years old, suggesting that breastfeeding may have a beneficial effect on maternal pulmonary function.
Collapse
Affiliation(s)
- Hyeokjoo Jang
- College of Medicine, Yonsei University, Seoul 03722, Republic of Korea
| | - Sebin Kwon
- College of Medicine, Yonsei University, Seoul 03722, Republic of Korea
| | - Bumyeol Lee
- College of Medicine, Yonsei University, Seoul 03722, Republic of Korea
| | - Gahyeon Kim
- College of Medicine, Yonsei University, Seoul 03722, Republic of Korea
| | - Wonjeong Chae
- Institute of Health Services Research, Yonsei University, Seoul 03722, Republic of Korea
- Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul 03722, Republic of Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul 03722, Republic of Korea
- Department of Preventive Medicine, Yonsei University, Seoul 03722, Republic of Korea
| |
Collapse
|
29
|
Oh EJ, Kim BG, Park S, Han S, Shin B, Lee H, Shin SH, Kim J, Choi D, Choi EA, Park HY. The impact of driving pressure on postoperative pulmonary complication in patients with different respiratory spirometry. Sci Rep 2022; 12:20875. [PMID: 36463247 PMCID: PMC9719554 DOI: 10.1038/s41598-022-24627-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 11/17/2022] [Indexed: 12/05/2022] Open
Abstract
Risk factors for postoperative pulmonary complication (PPC) have not been determined according to preoperative respiratory spirometry. Thus, we aimed to find contributors for PPC in patients with restrictive or normal spirometric pattern. We analyzed 654 patients (379 with normal and 275 with restrictive spirometric pattern). PPCs comprised respiratory failure, pleural effusion, atelectasis, respiratory infection, and bronchospasm. We analyzed the association between perioperative factors and PPC using binary logistic regression. In particular, we conducted subgroup analysis on the patients stratified according to preoperative spirometry. Of 654 patients, 27/379 patients (7.1%) with normal spirometric pattern and 33/275 patients (12.0%) with restrictive spirometric pattern developed PPCs. Multivariable analysis demonstrated that high driving pressure was the only intraoperative modifiable factor increasing PPC risk (OR = 1.13 [1.02-1.25], p = 0.025). In the subgroup of patients with restrictive spirometric pattern, intraoperative driving pressure was significantly associated with PPC (OR = 1.21 [1.05-1.39], p = 0.009), whereas driving pressure was not associated with PPC in patients with normal spirometric pattern (OR = 1.04 [0.89-1.21], p = 0.639). In patients with restrictive spirometric pattern, greater intraoperative driving pressure is significantly associated with increased PPC risk. In contrast, intraoperative driving pressure is not associated with PPC in patients with normal spirometric pattern.
Collapse
Affiliation(s)
- Eun Jung Oh
- grid.264381.a0000 0001 2181 989XDepartment of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Bo-Guen Kim
- grid.264381.a0000 0001 2181 989XDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sukhee Park
- grid.411199.50000 0004 0470 5702Department of Anesthesiology and Pain Medicine, International St. Mary’s Hospital, Catholic Kwandong University School of Medicine, Incheon, Korea
| | - Sangbin Han
- grid.264381.a0000 0001 2181 989XDepartment of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Beomsu Shin
- grid.15444.300000 0004 0470 5454Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyun Lee
- grid.49606.3d0000 0001 1364 9317Department of Internal Medicine, Hanyang Medical Center, Hanyang University College of Medicine, Seoul, Korea
| | - Sun Hye Shin
- grid.264381.a0000 0001 2181 989XDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeayoun Kim
- grid.264381.a0000 0001 2181 989XDepartment of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dancheong Choi
- grid.264381.a0000 0001 2181 989XDepartment of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Ah Choi
- grid.264381.a0000 0001 2181 989XDepartment of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Yun Park
- grid.264381.a0000 0001 2181 989XDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
30
|
Abdul Haddi AA, Ja’afar MH, Ismail H. Association between lung function impairment with urinary heavy metals in a community in Klang Valley, Malaysia. PeerJ 2022; 10:e13845. [PMID: 35966922 PMCID: PMC9373978 DOI: 10.7717/peerj.13845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/14/2022] [Indexed: 01/18/2023] Open
Abstract
Lung function status can be directly or indirectly affected by exposure to pollutants in the environment. Urinary heavy metals may be an indirect indicator of lung function impairment that leads to various diseases such as chronic obstructive pulmonary disease (COPD). This study aimed to explore the prevalence of lung function impairment as well as its association with urinary heavy metal levels and other influencing factors among the community in Klang Valley, Malaysia. Urinary sampling was done during various community events in the housing areas of Klang Valley between March and October 2019. Only respondents who consented would undergo a lung function test. Urine samples were obtained and sent for Inductively Coupled Plasma Mass Spectrometry (ICP-MS) analysis for heavy metal cadmium (Cd) and lead (Pb) concentration. Of the 200 recruited respondents, 52% were male and their ages ranged from 18 years old to 74 years old with a mean age of 38.4 ± 14.05 years. Urinary samples show high urinary Cd level in 12% of the respondents (n = 24) whereas none recorded a high urinary Pb level. There was a positive correlation between the levels of urinary Cd and urinary Pb (r = 0.303; p = 0.001). Furthermore, a negative correlation was detected between urinary Cd level and forced vital capacity (FVC) (r = - 0.202, p = 0.004), force expiratory volume at the first second (FEV1) (r = - 0.225, p = 0.001), and also force expiratory flow between 25-75% of FVC (FEF 25-75%) (r = - 0.187, p = 0.008). However, urinary Pb did not show any correlation with lung function parameters. Multiple linear regression analysis showed that urinary Cd had a significant negative effect on FVC (p = 0.025) and FEV1 (p = 0.004) based on the predicted value. Additionally, other factors such as education level (p = 0.013) also influenced lung function. However, no interaction was detected between heavy metals or other factors. In short, there was a significant negative linear relationship between urinary Cd and lung function, whereas urinary Pb was not associated with lung function. Beside acting as a biomarker for cadmium exposure level, urinary Cd may also be applied as indirect biomarker for asymptomatic chronic lung function deterioration among the healthy population.
Collapse
Affiliation(s)
- Ammar Amsyar Abdul Haddi
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia,Ministry of Health, Putrajaya, Malaysia
| | - Mohd Hasni Ja’afar
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Halim Ismail
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| |
Collapse
|
31
|
Role of Pulmonary Function in Predicting New-Onset Cardiometabolic Diseases and Cardiometabolic Multimorbidity. Chest 2022; 162:421-432. [DOI: 10.1016/j.chest.2021.12.663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022] Open
|
32
|
Kim HJ, Park SJ, Park HK, Byun DW, Suh K, Yoo MH. Association of free thyroxine with obstructive lung pattern in euthyroid middle-aged subjects: A population-based study. PLoS One 2022; 17:e0270126. [PMID: 35867637 PMCID: PMC9307150 DOI: 10.1371/journal.pone.0270126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 06/06/2022] [Indexed: 11/28/2022] Open
Abstract
Background The association between thyroid hormone levels and pulmonary function in euthyroid population is still unclear. We aimed to examine the relationship between thyroid function and lung function in a large cohort study of euthyroid subjects. Methods We analyzed biochemical and spirometry data from a nationwide, population-based, cross-sectional survey (KNHANES VI). A total of 1,261 middle-aged participants aged 45–65 years with spirometry tests and normal thyroid function were included in this study. The subjects were grouped according to free thyroxine (fT4) (ng/dL) quartiles (Q1, 0.89–1.09; Q2, 1.10–1.19; Q3, 1.20–1.30; Q4, 1.31–1.76). Obstructive lung pattern was defined as forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) <0.7. The probability of obstructive lung patterns according to fT4 quartiles was assessed using logistic regression models, adjusted for potential confounders. Results Overall, 10.9% of the subjects had an obstructive lung pattern. The mean fT4 levels were significantly higher in those with obstructive lung pattern than in those with normal lung function (1.26 vs. 1.20 ng/dL, p<0.001). The proportion of participants with obstructive lung pattern increased across the fT4 quartile categories (p<0.001). With the Q1 group as reference, the multivariate-adjusted odds ratios (95% confidence intervals) for obstructive lung pattern in the Q3 and Q4 groups were 2.875 (1.265–6.535) and 2.970 (1.287–6.854), respectively, even after adjusting for confounding variables. Conclusion High fT4 levels are an independent predictor of obstructive lung pattern in euthyroid middle-aged subjects. Further prospective studies are needed to confirm these findings.
