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Mraz T, Asgari S, Karimi A, Breyer MK, Hartl S, Sunanta O, Ofenheimer A, Burghuber OC, Zacharasiewicz A, Lamprecht B, Schiffers C, Wouters EFM, Breyer-Kohansal R. Updated reference values for static lung volumes from a healthy population in Austria. Respir Res 2024; 25:155. [PMID: 38570835 PMCID: PMC10988832 DOI: 10.1186/s12931-024-02782-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Reference values for lung volumes are necessary to identify and diagnose restrictive lung diseases and hyperinflation, but the values have to be validated in the relevant population. Our aim was to investigate the Global Lung Function Initiative (GLI) reference equations in a representative healthy Austrian population and create population-derived reference equations if poor fit was observed. METHODS We analysed spirometry and body plethysmography data from 5371 respiratory healthy subjects (6-80 years) from the Austrian LEAD Study. Fit with the GLI equations was examined using z-scores and distributions within the limits of normality. LEAD reference equations were then created using the LMS method and the generalized additive model of location shape and scale package according to GLI models. RESULTS Good fit, defined as mean z-scores between + 0.5 and -0.5,was not observed for the GLI static lung volume equations, with mean z-scores > 0.5 for residual volume (RV), RV/TLC (total lung capacity) and TLC in both sexes, and for expiratory reserve volume (ERV) and inspiratory capacity in females. Distribution within the limits of normality were shifted to the upper limit except for ERV. Population-derived reference equations from the LEAD cohort showed superior fit for lung volumes and provided reproducible results. CONCLUSION GLI lung volume reference equations demonstrated a poor fit for our cohort, especially in females. Therefore a new set of Austrian reference equations for static lung volumes was developed, that can be applied to both children and adults (6-80 years of age).
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Affiliation(s)
- Tobias Mraz
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, Sanatoriumstrasse 2, Vienna, 1140, Austria.
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.
| | - Shervin Asgari
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
| | - Ahmad Karimi
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
| | - Marie-Kathrin Breyer
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, Sanatoriumstrasse 2, Vienna, 1140, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
| | - Owat Sunanta
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Alina Ofenheimer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
- School of Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Otto C Burghuber
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, Sanatoriumstrasse 2, Vienna, 1140, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
| | | | - Bernd Lamprecht
- Department of Pulmonology, Kepler University Hospital, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | | | - Emiel F M Wouters
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
- School of Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Hietzing, Vienna, Austria
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Veneroni C, Valach C, Wouters EFM, Gobbi A, Dellacà RL, Breyer MK, Hartl S, Sunanta O, Irvin CG, Schiffers C, Pompilio PP, Breyer-Kohansal R. Reply to: Z-Scores or Fixed Cut-Off Values to Interpret Oscillometry: Opportunities from the LEAD Study. Am J Respir Crit Care Med 2024. [PMID: 38364256 DOI: 10.1164/rccm.202312-2316le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/15/2024] [Indexed: 02/18/2024] Open
Affiliation(s)
- Chiara Veneroni
- Politecnico di Milano, Dipartimento di Bioingegneria, Milan, Italy;
| | - Christoph Valach
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, 1140, Austria
| | - Emiel F M Wouters
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | | | | | - Marie-Kathrin Breyer
- Centre for Intergrated Rehabilitation of Organ failure (CIRO), Department of Research, Development and Education, HORN, Netherlands
| | - Sylvia Hartl
- Otto Wagner Hospital, Department for Respiratory and Critical Care Medicine, Vienna, Austria
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
- Sigmund Freud University, Medical School, Barcelona, Spain
| | - Owat Sunanta
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, 1140, Austria
| | - Charles G Irvin
- University of Vermont, Medicine, Burlington, Vermont, United States
| | - Caspar Schiffers
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | | | - Robab Breyer-Kohansal
- Otto Wagner Hospital, Department for Respiratory and Critical Care Medicine, Vienna, Austria
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, 1140, Austria
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Veneroni C, Valach C, Wouters EFM, Gobbi A, Dellacà RL, Breyer MK, Hartl S, Sunanta O, Irvin CG, Schiffers C, Pompilio PP, Breyer-Kohansal R. Diagnostic Potential of Oscillometry: A Population-based Approach. Am J Respir Crit Care Med 2024; 209:444-453. [PMID: 37972230 PMCID: PMC10878374 DOI: 10.1164/rccm.202306-0975oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/16/2023] [Indexed: 11/19/2023] Open