Collapse
Affiliation(s)
- Hye Jeong Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
- * E-mail:
| | - Sang Joon Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Hyeong Kyu Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Dong Won Byun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Kyoil Suh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Myung Hi Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
- Elim Thyroid Clinic, Seoul, Korea
| |
Collapse
|
33
|
Hsan S, Lakhdar N, Harrabi I, Zaouali M, Burney P, Denguezli M. Reduced forced vital capacity is independently associated with, aging, height and a poor socioeconomic status: a report from the Tunisian population-based BOLD study. BMC Pulm Med 2022; 22:267. [PMID: 35818049 PMCID: PMC9275164 DOI: 10.1186/s12890-022-02062-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background Reduced forced vital capacity (FVC) is a risk factor of all-cause mortality; however, the prevalence and determinants of reduced FVC are not available for the Tunisian population. This study investigated the association of reduced FVC with risk factors and health variables in an urban population of subjects aged ≥ 40 years and living in the city of Sousse in Tunisia. Methods A cross-sectional survey was performed using data from the Tunisian Burden of Obstructive Lung Disease (BOLD) study. We defined reduced FVC as a post-bronchodilator FVC below the lower limit of normal using National Health and Nutrition Examination Survey (NHANES) values and Global Lung Function Initiative 2012 equations (GLI 2012) and determined the relation between this finding and the potential risk factors (demographic and socioeconomic factors and the presence of chronic diseases), using multivariable regression analysis. Results The prevalence of reduced FVC was 26.6% (176/661) when using NHANES values for white Americans and 14.2% (94/661) using the GLI 2012 equations. Compared to people with normal FVC, those with a reduced FVC were significantly older, taller, had a lower body mass index (BMI), more respiratory symptoms and a higher prevalence of heart disease and hypertension. Multivariable analysis showed that reduced FVC was essentially driven by exposure to biomass smoke for heating, a number of schooling years lower than or equal to 6 years, a childhood history of hunger for a lack of money, aging and height. Conclusions The prevalence of reduced FVC is associated with a poor socioeconomic status aging and height.
Collapse
Affiliation(s)
- Safa Hsan
- Laboratoire de recherche: Physiologie de l'exercice et physiopathologie: de l'intégré au moleculaire, LR19ES09, Faculté de Médecine de Sousse, Université de Sousse, 4000, Sousse, Tunisia
| | - Nadia Lakhdar
- Laboratoire de recherche: Physiologie de l'exercice et physiopathologie: de l'intégré au moleculaire, LR19ES09, Faculté de Médecine de Sousse, Université de Sousse, 4000, Sousse, Tunisia
| | - Imed Harrabi
- Service d'épidémiologie, Faculté de Médecine de Sousse, Hôpital Farhat Hached, Université de Sousse, 4000, Sousse, Tunisia
| | - Monia Zaouali
- Laboratoire de recherche: Physiologie de l'exercice et physiopathologie: de l'intégré au moleculaire, LR19ES09, Faculté de Médecine de Sousse, Université de Sousse, 4000, Sousse, Tunisia
| | - Peter Burney
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Meriam Denguezli
- Laboratoire de recherche: Physiologie de l'exercice et physiopathologie: de l'intégré au moleculaire, LR19ES09, Faculté de Médecine de Sousse, Université de Sousse, 4000, Sousse, Tunisia. .,Faculté de Médecine Dentaire de Monastir, Université de Monastir, Avenue Avicenne, Monastir, Tunisia.
| |
Collapse
|
34
|
Ramalho SHR, Claggett BL, Washko GR, Jose Estepar RS, Chang PP, Kitzman DW, Cipriano Junior G, Solomon SD, Skali H, Shah AM. Association of Pulmonary Function With Late-Life Cardiac Function and Heart Failure Risk: The ARIC Study. J Am Heart Assoc 2022; 11:e023990. [PMID: 35861819 PMCID: PMC9707834 DOI: 10.1161/jaha.121.023990] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Pulmonary and cardiac functions decline with age, but the associations of pulmonary dysfunction with cardiac function and heart failure (HF) risk in late life is not known. We aimed to determine the associations of percent predicted forced vital capacity (ppFVC) and the ratio of forced expired volume in 1 second (FEV1) to forced vital capacity (FVC; FEV1/FVC) with cardiac function and incident HF with preserved or reduced ejection fraction in late life. Methods and Results Among 3854 HF-free participants in the ARIC (Atherosclerosis Risk in Communities) cohort study who underwent echocardiography and spirometry at the fifth study visit (2011-2013), associations of FEV1/FVC and ppFVC with echocardiographic measures, cardiac biomarkers, and risk of HF, HF with preserved ejection fraction, and HF with reduced ejection fraction were assessed. Multivariable linear and Cox regression models adjusted for demographics, body mass index, coronary disease, atrial fibrillation, hypertension, and diabetes. Mean age was 75±5 years, 40% were men, 19% were Black, and 61% were ever smokers. Mean FEV1/FVC was 72±8%, and ppFVC was 98±17%. In adjusted analyses, lower FEV1/FVC and ppFVC were associated with higher NT-proBNP (N-terminal pro-B-type natriuretic peptide; both P<0.001) and pulmonary artery pressure (P<0.004). Lower ppFVC was also associated with higher left ventricular mass, left ventricular filling pressure, and high-sensitivity C-reactive protein (all P<0.01). Lower FEV1/FVC was associated with a trend toward higher risk of incident HF with preserved ejection fraction (hazard ratio [HR] per 10-point decrease, 1.31; 95% CI, 0.98-1.74; P=0.07) and HF with reduced ejection fraction (HR per 10-point decrease, 1.24; 95% CI, 0.91-1.70; P=0.18), but these associations did not reach statistical significance. Lower ppFVC was associated with incident HF with preserved ejection fraction (HR per 10-unit decrease, 1.21; 95% CI, 1.04-1.41; P=0.013) but not with HF with reduced ejection fraction (HR per 10-unit decrease, 0.90; 95% CI, 0.76-1.07; P=0.24). Conclusions Subclinical reductions in FEV1/FVC and ppFVC differentially associate with cardiac function and HF risk in late life.