Abstract
Rationale: Respiratory resistance (Rrs) and reactance (Xrs) as measured by oscillometry and their intrabreath changes have emerged as sensitive parameters for detecting early pathological impairments during tidal breathing. Objectives: This study evaluates the prevalence and association of abnormal oscillometry parameters with respiratory symptoms and respiratory diseases in a general adult population. Methods: A total of 7,560 subjects in the Austrian LEAD (Lung, hEart, sociAl, boDy) Study with oscillometry measurements (computed with the Resmon Pro FULL; Restech Srl) were included in this study. The presence of respiratory symptoms and doctor-diagnosed respiratory diseases was assessed using an interview-based questionnaire. Rrs and Xrs at 5 Hz, their inspiratory and expiratory components, the area above the Xrs curve, and the presence of tidal expiratory flow limitation were analyzed. Normality ranges for oscillometry parameters were defined. Measurements and Main Results: The overall prevalence of abnormal oscillometry parameters was 20%. The incidence of abnormal oscillometry increased in the presence of symptoms or diagnoses: 17% (16-18%) versus 27% (25-29%), P < 0.0001. All abnormal oscillometry parameters except Rrs at 5 Hz were significantly associated with respiratory symptoms/diseases. Significant associations were found, even in subjects with normal spirometry, with abnormal oscillometry incidence rates increasing by 6% (4-8%; P < 0.0001) in subjects with symptoms or diagnoses. Conclusions: Abnormal oscillometry parameters are present in one-fifth of this adult population and are significantly associated with respiratory symptoms and disease. Our findings underscore the potential of oscillometry as a tool for detecting and evaluating respiratory impairments, even in individuals with normal spirometry.
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Affiliation(s)
- Chiara Veneroni
- Department of Electronics, Information and Bioengineering, Polytechnic University of Milan, Milan, Italy
| | - Christoph Valach
- Faculty for Medicine, Sigmund Freud University, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory Medicine, Maastricht University, Maastricht, the Netherlands
| | - Emiel F. M. Wouters
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory Medicine, Maastricht University, Maastricht, the Netherlands
- Department of Pulmonary and Critical Care Medicine, University of Vermont, Burlington, Vermont; and
| | | | - Raffaele L. Dellacà
- Department of Electronics, Information and Bioengineering, Polytechnic University of Milan, Milan, Italy
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, Vienna, Austria
| | - Sylvia Hartl
- Faculty for Medicine, Sigmund Freud University, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Owat Sunanta
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Charles G. Irvin
- Department of Pulmonary and Critical Care Medicine, University of Vermont, Burlington, Vermont; and
| | | | | | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Pulmonary Diseases, Clinic Hietzing, Vienna Healthcare Group, Vienna Austria
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Ofenheimer A, Breyer MK, Wouters EFM, Schiffers C, Hartl S, Burghuber OC, Krach F, Maninno DM, Franssen FME, Mraz T, Puchhammer P, Breyer-Kohansal R. The effect of body compartments on lung function in childhood and adolescence. Clin Nutr 2024; 43:476-481. [PMID: 38181525 DOI: 10.1016/j.clnu.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 11/27/2023] [Accepted: 12/13/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND There is an association between body composition and lung function, assessed by spirometry, but the effects of body compartments on static lung volumes and its changes during lung growth remain to be explored. We aimed to investigate the association of appendicular lean mass, reflecting skeletal muscle mass, and fat mass on forced and static lung function measures in childhood and adolescence. METHODS In total, 1489 children and adolescents (6-18 years) of the observational, longitudinal (first and second visit within 4 years), general population-based LEAD study have been investigated. The association of appendicular lean mass and fat mass indices (ALMI and FMI; assessed by dual-energy X-ray absorptiometry) on lung function by spirometry (FEV1, FVC) and body plethysmography (TLC, RV, FRC) was investigated cross-sectionally. Longitudinal associations between lung function and body compartment changes between the two visits were analyzed. FINDINGS The ALMI is positively associated with FEV1, FVC, and TLC. Contrary, FMI is inversely associated with lung function measures including FRC and RV. During the phase of lung growth, higher gain in muscle mass is associated with higher increases of FVC and TLC. INTERPRETATION This study demonstrates the different effects of muscle and fat mass on forced expiratory and static lung volumes. Achieving and maintaining muscle mass in childhood and adolescence might become an important preventive strategy for lung health in adulthood.
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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 Health Care Group, 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
| | | | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Health Care Group, Vienna, Austria; Sigmund Freud University, Medical School, Vienna, Austria
| | - Otto C Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Sigmund Freud University, Medical School, Vienna, Austria
| | - Florian Krach
- ETH Zürich, Department of Mathematics, Zurich, Switzerland
| | - David M Maninno
- University of Kentucky, College of Medicine, Lexington, KY, USA
| | - Frits M E Franssen
- NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Research and Education, CIRO, Horn, the Netherlands
| | - Tobias Mraz
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Health Care Group, Vienna, Austria
| | | | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Pulmonary Diseases, Clinic Hietzing, Vienna Health Care Group, Vienna, Austria
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Abozid H, Patel J, Burney P, Hartl S, Breyer-Kohansal R, Mortimer K, Nafees AA, Al Ghobain M, Welte T, Harrabi I, Denguezli M, Loh LC, Rashid A, Gislason T, Barbara C, Cardoso J, Rodrigues F, Seemungal T, Obaseki D, Juvekar S, Paraguas SN, Tan WC, Franssen FM, Mejza F, Mannino D, Janson C, Cherkaski HH, Anand MP, Hafizi H, Buist S, Koul PA, El Sony A, Breyer MK, Burghuber OC, Wouters EF, Amaral AF. Prevalence of chronic cough, its risk factors and population attributable risk in the Burden of Obstructive Lung Disease (BOLD) study: a multinational cross-sectional study. EClinicalMedicine 2024; 68:102423. [PMID: 38268532 PMCID: PMC10807979 DOI: 10.1016/j.eclinm.2024.102423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 01/26/2024] Open
Abstract
Background Chronic cough is a common respiratory symptom with an impact on daily activities and quality of life. Global prevalence data are scarce and derive mainly from European and Asian countries and studies with outcomes other than chronic cough. In this study, we aimed to estimate the prevalence of chronic cough across a large number of study sites as well as to identify its main risk factors using a standardised protocol and definition. Methods We analysed cross-sectional data from 33,983 adults (≥40 years), recruited between Jan 2, 2003 and Dec 26, 2016, in 41 sites (34 countries) from the Burden of Obstructive Lung Disease (BOLD) study. We estimated the prevalence of chronic cough for each site accounting for sampling design. To identify risk factors, we conducted multivariable logistic regression analysis within each site and then pooled estimates using random-effects meta-analysis. We also calculated the population attributable risk (PAR) associated with each of the identifed risk factors. Findings The prevalence of chronic cough varied from 3% in India (rural Pune) to 24% in the United States of America (Lexington,KY). Chronic cough was more common among females, both current and passive smokers, those working in a dusty job, those with a history of tuberculosis, those who were obese, those with a low level of education and those with hypertension or airflow limitation. The most influential risk factors were current smoking and working in a dusty job. Interpretation Our findings suggested that the prevalence of chronic cough varies widely across sites in different world regions. Cigarette smoking and exposure to dust in the workplace are its major risk factors. Funding Wellcome Trust.