Collapse
Affiliation(s)
- Sergio H. R. Ramalho
- Division of Cardiovascular MedicineBrigham and Women’s HospitalBostonMA,Health Sciences and Technologies Program – University of BrasiliaBrasíliaBrazil,DASA Clinical Research Center ‐ Hospital BrasíliaBrasíliaBrazil
| | - Brian L. Claggett
- Division of Cardiovascular MedicineBrigham and Women’s HospitalBostonMA
| | - George R. Washko
- Division of Pulmonary and Critical Care MedicineBrigham and Women’s HospitalBostonMA
| | | | | | | | - Gerson Cipriano Junior
- Health Sciences and Technologies Program – University of BrasiliaBrasíliaBrazil,Rehabilitation Sciences Program – University of BrasiliaBrasíliaBrazil
| | - Scott D. Solomon
- Division of Cardiovascular MedicineBrigham and Women’s HospitalBostonMA
| | - Hicham Skali
- Division of Cardiovascular MedicineBrigham and Women’s HospitalBostonMA
| | - Amil M. Shah
- Division of Cardiovascular MedicineBrigham and Women’s HospitalBostonMA
| |
Collapse
|
35
|
Chen R, Zhang J, Pang Y, Liu Q, Peng J, Lin X, Cao L, Gu W, Zhang L, Li R, Sun Q, Zhang R, Liu C. Qianjinweijing Decoction Protects Against Fine Particulate Matter Exposure-mediated Lung Function Disorder. Front Pharmacol 2022; 13:873055. [PMID: 35814198 PMCID: PMC9263354 DOI: 10.3389/fphar.2022.873055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/06/2022] [Indexed: 11/20/2022] Open
Abstract
Fine particulate matter (PM2.5) is well known to impair lung function. Strategies protecting against PM2.5-exerted lung dysfunction have been less investigated. Qianjinweijing decoction (QJWJ), a decoction of a herbal medicine of natural origin, has been used to treat lung disorders as it inhibits oxidation and inflammation. However, no clinical trial has yet evaluated the role of QJWJ in PM2.5-induced lung dysfunction. Therefore, we conducted a randomized, double-blind, placebo-controlled trial to assess whether QJWJ provided lung benefits against the adverse effects of PM2.5 exposure among adults. Eligible participants (n = 65) were recruited and randomized to receive QJWJ decoction (n = 32) or placebo (n = 33) for 4 weeks. The restrictive ventilatory defect (RVD), lung function parameters, and induced sputum were analyzed. The PM2.5 exposure concentration was significantly associated with the vital capacity (VC), peak expiratory flow (PEF), and forced expiratory flow at 75% of the forced vital capacity (FEF75). The negative associations between PM2.5 and the lung function parameters were eliminated in response to the QJWJ intervention. Additionally, the percentage of RVD (P = 0.018) and the proportion of eosinophils (Eo%) in induced sputum (P = 0.014) in the QJWJ group was significantly lower than that in the placebo group. This study demonstrated that QJWJ could alleviated PM2.5-induced lung dysfunction and could be a potential treatment for air pollution-related chronic respiratory disease.
Collapse
Affiliation(s)
- Rucheng Chen
- School of Public Health, Joint China-US Research Center for Environment and Pulmonary Diseases, Zhejiang Chinese Medical University, Hangzhou, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou, China
| | - Jinna Zhang
- School of Public Health, Joint China-US Research Center for Environment and Pulmonary Diseases, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yaxian Pang
- Department of Toxicology, Hebei Medical University, Shijiazhuang, China
| | - Qingping Liu
- Department of Toxicology, Hebei Medical University, Shijiazhuang, China
| | - Jing Peng
- School of Public Health, Joint China-US Research Center for Environment and Pulmonary Diseases, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiujuan Lin
- School of Public Health, Joint China-US Research Center for Environment and Pulmonary Diseases, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lingyong Cao
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Weijia Gu
- School of Public Health, Joint China-US Research Center for Environment and Pulmonary Diseases, Zhejiang Chinese Medical University, Hangzhou, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou, China
| | - Lu Zhang
- School of Public Health, Joint China-US Research Center for Environment and Pulmonary Diseases, Zhejiang Chinese Medical University, Hangzhou, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou, China
| | - Ran Li
- School of Public Health, Joint China-US Research Center for Environment and Pulmonary Diseases, Zhejiang Chinese Medical University, Hangzhou, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou, China
| | - Qinghua Sun
- School of Public Health, Joint China-US Research Center for Environment and Pulmonary Diseases, Zhejiang Chinese Medical University, Hangzhou, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou, China
| | - Rong Zhang
- Department of Toxicology, Hebei Medical University, Shijiazhuang, China
- *Correspondence: Cuiqing Liu, ; Rong Zhang,
| | - Cuiqing Liu
- School of Public Health, Joint China-US Research Center for Environment and Pulmonary Diseases, Zhejiang Chinese Medical University, Hangzhou, China
- Zhejiang International Science and Technology Cooperation Base of Air Pollution and Health, Hangzhou, China
- *Correspondence: Cuiqing Liu, ; Rong Zhang,
| |
Collapse
|
36
|
Cause-specific Death in Chronic Airway Obstruction and Restrictive Spirometric Pattern. Ann Am Thorac Soc 2022; 19:1783-1787. [DOI: 10.1513/annalsats.202203-243rl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
|
37
|
Lee SN, Ko SH, Her SH, Han K, Moon D, Kim SK, Yoo KD, Ahn YB. Association between lung function and the risk of atrial fibrillation in a nationwide population cohort study. Sci Rep 2022; 12:4007. [PMID: 35256653 PMCID: PMC8901639 DOI: 10.1038/s41598-022-07534-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 02/21/2022] [Indexed: 11/09/2022] Open
Abstract
We investigated the association between lung function and atrial fibrillation (AF) in 21,349 adults without AF aged ≥ 40 years who underwent spirometry. The study participants were enrolled from the Korean National Health and Nutritional Examination Survey between 2008 and 2016. The primary outcome was new-onset non-valvular AF identified from the National Health Insurance Service database. During the median follow-up of 6.5 years, 2.15% of participants developed new-onset AF. The incidence rate of AF per 1000 person-years was inversely related to the forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC quartile. After adjustment for multiple variables, the AF risk in the lowest FEV1 quartile was 1.64-fold higher than that in the highest quartile (hazard ratio (HR) 1.64 (95% confidence interval (CI) 1.26–2.12) for lowest FEV1 quartile). The lowest quartile of FVC had 1.56-fold higher AF risk than the highest quartile (HR 1.56 (95% CI 1.18–2.08) for lowest FVC quartile). Although the lowest FEV1/FVC quartile was associated with an increased risk of AF in the unadjusted model, this increased risk was not statistically significant in the multivariable analysis. Compared to those with normal lung function, participants with restrictive or obstructive lung function had 1.49 and 1.42-fold higher AF risks, respectively. In this large nationwide cohort study, both obstructive and restrictive patterns of reduced lung function were significantly associated with increased AF risk.
Collapse
Affiliation(s)
- Su Nam Lee
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon, Gyunggi-do, 16247, Republic of Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon, Gyunggi-do, 16247, Republic of Korea.
| | - Sung-Ho Her
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon, Gyunggi-do, 16247, Republic of Korea.