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Affiliation(s)
- Hazim Abozid
- Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Jaymini Patel
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Peter Burney
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Sigmund Freud University, Faculty for Medicine, Vienna, Austria
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Pulmonary Diseases, Clinic Hietzing, Vienna Healthcare Group, Vienna, Austria
| | - Kevin Mortimer
- University of Cambridge, Cambridge, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Asaad A. Nafees
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Mohammed Al Ghobain
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Tobias Welte
- Department of Respiratory Medicine/Infectious Disease, Member of the German Centre for Lung Research, Hannover School of Medicine, Germany
| | - Imed Harrabi
- Ibn El Jazzar Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Meriam Denguezli
- Department of Pneumology, Faculty of Medicine Annaba, University Badji Mokhtar of Annaba, Annaba, Algeria
| | - Li Cher Loh
- Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Penang, Malaysia
| | - Abdul Rashid
- Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Penang, Malaysia
| | - Thorarinn Gislason
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Department of Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Cristina Barbara
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Serviço de Pneumologia, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Joao Cardoso
- Pulmonology Department, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
- NOVA Medical School, Nova University Lisbon, Lisboa, Portugal
| | - Fatima Rodrigues
- Serviço de Pneumologia, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Institute of Environmental Health, Associate Laboratory TERRA, Lisbon Medical School, Lisbon University, Lisbon, Portugal
| | - Terence Seemungal
- Faculty of Medical Sciences, University of West Indies, St Augustine, Trinidad and Tobago
| | - Daniel Obaseki
- Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Sanjay Juvekar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | | | - Wan C. Tan
- University of British Columbia Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, Canada
| | | | - Filip Mejza
- Centre for Evidence Based Medicine, 2nd Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - David Mannino
- University of Kentucky, Lexington, KY, USA
- COPD Foundation, Miami, FL, USA
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Hamid Hacene Cherkaski
- Department of Pneumology, Faculty of Medicine Annaba, University Badji Mokhtar of Annaba, Annaba, Algeria
| | | | - Hasan Hafizi
- Faculty of Medicine, Tirana University Hospital “Shefqet Ndroqi”, Tirana, Albania
| | - Sonia Buist
- Oregon Health & Science University, Portland, USA
| | - Parvaiz A. Koul
- Department of Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, India
| | | | - Marie-Kathrin Breyer
- Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Otto C. Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Sigmund Freud University, Faculty for Medicine, Vienna, Austria
| | - Emiel F.M. Wouters
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Andre F.S. Amaral
- National Heart and Lung Institute, Imperial College London, London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
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6
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Perkmann T, Koller T, Perkmann-Nagele N, Ozsvar-Kozma M, Eyre D, Matthews P, Bown A, Stoesser N, Breyer MK, Breyer-Kohansal R, Burghuber OC, Hartl S, Aletaha D, Sieghart D, Quehenberger P, Marculescu R, Mucher P, Radakovics A, Klausberger M, Duerkop M, Holzer B, Hartmann B, Strassl R, Leitner G, Grebien F, Gerner W, Grabherr R, Wagner OF, Binder CJ, Haslacher H. Increasing test specificity without impairing sensitivity: lessons learned from SARS-CoV-2 serology. J Clin Pathol 2023; 76:770-777. [PMID: 36041815 DOI: 10.1136/jcp-2022-208171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 08/12/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Serological tests are widely used in various medical disciplines for diagnostic and monitoring purposes. Unfortunately, the sensitivity and specificity of test systems are often poor, leaving room for false-positive and false-negative results. However, conventional methods were used to increase specificity and decrease sensitivity and vice versa. Using SARS-CoV-2 serology as an example, we propose here a novel testing strategy: the 'sensitivity improved two-test' or 'SIT²' algorithm. METHODS SIT² involves confirmatory retesting of samples with results falling in a predefined retesting zone of an initial screening test, with adjusted cut-offs to increase sensitivity. We verified and compared the performance of SIT² to single tests and orthogonal testing (OTA) in an Austrian cohort (1117 negative, 64 post-COVID-positive samples) and validated the algorithm in an independent British cohort (976 negatives and 536 positives). RESULTS The specificity of SIT² was superior to single tests and non-inferior to OTA. The sensitivity was maintained or even improved using SIT² when compared with single tests or OTA. SIT² allowed correct identification of infected individuals even when a live virus neutralisation assay could not detect antibodies. Compared with single testing or OTA, SIT² significantly reduced total test errors to 0.46% (0.24-0.65) or 1.60% (0.94-2.38) at both 5% or 20% seroprevalence. CONCLUSION For SARS-CoV-2 serology, SIT² proved to be the best diagnostic choice at both 5% and 20% seroprevalence in all tested scenarios. It is an easy to apply algorithm and can potentially be helpful for the serology of other infectious diseases.
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Affiliation(s)
- Thomas Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Thomas Koller
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | | | - Maria Ozsvar-Kozma
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - David Eyre
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Abbie Bown
- Public Health England Porton Down, Salisbury, UK
| | - Nicole Stoesser
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Marie-Kathrin Breyer
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Robab Breyer-Kohansal
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Otto C Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Sigmund Freud Private University Vienna, Vienna, Austria
| | - Slyvia Hartl
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Sigmund Freud Private University Vienna, Vienna, Austria
| | - Daniel Aletaha
- Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Daniela Sieghart
- Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Peter Quehenberger
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Rodrig Marculescu
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Patrick Mucher
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Astrid Radakovics
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Miriam Klausberger
- Institute of Molecular Biotechnology, Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Vienna, Austria
| | - Mark Duerkop
- Institute of Bioprocess Science and Engineering, Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Vienna, Austria
| | - Barba Holzer
- Institute for Veterinary Disease Control, Austrian Agency for Health and Food Safety (AGES), Moedling, Austria
| | - Boris Hartmann
- Institute for Veterinary Disease Control, Austrian Agency for Health and Food Safety (AGES), Moedling, Austria
| | - Robert Strassl
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Gerda Leitner
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | - Florian Grebien
- Institute for Medical Biochemistry, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Wilhelm Gerner
- Institute of Immunology, University of Veterinary Medicine Vienna, Vienna, Austria
- Christian Doppler Laboratory for an Optimized Prediction of Vaccination Success in Pigs, University of Veterinary Medicine Vienna, Vienna, Austria
- The Pirbright Institute, Pirbright, UK (current)
| | - Reingard Grabherr
- Institute of Molecular Biotechnology, Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Vienna, Austria
| | - Oswald F Wagner
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Christoph J Binder
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
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7
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Müller A, Mraz T, Wouters EF, van Kuijk SM, Amaral AF, Breyer-Kohansal R, Breyer MK, Hartl S, Janssen DJ. Prevalence of dyspnea in general adult populations: A systematic review and meta-analysis. Respir Med 2023; 218:107379. [PMID: 37595674 DOI: 10.1016/j.rmed.2023.107379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/07/2023] [Accepted: 08/10/2023] [Indexed: 08/20/2023]
Abstract
INTRODUCTION Dyspnea is a commonly described symptom in various chronic and acute conditions. Despite its frequency, relatively little is known about the prevalence and assessment of dyspnea in general populations. The aims of this review were: 1) to estimate the prevalence of dyspnea in general adult populations; 2) to identify associated factors; and 3) to identify used methods for dyspnea assessment. METHODS A systematic literature search was conducted using MEDLINE/PubMed, Embase, CINAHL and JAMA network. Records were screened by two independent reviewers and quality was assessed by using the Joanna Briggs Institute checklist for risk of bias in prevalence studies. Multi-level meta-analysis was performed to estimate pooled prevalence. The protocol was registered on PROSPERO (CRD42021275499). RESULTS Twenty original articles, all from studies in high-income countries, met the criteria for inclusion. Overall, their quality was good. Pooled prevalence of dyspnea in general adult populations based on 11 studies was 10% (95% CI 7, 15), but heterogeneity across studies was high. The most frequently reported risk factors were increasing age, female sex, higher BMI and respiratory or cardiac disease. The MRC or the modified MRC scale was the most used tool to assess dyspnea in general populations. CONCLUSIONS Dyspnea is a common symptom in adults in high-income countries. However, the high heterogeneity across studies and the lack of data from low- and middle-income countries limit the generalizability of our findings. Therefore, more research is needed to unveil the prevalence of dyspnea and its main risk factors in general populations around the world.
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Affiliation(s)
- Alexander Müller
- Ludwig Boltzmann Institute for Lung Health, Sanatoriumstrasse 2, 1140, Vienna, Austria; Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands.