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Donggyu Moon
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon, Gyunggi-do, 16247, Republic of Korea
| | - Sung Kyoung Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki-Dong Yoo
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon, Gyunggi-do, 16247, Republic of Korea
| | - Yu-Bae Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon, Gyunggi-do, 16247, Republic of Korea
| |
Collapse
|
38
|
Myrberg T, Lindberg A, Eriksson B, Hedman L, Stridsman C, Lundbäck B, Rönmark E, Backman H. Restrictive spirometry versus restrictive lung function using the GLI reference values. Clin Physiol Funct Imaging 2022; 42:181-189. [PMID: 35225428 PMCID: PMC9311670 DOI: 10.1111/cpf.12745] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Restrictive lung function may indicate various underlying diseases. The aim of this study was to evaluate the accuracy of different restrictive spirometry patterns (RSPs) to identify restrictive lung function (total lung capacity [TLC] < lower limit of normal [LLN]) according to reference values by the Global Lung Function Initiative (GLI) in a wide age-ranged, general population sample. METHODS A general population sample (n = 607, age 23-72 years, smokers 18.8%) with proper dynamic spirometry and TLC measurements, was included. Accuracy of two main categories of RSP to identify TLC < LLN were evaluated: traditional RSPs (definition 1: FVC < 80% of predicted and FEV1 /FVC ≥ 0.7 and definition 2: FVC < LLN and FEV1 /FVC ≥ LLN) and RSPs defined by Youden's method (definition 3: FVC < 85.5% of predicted and FEV1 /FVC ≥ LLN and definition 4: FVC Z-score < -1.0 and FEV1 /FVC ≥ LLN). RESULTS The prevalence of restrictive lung function (TLC < LLN) was 5.3%. The most accurate cut-offs for FVC to identify TLC < LLN were 85.5% for FVC% of predicted, and -1.0 for FVC Z-score. The traditional RSP definitions 1 and 2 had higher specificity (95.0% and 96.9%) but substantially lower sensitivity compared to RSP definitions 3 and 4. CONCLUSION Based on the GLI reference values, the RSP definition FVC < LLN and FEV1 /FVC ≥ LLN yielded the highest specificity and may appropriately be used to rule out restrictive lung function. The RSP definition with the most favourable trade-off between sensitivity and specificity, FVC < 85.5% of predicted and FEV1 /FVC ≥ LLN, may serve as an alternative with higher sensitivity for screening.
Collapse
Affiliation(s)
- Tomi Myrberg
- Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden
| | - Anne Lindberg
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - Berne Eriksson
- Department of Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,Department of Research and Development, Region Halland, Halmstad, Sweden
| | - Linnea Hedman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN Unit, Umeå University, Umeå, Sweden
| | - Caroline Stridsman
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - Bo Lundbäck
- Department of Research and Development, Region Halland, Halmstad, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN Unit, Umeå University, Umeå, Sweden
| | - Helena Backman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN Unit, Umeå University, Umeå, Sweden
| |
Collapse
|
39
|
Kulbacka-Ortiz K, Triest FJJ, Franssen FME, Wouters EFM, Studnicka M, Vollmer WM, Lamprecht B, Burney PGJ, Amaral AFS, Vanfleteren LEGW. Restricted spirometry and cardiometabolic comorbidities: results from the international population based BOLD study. Respir Res 2022; 23:34. [PMID: 35177082 PMCID: PMC8855577 DOI: 10.1186/s12931-022-01939-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 01/24/2022] [Indexed: 12/15/2022] Open
Abstract
Background Whether restricted spirometry, i.e. low Forced Vital Capacity (FVC), predicts chronic cardiometabolic disease is not definitely known. In this international population-based study, we assessed the relationship between restricted spirometry and cardiometabolic comorbidities. Methods A total of 23,623 subjects (47.5% males, 19.0% current smokers, age: 55.1 ± 10.8 years) from five continents (33 sites in 29 countries) participating in the Burden of Obstructive Lung Disease (BOLD) study were included. Restricted spirometry was defined as post-bronchodilator FVC < 5th percentile of reference values. Self-reports of physician-diagnosed cardiovascular disease (CVD; heart disease or stroke), hypertension, and diabetes were obtained through questionnaires. Results Overall 31.7% of participants had restricted spirometry. However, prevalence of restricted spirometry varied approximately ten-fold, and was lowest (8.5%) in Vancouver (Canada) and highest in Sri Lanka (81.3%). Crude odds ratios for the association with restricted spirometry were 1.60 (95% CI 1.37–1.86) for CVD, 1.53 (95% CI 1.40–1.66) for hypertension, and 1.98 (95% CI 1.71–2.29) for diabetes. After adjustment for age, sex, education, Body Mass Index (BMI) and smoking, the odds ratios were 1.54 (95% CI 1.33–1.79) for CVD, 1.50 (95% CI 1.39–1.63) for hypertension, and 1.86 (95% CI 1.59–2.17) for diabetes. Conclusion In this population-based, international, multi-site study, restricted spirometry associates with cardiometabolic diseases. The magnitude of these associations appears unattenuated when cardiometabolic risk factors are taken into account.
Collapse
Affiliation(s)
- Katarzyna Kulbacka-Ortiz
- COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Filip J J Triest
- CIRO, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands.,Department of Respiratory Medicine, AZ Sint-Lucas, Gent, Belgium.,Department of Respiratory Medicine, MUMC+, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Frits M E Franssen
- CIRO, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands.,Department of Respiratory Medicine, MUMC+, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Emiel F M Wouters
- CIRO, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands.,Department of Respiratory Medicine, MUMC+, Maastricht University Medical Centre, Maastricht, the Netherlands.,Ludwig Boltzman Institute for Lung Health, Vienna, Austria
| | - Michael Studnicka
- Department of Pneumology, Paracelsus Medical University, Salzburg, Austria
| | | | - Bernd Lamprecht
- Department of Pulmonary Medicine, Kepler-University-Hospital, Linz, Austria.,Faculty of Medicine, Johannes-Kepler-University, Linz, Austria
| | - Peter G J Burney
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Andre F S Amaral
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Lowie E G W Vanfleteren
- COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden. .,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| |
Collapse
|
40
|