| | - Tobias Mraz
- Ludwig Boltzmann Institute for Lung Health, Sanatoriumstrasse 2, 1140, Vienna, Austria; Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna Healthcare Group, Sanatoriumstrasse 2, 1140, Vienna, Austria
| | - Emiel Fm Wouters
- Ludwig Boltzmann Institute for Lung Health, Sanatoriumstrasse 2, 1140, Vienna, Austria
| | - Sander Mj van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Peter Debyeplein 1, 6229 HA, Maastricht, the Netherlands
| | - André Fs Amaral
- National Heart and Lung Institute, Imperial College London, 1B Manresa Road, London, SW3 6LR, UK; NIHR Imperial Biomedical Research Centre, The Bays, Entrance 2, South Wharf Road, St. Mary's Hospital, London, W2 1NY, UK
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Sanatoriumstrasse 2, 1140, Vienna, Austria; Department of Respiratory and Pulmonary Diseases, Clinic Hietzing, Vienna Healthcare Group, Wolkersbergenstrasse 1, 1130, Vienna, Austria
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Sanatoriumstrasse 2, 1140, Vienna, Austria; Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna Healthcare Group, Sanatoriumstrasse 2, 1140, Vienna, Austria
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Sanatoriumstrasse 2, 1140, Vienna, Austria
| | - Daisy Ja Janssen
- Department of Health Services Research and Department of Family Medicine, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands; Department of Research & Development, Ciro, Hornerheide 1, 6085 NM, Horn, the Netherlands
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8
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Schiffers C, Mraz T, Breyer MK, Hartl S, Breyer-Kohansal R, Wouters EFM. Restrictive Spirometry or PRISm: Does it Matter? Am J Respir Crit Care Med 2023; 208:905-907. [PMID: 37586047 DOI: 10.1164/rccm.202304-0765le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/16/2023] [Indexed: 08/18/2023] Open
Affiliation(s)
| | - Tobias Mraz
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Pulmonary Diseases, Clinic Penzing, and
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Pulmonary Diseases, Clinic Penzing, and
| | - Sylvia Hartl
- Department of Respiratory and Pulmonary Diseases, Clinic Penzing, and
- Faculty of Medicine, Sigmund Freud University, Vienna, Austria; and
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Pulmonary Diseases, Clinic Hietzing, Vienna Healthcare Group, 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
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9
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Schiffers C, Faner R, Ofenheimer A, Sunanta O, Puchhammer P, Mraz T, Breyer MK, Burghuber OC, Hartl S, Agustí A, Breyer-Kohansal R. Supranormal lung function: Prevalence, associated factors and clinical manifestations across the lifespan. Respirology 2023; 28:942-953. [PMID: 37434280 DOI: 10.1111/resp.14553] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 07/03/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND AND OBJECTIVE It is now well established that there are different life-long lung function trajectories in the general population, and that some are associated with better or worse health outcomes. Yet, the prevalence, clinical characteristics and risk factors of individuals with supranormal FEV1 or FVC values (above the upper-limit of normal [ULN]) in different age-bins through the lifetime in the general population are poorly understood. METHOD To address these questions, we investigated the prevalence of supranormal FEV1 and FVC values in the LEAD (Lung, hEart, sociAl and boDy) study, a general population cohort in Austria that includes participants from 6 to 82 years of age. RESULTS We found that: (1) the prevalence of supranormal pre-bronchodilator FEV1 and FVC values was 3.4% and 3.1%, respectively, and that these figures remained relatively stable through different age-bins except for participants >60 years., in whom they increased (5.0% and 4.2%, respectively). Approximately 50% of supranormal individuals had both increased FEV1 and FVC values; (2) supranormal spirometric values were consistently accompanied by higher static lung volumes and lower specific airway resistance through the lifespan, indicating better overall lung function; and (3) multivariate regression analysis identified that female sex, higher muscle mass (FFMI), less diabetes and fewer respiratory symptoms were consistently associated with supranormal FEV1 and FVC values. CONCLUSION Supranormal FEV1 and/or FVC values occur in about 3% of the general population in different age bins and are associated with better health markers.