Voraphani N, Stern DA, Zhai J, Wright AL, Halonen M, Sherrill DL, Hallberg J, Kull I, Bergström A, Murray CS, Lowe L, Custovic A, Morgan WJ, Martinez FD, Melén E, Simpson A, Guerra S. The role of growth and nutrition in the early origins of spirometric restriction in adult life: a longitudinal, multicohort, population-based study. THE LANCET. RESPIRATORY MEDICINE 2022; 10:59-71. [PMID: 34843665 PMCID: PMC8855728 DOI: 10.1016/s2213-2600(21)00355-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/03/2021] [Accepted: 07/19/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Spirometric restriction, defined as a reduced forced vital capacity (FVC) with a preserved FEV1/FVC ratio, is associated with increased respiratory and non-respiratory comorbidities and all-cause mortality in adulthood. Little is known about the early origins of this condition. We sought to identify early-life risk factors for spirometric restriction in adult life. METHODS In this longitudinal, multicohort, population-based study, we used data from the Tucson Children's Respiratory Study (TCRS), which recruited 1246 healthy infants at birth between April 1980, and October 1984, in Tucson, AZ, USA. Questionnaires were answered by the primary caregiver at enrolment, immediately after the child's birth, and multiple follow-up questionnaires were completed through childhood and adulthood. At the age of 22, 26, 32, and 36 years, lung function was measured with spirometry. At each survey, three mutually exclusive spirometric patterns were defined: (1) normal (FEV1/FVC ≥10th percentile and FVC ≥10th percentile); (2) restrictive (FEV1/FVC ≥10th percentile and FVC <10th percentile); and (3) obstructive (FEV1/FVC <10th percentile, independent of FVC). Data on demographic features and parental health factors were collected from questionnaires; pregnancy and perinatal data (including nutritional problems) and birth measurements were obtained from medical records; and weight, height, and body-mass index (BMI) during childhood (age 6-16 years) were measured by study nurses. The associations between early-life risk factors and spirometric patterns were assessed by multivariate multinomial logistic regression analysis, adjusted for survey year, sex, and race-ethnicity. Significant risk factors were further tested for replication in the Swedish Child (Barn), Allergy, Milieu, Stockholm, Epidemiological (BAMSE; n=1817; spirometry surveys were done at age 24 years) survey and the UK Manchester Asthma and Allergy Study (MAAS; n=411; spirometry surveys were done at age 18 years) birth cohorts, and fixed-effect meta-analyses of relative risk ratios (RRRs) from multinomial logistic regression models were done to generate a pooled estimate of the effect across the three cohorts. Measurements of body composition (MAAS; n=365) and total lung capacity (TCRS; n=173 and MAAS; n=407) were also available for a subset of participants. FINDINGS Of 1246 healthy infants included in TCRS, for the present study we included data for 652 participants who had at least one set of spirometry data, contributing up to 1668 observations. In the TCRS cohort, results from the multivariate models showed that maternal nutritional problems during pregnancy (RRR 2·48 [95% CI 1·30-4·76]; p=0·0062), being born small for gestational age (birthweight <10th percentile; 3·26 [1·34-7·93]; p=0·0093), and being underweight in childhood (BMI-for-age <5th percentile; 3·54 [1·35-9·26]; p=0·010) were independent predictors of spirometric restriction in adult life. Associations between being small for gestational age (p=0·0028) and underweight in childhood (p<0·0001) with adult spirometric restriction were supported by the results of meta-analysis of data from all three cohorts. In the MAAS cohort, having a low lean BMI (ie, <10th percentile) at age 11 years predicted adult (age 18 years) spirometric restriction (RRR 3·66 [1·48-9·02]; p=0·0048). These associations of spirometric restriction with small for gestational age, childhood underweight, and low lean BMI in childhood were verified in participants with spirometric restriction who had diminished total lung capacity, indicating that these factors specifically increase the risk of lung restriction. INTERPRETATION Poor growth and nutritional deficits in utero and throughout childhood precede and predict the development of spirometric restriction in adult life. Strategies to improve prenatal and childhood growth trajectories could help to prevent spirometric restriction and its associated morbidity and mortality burden. FUNDING National Institutes of Health.
Collapse
Affiliation(s)
- Nipasiri Voraphani
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Debra A Stern
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Jing Zhai
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Anne L Wright
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Marilyn Halonen
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Duane L Sherrill
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Jenny Hallberg
- Department of Clinical Sciences and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Stockholm, Sweden
| | - Inger Kull
- Department of Clinical Sciences and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Stockholm, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Clare S Murray
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre and NIHR Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Lesley Lowe
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre and NIHR Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Adnan Custovic
- Section of Paediatrics, National Heart and Lung Institute, Imperial College London, London, UK
| | - Wayne J Morgan
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Fernando D Martinez
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Erik Melén
- Department of Clinical Sciences and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Stockholm, Sweden
| | - Angela Simpson
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre and NIHR Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Stefano Guerra
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA; ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.
| |
Collapse
|
41
|
Frenzel S, Bis JC, Gudmundsson EF, O’Donnell A, Simino J, Yaqub A, Bartz TM, Brusselle GGO, Bülow R, DeCarli CS, Ewert R, Gharib SA, Ghosh S, Gireud-Goss M, Gottesman RF, Ikram MA, Knopman DS, Launer LJ, London SJ, Longstreth W, Lopez OL, Melo van Lent D, O’Connor G, Satizabal CL, Shrestha S, Sigurdsson S, Stubbe B, Talluri R, Vasan RS, Vernooij MW, Völzke H, Wiggins KL, Yu B, Beiser AS, Gudnason V, Mosley T, Psaty BM, Wolters FJ, Grabe HJ, Seshadri S. Associations of Pulmonary Function with MRI Brain Volumes: A Coordinated Multi-Study Analysis. J Alzheimers Dis 2022; 90:1073-1083. [PMID: 36213999 PMCID: PMC9712227 DOI: 10.3233/jad-220667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Previous studies suggest poor pulmonary function is associated with increased burden of cerebral white matter hyperintensities and brain atrophy among elderly individuals, but the results are inconsistent. OBJECTIVE To study the cross-sectional associations of pulmonary function with structural brain variables. METHODS Data from six large community-based samples (N = 11,091) were analyzed. Spirometric measurements were standardized with respect to age, sex, height, and ethnicity using reference equations of the Global Lung Function Initiative. Associations of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and their ratio FEV1/FVC with brain volume, gray matter volume, hippocampal volume, and volume of white matter hyperintensities were investigated using multivariable linear regressions for each study separately and then combined using random-effect meta-analyses. RESULTS FEV1 and FVC were positively associated with brain volume, gray matter volume, and hippocampal volume, and negatively associated with white matter hyperintensities volume after multiple testing correction, with little heterogeneity present between the studies. For instance, an increase of FVC by one unit was associated with 3.5 ml higher brain volume (95% CI: [2.2, 4.9]). In contrast, results for FEV1/FVC were more heterogeneous across studies, with significant positive associations with brain volume, gray matter volume, and hippocampal volume, but not white matter hyperintensities volume. Associations of brain variables with both FEV1 and FVC were consistently stronger than with FEV1/FVC, specifically with brain volume and white matter hyperintensities volume. CONCLUSION In cross-sectional analyses, worse pulmonary function is associated with smaller brain volumes and higher white matter hyperintensities burden.
Collapse
Affiliation(s)
- Stefan Frenzel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Joshua C. Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Adrienne O’Donnell
- Framingham Heart Study, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Jeannette Simino
- Gertrude C. Ford Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Data Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Amber Yaqub
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Traci M. Bartz
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Guy G. O. Brusselle
- Department of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Charles S. DeCarli
- Department of Neurology and Center for Neuroscience, University of California at Davis, Sacramento, CA, USA
- Imaging of Dementia and Aging (IDeA) Laboratory, Department of Neurology, University of California-Davis, Davis, CA, USA
| | - Ralf Ewert
- Department of Internal Medicine B, Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Greifswald, Germany
| | - Sina A. Gharib
- Center for Lung Biology, Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Saptaparni Ghosh
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University Schoolof Medicine, Boston, MA, USA
| | - Monica Gireud-Goss
- Glenn Biggs Institute for Alzheimer and Neurodegenerative Diseases, The University of Texas Health Science Center at San Antonio, SanAntonio, TX, USA
| | - Rebecca F. Gottesman
- Stroke, Cognition, and Neuroepidemiology (SCAN) section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Lenore J. Launer
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MD, USA
| | - Stephanie J. London
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, NC, USA
| | - W.T. Longstreth
- Department of Neurology, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Oscar L. Lopez
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Debora Melo van Lent
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University Schoolof Medicine, Boston, MA, USA
- Glenn Biggs Institute for Alzheimer and Neurodegenerative Diseases, The University of Texas Health Science Center at San Antonio, SanAntonio, TX, USA
| | - George O’Connor
- Framingham Heart Study, Framingham, MA, USA
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Claudia L. Satizabal
- Glenn Biggs Institute for Alzheimer and Neurodegenerative Diseases, The University of Texas Health Science Center at San Antonio, SanAntonio, TX, USA
- Department of Population Health Sciences, The University of Texas Health Science Center at San Antonio, SanAntonio, TX, USA
| | - Srishti Shrestha
- Gertrude C. Ford Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Neurology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | | | - Beate Stubbe
- Department of Internal Medicine B, Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Greifswald, Germany
| | - Rajesh Talluri
- Department of Data Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Ramachandran S. Vasan
- Framingham Heart Study, Framingham, MA, USA
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Meike W. Vernooij
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Kerri L. Wiggins
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Bing Yu
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Alexa S. Beiser
- Framingham Heart Study, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Neurology, Boston School of Medicine, Boston, MA, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Thomas Mosley
- Gertrude C. Ford Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Neurology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Medicine, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Frank J. Wolters
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Disease (DZNE), partner site Rostock/Greifswald, Germany
| | - Sudha Seshadri
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University Schoolof Medicine, Boston, MA, USA
- Glenn Biggs Institute for Alzheimer and Neurodegenerative Diseases, The University of Texas Health Science Center at San Antonio, SanAntonio, TX, USA
- Department of Neurology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| |
Collapse
|
42
|
He D, Sun Y, Gao M, Wu Q, Cheng Z, Li J, Zhou Y, Ying K, Zhu Y. Different Risks of Mortality and Longitudinal Transition Trajectories in New Potential Subtypes of the Preserved Ratio Impaired Spirometry: Evidence From the English Longitudinal Study of Aging. Front Med (Lausanne) 2021; 8:755855. [PMID: 34859011 PMCID: PMC8631955 DOI: 10.3389/fmed.2021.755855] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Preserved ratio impaired spirometry (PRISm), characterized by the decreased forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) with a preserved FEV1/FVC ratio, is highly prevalent and heterogeneous. We aimed to identify the subtypes of PRISm and examine their differences in clinical characteristics, long-term mortality risks, and longitudinal transition trajectories. Methods: A total of 6,616 eligible subjects were included from the English longitudinal study of aging. Two subtypes of the PRISm were identified as mild PRISm (either of FEV1 and FVC <80% predicted value, FEV1/FVC ≥0.7) and severe PRISm (both FEV1 and FVC <80% predicted values, FEV1/FVC ≥0.7). Normal spirometry was defined as both FEV1 and FVC ≥80% predicted values and FEV1/FVC ≥0.7. Hazard ratios (HRs) and 95% CIs were calculated by the multiple Cox regression models. Longitudinal transition trajectories were described with repeated spirometry data. Results: At baseline, severe PRISm had increased respiratory symptoms, including higher percentages of phlegm, wheezing, dyspnea, chronic bronchitis, and emphysema than mild PRISm. After an average of 7.7 years of follow-up, severe PRISm significantly increased the risks of all-cause mortality (HR=1.91, 95%CI = 1.58–2.31), respiratory mortality (HR = 6.02, 95%CI = 2.83–12.84), and CVD mortality (HR = 2.11, 95%CI = 1.42–3.13) compared with the normal spirometry, but no significantly increased risks were found for mild PRISm. In the two longitudinal transitions, mild PRISm tended to transition toward normal spirometry (40.2 and 54.7%), but severe PRISm tended to maintain the status (42.4 and 30.4%) or transition toward Global Initiative for Chronic Obstructive Lung Disease (GOLD)2–4 (28.3 and 33.9%). Conclusion: Two subtypes of PRISm were identified. Severe PRISm had increased respiratory symptoms, higher mortality risks, and a higher probability of progressing to GOLD2–4 than mild PRISm. These findings provided new evidence for the stratified management of PRISm.
Collapse
Affiliation(s)
- Di He
- Department of Respiratory Diseases, Sir Run Shaw Hospital Affiliated to School of Medicine, Zhejiang University, Hangzhou, China.,Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Yilan Sun
- Department of Respiratory and Critical Care Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Musong Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Qiong Wu
- Department of Respiratory Diseases, Sir Run Shaw Hospital Affiliated to School of Medicine, Zhejiang University, Hangzhou, China.,Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Zongxue Cheng
- Department of Respiratory Diseases, Sir Run Shaw Hospital Affiliated to School of Medicine, Zhejiang University, Hangzhou, China.,Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Jun Li
- Department of Respiratory Diseases, Sir Run Shaw Hospital Affiliated to School of Medicine, Zhejiang University, Hangzhou, China.,Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Yong Zhou
- Department of Respiratory Diseases, Sir Run Shaw Hospital Affiliated to School of Medicine, Zhejiang University, Hangzhou, China
| | - Kejing Ying
- Department of Respiratory Diseases, Sir Run Shaw Hospital Affiliated to School of Medicine, Zhejiang University, Hangzhou, China
| | - Yimin Zhu
- Department of Respiratory Diseases, Sir Run Shaw Hospital Affiliated to School of Medicine, Zhejiang University, Hangzhou, China.,Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| |
Collapse
|
43
|
Firnhaber J. Performance and Interpretation of Office Spirometry. Prim Care 2021; 48:645-654. [PMID: 34752275 DOI: 10.1016/j.pop.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Pulmonary function testing (PFT) is an important component of the evaluation, monitoring, and management of patients with suspected or established lung disease. Spirometry is easily accomplished in the primary care office setting; determination of lung volumes and diffusion capacity is performed in a pulmonary laboratory. Spirometry evaluates vital capacity of the lungs and expiratory flow rates and provides both numeric data and a graphic depiction of respiratory air flow. Characteristic patterns in spirometry-derived data allow the clinician to identify potential lung disease, as well as establish relative reversibility of airflow abnormalities.
Collapse
Affiliation(s)
- Jonathon Firnhaber
- Brody School of Medicine, East Carolina University, 101 Heart Drive, Greenville, NC 27834, USA.
| |
Collapse
|
44
|
Dugrenot E, Balestra C, Gouin E, L'Her E, Guerrero F. Physiological effects of mixed-gas deep sea dives using a closed-circuit rebreather: a field pilot study. Eur J Appl Physiol 2021; 121:3323-3331. [PMID: 34435274 DOI: 10.1007/s00421-021-04798-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/19/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE Deep diving using mixed gas with closed-circuit rebreathers (CCRs) is increasingly common. However, data regarding the effects of these dives are still scarce. This preliminary field study aimed at evaluating the acute effects of deep (90-120 msw) mixed-gas CCR bounce dives on lung function in relation with other physiological parameters. METHODS Seven divers performed a total of sixteen open-sea CCR dives breathing gas mixture of helium, nitrogen and oxygen (trimix) within four days at 2 depths (90 and 120 msw). Spirometric parameters, SpO2, body mass, hematocrit, short term heart rate variability (HRV) and critical flicker fusion frequency (CFFF) were measured at rest 60 min before the dive and 120 min after surfacing. RESULTS The median [1st-3rd quartile] of the forced vital capacity was lower (84% [76-93] vs 91% [74-107] of predicted values; p = 0.029), whereas FEV1/FVC was higher (98% [95-99] vs 95% [89-99]; p = 0.019) after than before the dives. The other spirometry values and SpO2 were unchanged. Body mass decreased from 73.5 kg (72.0-89.6) before the dives to 70.0 kg (69.2-85.8) after surfacing (p = 0.001), with no change of hematocrit or CFFT. HRV was increased as indicated by the higher SDNN, RMSSD and pNN50 after than before dives. CONCLUSION The present observation represents the first original data regarding the effects of deep repeated CCR dives. The body mass loss and decrease of FVC after bounce dives at depth of about 100 msw may possibly impose an important physiological stress for the divers.
Collapse
Affiliation(s)
- Emmanuel Dugrenot
- TEK diving SAS, F-29200, Brest, France
- Univ Brest, ORPHY, IBSAM, 6 avenue Le Gorgeu, F-29200, Brest, France
| | - Costantino Balestra
- Environmental and Occupational Physiology Laboratory, (ISEK), Haute Ecole Bruxelles-Brabant (HE2B), 1160, Brussels, Belgium
| | | | - Erwan L'Her
- Médecine Intensive et Réanimation, CHRU de Brest, Brest, NA, France
| | - François Guerrero
- Univ Brest, ORPHY, IBSAM, 6 avenue Le Gorgeu, F-29200, Brest, France.
| |
Collapse
|
45
|
Spirometric Abnormalities and Lung Function Decline in Current and Former Microwave Popcorn and Current Flavoring Manufacturing Workers. J Occup Environ Med 2021; 62:412-419. [PMID: 32510907 DOI: 10.1097/jom.0000000000001860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to compare spirometry results in microwave popcorn and flavoring manufacturing workers. METHODS We used NIOSH data on current and former microwave popcorn workers (MPWs) and surveillance data on flavoring manufacturing workers (FMWs). RESULTS Former MPW had higher prevalence of mixed and high severity abnormalities, some had excessive lung function drops. Current MPW had lowest occurrence of excessive lung function drops. FMW with excessive drops and spirometric abnormalities at last test had developed a restrictive pattern. Spirometric abnormalities and excessive drops were associated with work-related factors. CONCLUSION There was evidence of a healthy worker survivor effect in MPW. Importantly, removal from exposure did not always stabilize lung function decline indicating a need for continued monitoring. The development of a restrictive pattern should raise the level of suspicion for possible work-related disease in flavoring-exposed workers.
Collapse
|
46
|
Guilherme EM, Moreira RDFC, de Oliveira A, Ferro AM, Di Lorenzo VAP, Gianlorenço ACL. Respiratory Disorders in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2021; 11:993-1010. [PMID: 33780376 DOI: 10.3233/jpd-212565] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Parkinson's disease (PD) non motor symptoms may present early in the disease course and worsen with advancing disease. Respiratory changes can affect individuals to remain physically active, contributing to a reduction of functionality and quality of life. OBJECTIVE The aim of this systematic review is to synthesize evidence of respiratory disorders in patients with PD. METHODS An electronic search was performed up to November 2020 on PubMed-MEDLINE, Embase, Web of Science, Lilacs, Cinahl, and Cochrane using the following keyword combination: [("Parkinson disease") AND ("respiratory function tests" OR "evaluation") AND ("respiratory system" OR "respiration disorders" OR "respiratory muscles")]. RESULTS The electronic search resulted in 601 references in English or Portuguese. The selection process and data extraction were made by two independent reviewers. We selected 19 studies including cross-sectional studies that investigated the respiratory disorders in patients with PD through pulmonary function, respiratory muscle strength, or physical capacity evaluation. We excluded studies that considered patients with other diseases. Eighteen studies evaluated the pulmonary function in patients with PD, eleven studies verified the influence of PD on respiratory muscle strength, and three studies assessed the physical capacity through functional tests. CONCLUSION The evidence showed that PD patients have higher chances to present a pulmonary dysfunction, either obstructive or restrictive, when compared to healthy subjects. In addition, these patients present lower respiratory muscle strength and a consequent decrease in physical capacity in endurance exercises. The respiratory impairment in PD seems to be directly related to the progression of the disease.
Collapse
Affiliation(s)
- Evelyn M Guilherme
- Laboratory of Neuroscience, Federal University of Sao Carlos, Brazil.,Department of Physical Therapy, Federal University of Sao Carlos, Brazil
| | | | - Adriele de Oliveira
- Laboratory of Neuroscience, Federal University of Sao Carlos, Brazil.,Department of Physical Therapy, Federal University of Sao Carlos, Brazil
| | - Alyne Montero Ferro
- Laboratory of Neuroscience, Federal University of Sao Carlos, Brazil.,Department of Physical Therapy, Federal University of Sao Carlos, Brazil
| | - Valéria A Pires Di Lorenzo
- Department of Physical Therapy, Federal University of Sao Carlos, Brazil.,Spirometry and Respiratory Physical Therapy Laboratory (LEFiR), Federal University of Sao Carlos, Brazil
| | - Anna Carolyna L Gianlorenço
- Laboratory of Neuroscience, Federal University of Sao Carlos, Brazil.,Department of Physical Therapy, Federal University of Sao Carlos, Brazil
| |
Collapse
|
47
|
Yang B, Choi H, Shin SH, Kim Y, Moon JY, Park HY, Lee H. Association of Ventilatory Disorders with Respiratory Symptoms, Physical Activity, and Quality of Life in Subjects with Prior Tuberculosis: A National Database Study in Korea. J Pers Med 2021; 11:jpm11070678. [PMID: 34357145 PMCID: PMC8305056 DOI: 10.3390/jpm11070678] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 01/13/2023] Open
Abstract
Tuberculosis (TB) survivors experience post-TB lung damage and ventilatory function disorders. However, the proportions of obstructive and restrictive ventilatory disorders as well as normal ventilation among subjects with prior TB are unknown. In addition, the impacts of ventilatory disorder and its severity on respiratory symptoms, physical activity limitations, and the quality of life in subjects with prior TB remain unclear. Subjects who participated in the Korean National Health and Nutritional Examination Survey 2007–2016 were enrolled in this study. We evaluated the impact of each ventilatory disorder and its severity on respiratory symptoms, physical activity limitations, and quality of life (measured by the EuroQoL five dimensions questionnaire [EQ-5D] index values) in subjects with prior TB. Among 1466 subjects with prior TB, 29% and 16% had obstructive ventilatory disorders and restrictive ventilatory disorders, respectively. Mild and moderate obstructive ventilatory disorders were not associated with respiratory symptoms, physical activity limitations, or EQ-5D index value compared with normal ventilation; however, severe obstructive ventilatory disorders were associated with more respiratory symptoms (adjusted odds ratio [aOR] = 13.62, 95% confidence interval [CI] = 4.64–39.99), more physical activity limitation (aOR = 218.58, 95% CI = 26.82–1781.12), and decreased EQ-5D index (adjusted coefficient = −0.06, 95% CI = (−0.12–−0.10) compared with normal ventilation. Mild restrictive ventilatory disorders were associated with more respiratory symptoms (aOR = 2.10, 95% CI = 1.07–4.14) compared with normal ventilation, while moderate (aOR = 5.71, 95% CI = 1.14–28.62) and severe restrictive ventilatory disorders (aOR = 9.17, 95% CI = 1.02–82.22) were associated with physical activity limitation compared with normal ventilation. In conclusion, among subjects with prior TB, 29% and 16% developed obstructive and restrictive ventilatory disorders, respectively. Severe obstructive ventilatory disorder was associated with more respiratory symptoms, more physical activity limitation, and poorer quality of life, while severe restrictive ventilatory disorder was associated with more physical activity limitations.
Collapse
Affiliation(s)
- Bumhee Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, Korea;
| | - Hayoung Choi
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea;
| | - Sun Hye Shin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
| | - Youlim Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon 24252, Korea;
- Lung Research Institute, Hallym University College of Medicine, Chuncheon 24252, Korea
| | - Ji-Yong Moon
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea;
| | - Hye Yun Park
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
- Correspondence: (H.Y.P.); (H.L.)
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea;
- Correspondence: (H.Y.P.); (H.L.)
| |
Collapse
|
48
|
Marott JL, Ingebrigtsen TS, Çolak Y, Vestbo J, Lange P. Trajectory of Preserved Ratio Impaired Spirometry: Natural History and Long-Term Prognosis. Am J Respir Crit Care Med 2021; 204:910-920. [PMID: 34233141 DOI: 10.1164/rccm.202102-0517oc] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Natural history of Preserved Ratio Impaired Spirometry (PRISm), often defined as FEV1/FVC≥lower limit of normal and FEV1<80% of predicted value, is not well-described. OBJECTIVE To investigate natural history and long-term prognosis of PRISm trajectories: persistent PRISm trajectory (individuals with PRISm both as young and as middle-aged); normal-to-PRISm trajectory (individuals developing PRISm from normal spirometry in young adulthood); and PRISm-to-normal trajectory (individuals recovering from PRISm in young adulthood by normalizing spirometry while middle-aged). METHODS We followed 1160 individuals aged 20-40 years from the Copenhagen City Heart Study from 1976-83 until 2001-03 to determine their lung function trajectory: 72 had persistent PRISm trajectory, 76 normal-to-PRISm trajectory, 155 PRISm-to-normal trajectory, and 857 had normal trajectory. From 2001-03 until 2018, we determined risk of cardiopulmonary disease and death. MEASUREMENTS AND MAIN RESULTS We recorded 198 admissions for heart disease, 143 for pneumonia, and 64 for COPD, and 171 deaths. Compared to individuals with normal trajectory, hazards ratios for individuals with persistent PRISm trajectory were 1.55 (95% CI, 0.91-2.65) for heart disease admission, 2.86 (1.70-4.83) for pneumonia admission, 6.57 (3.41-12.66) for COPD admission, and 3.68 (2.38-5.68) for all-cause mortality. Corresponding hazards ratios for individuals with normal-to-PRISm trajectory were 1.91 (1.24-2.95), 2.74 (1.70-4.42), 6.03 (3.41-10.64), and 2.96 (1.94-4.51), respectively. Prognosis of individuals with PRISm-to-normal trajectory did not differ from those with normal trajectory. CONCLUSIONS PRISm in middle-aged individuals is associated with increased risk of cardiopulmonary disease and all-cause mortality, but individuals who recover from PRISm during their adult life are no longer at increased risk.
Collapse
Affiliation(s)
- Jacob Louis Marott
- Frederiksberg Hospital, The Copenhagen City Heart Study, Copenhagen, Denmark
| | | | - Yunus Çolak
- Herlev and Gentofte Hospital, Copenhagen University Hospital , Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev, Denmark
| | - Jørgen Vestbo
- The University of Manchester, 5292, Division of Infection, Immunity and Respiratory Medicine, Manchester, United Kingdom of Great Britain and Northern Ireland.,Manchester University NHS Foundation Trust, 5293, North West Lung Centre, Manchester, United Kingdom of Great Britain and Northern Ireland
| | - Peter Lange
- University of Copenhagen, Department of Public Health, Copenhagen, Denmark.,HVidovre Hospital, Respiratory Medicine, Hvidovre, Denmark;
| |
Collapse
|
49
|
Ratanachina J, Amaral A, De Matteis S, Cullinan P, Burney P. Farming, pesticide exposure and respiratory health: a cross-sectional study in Thailand. Occup Environ Med 2021; 79:38-45. [PMID: 34162719 DOI: 10.1136/oemed-2020-107325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/09/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the association of lung function and respiratory symptoms with farming, particularly pesticide use, in an agricultural province in Thailand. METHODS We undertook a cross-sectional survey of adults aged 40-65 in Nan province, Thailand, between May and August 2019. We randomly recruited 345 villagers and enriched the sample with 82 government employees. All participants performed post-bronchodilator spirometry and completed a questionnaire covering information on respiratory symptoms, farming activities, pesticide use and known risk factors for respiratory disease. Associations of respiratory outcomes with farming and pesticide exposures were examined by multivariable regression analysis. RESULTS The response rate was 94%. The prevalence of chronic airflow obstruction among villagers was 5.5%. Villagers had, on average, a lower percent predicted post-bronchodilator forced expiratory volume in one second/forced vital capacity (FEV1/FVC) than government employees (98.3% vs 100.3%; p=0.04). There was no evidence of association of lung function with farming activities, the use of specific herbicides (glyphosate and paraquat), insecticides (organophosphates and pyrethroids) or fungicides. The exceptions were poultry farming, associated with chronic cough and an increase of FEV1/FVC, and atrazine, for which duration (p-trend <0.01), intensity (p-trend <0.01) and cumulative hours (p-trend=0.01) of use were all associated with higher FEV1/FVC in an exposure-response manner. Cumulative hours (-280 mL/hour), low duration (-270 mL/year) and intensity (-270 mL/hour/year) of atrazine use were associated with lower FVC. CONCLUSIONS Chronic airflow obstruction is uncommon among villagers of an agricultural province in Nan, Thailand. Farming and pesticide use are unlikely to be major causes of respiratory problems there.
Collapse
Affiliation(s)
- Jate Ratanachina
- National Heart and Lung Institute, Imperial College London, London, UK .,Department of Preventive and Social Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Andre Amaral
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sara De Matteis
- National Heart and Lung Institute, Imperial College London, London, UK.,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Sardegna, Italy
| | - Paul Cullinan
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Peter Burney
- National Heart and Lung Institute, Imperial College London, London, UK
| |
Collapse
|
50
|
Longitudinal Association of Economic Growth with Lung Function of Chinese Children and Adolescents over 30 Years: Evidence from Seven Successive National Surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126592. [PMID: 34205232 PMCID: PMC8296369 DOI: 10.3390/ijerph18126592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Recent studies reported that decrease in lung function of Chinese children and adolescents continues to decline, although the change has been insignificant and has reached a plateau. However, studies have not explored the relationship between lung function and economic development in China. This study sought to explore the longitudinal association between socio-economic indicators and lung function; (2) Method: Data were obtained from seven successive national surveys conducted by the Chinese National Survey on Students' Constitution and Health from 1985 to 2014. Lung function of school-age children (7-22 years) was determined using forced vital capacity (FVC). GDP per capita and urbanization ratio were used as economic indicators. A fixed-effects model was employed to examine the longitudinal association after adjusting for height, weight, and time trends; (3) Results: Socio-economic indicators showed a U-curve relationship with lung function of boys and girls from urban and rural areas. Lung function initially decreased with GDP per capita or urbanization ratio and reached a minimum. Lung function then increased with increase in GDP per capita or urbanization ratio. The findings indicate that the relationship between economic growth and lung function is different in different development stages. In less-developed provinces, economic growth was negatively correlated with lung function, whereas, in developed provinces, economic growth was positively correlated with lung function; (4) Conclusion: The findings of the current study show that economic growth has significantly different effects on lung function at different economic levels. Therefore, governments should improve lung health in children and adolescents from low and middle economic regions.
Collapse
|