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Affiliation(s)
| | - Rosa Faner
- University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - 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
| | - Owat Sunanta
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | | | - Tobias Mraz
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
| | - Otto Chris Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Medical School, Sigmund Freud University, Vienna, Austria
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
- Medical School, Sigmund Freud University, Vienna, Austria
| | - Alvar Agustí
- University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
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10
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Abozid H, Kirby M, Nasir N, Hartl S, Breyer-Kohansal R, Breyer MK, Burghuber OC, Bourbeau J, Wouters EFM, Tan W. CT airway remodelling and chronic cough. BMJ Open Respir Res 2023; 10:10/1/e001462. [PMID: 37173074 DOI: 10.1136/bmjresp-2022-001462] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
RATIONALE Structural airway changes related to chronic cough (CC) are described in the literature, but so far reported data are rare and non-conclusive. Furthermore, they derive mainly from cohorts with small sample sizes. Advanced CT imaging not only allows airway abnormalities to be quantified, but also to count the number of visible airways. The current study evaluates these airway abnormalities in CC and assesses the contribution of CC in addition to CT findings on the progression of airflow limitation, defined as a decline in forced expiratory volume in 1 s (FEV1) over time. METHODS A total of 1183 males and females aged ≥40 years with thoracic CT scans and valid spirometry from Canadian Obstructive Lung Disease, a Canadian multicentre, population-based study has been included in this analysis. Participants were stratified into 286 never-smokers, 297 ever-smokers with normal lung function and 600 with chronic obstructive pulmonary disease (COPD) of different severity grades. Imaging parameters analyses included total airway count (TAC), airway wall thickness, emphysema as well as parameters for functional small airway disease quantification. RESULTS Irrespective of COPD presence, CC was not related to specific airway and lung structure features. Independent of TAC and emphysema score, CC was highly associated with FEV1 decline over time in the entire study population, particularly in ever-smokers (p<0.0001). CONCLUSION The absence of specific structural CT features independently from COPD presence indicate that other underlying mechanisms are contributing to the symptomatology of CC. On top of derived CT parameters, CC seems to be independently associated with FEV1 decline. TRIAL REGISTRATION NUMBER NCT00920348.
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Affiliation(s)
- Hazim Abozid
- Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Miranda Kirby
- Department of Physics, Toronto Metropolitan University, Toronto, Ontario, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST), Unity Health Toronto, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Neha Nasir
- Department of Physics, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, Vienna, Austria
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, Vienna, Austria
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, Vienna, Austria
| | - Otto C Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty for Medicine, Sigmund Freud University, Vienna, Austria
| | - Jean Bourbeau
- Respiratory Epidemiology and Clinical Research Unit, Research Institute, McGill University, Montreal, Québec, Canada
| | - Emiel F M Wouters
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Maastricht University Medical Center, Maastricht, The Netherlands
| | - Wan Tan
- Centre for Heart Lung Innovation, University of British Columbia, St Pauls's Hospital, Vancouver, British Columbia, Canada
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11
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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12
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Schiffers C, Wouters EFM, Breyer-Kohansal R, Buhl R, Pohl W, Irvin CG, Breyer MK, Hartl S. Asthma Prevalence and Phenotyping in the General Population: The LEAD (Lung, hEart, sociAl, boDy) Study. J Asthma Allergy 2023; 16:367-382. [PMID: 37063243 PMCID: PMC10094413 DOI: 10.2147/jaa.s402326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/15/2023] [Indexed: 04/18/2023] Open
Abstract
Background Asthma is a chronic heterogeneous respiratory disease involving differential pathophysiological pathways and consequently distinct asthma phenotypes. Objective and Methods In the LEAD Study, a general population cohort (n=11.423) in Vienna ranging from 6-82 years of age, we addressed the prevalence of asthma and explored inflammatory asthma phenotypes that included allergic and non-allergic asthma, and within these phenotypes, an eosinophilic (eosinophils ≥300 cells/µL, or ≥150 cells/µL in the presence of ICS medication) or non-eosinophilic (eosinophils <300 cells/µL, or <150 cells/µL in the presence of ICS) phenotype. In addition, we compared various factors related to biomarkers, body composition, lung function, and symptoms in control subjects versus subjects with current asthma (current doctor's diagnosis of asthma). Results An overall prevalence of 4.6% was observed for current asthma. Furthermore, an age-dependent shift from allergic to non-allergic asthma was found. The non-eosinophilic phenotype was more prominent. Obesity was a prevalent condition, and body composition including visceral adipose tissue (VAT), is affected in current asthma versus controls. Conclusion This broad-aged and large general population cohort identified differential patterns of inflammatory asthma phenotypes that were age-dependent. The presence of eosinophilia was associated with worse asthma control, increased asthma medication, increased VAT, and lower lung function, the opposite was found for the presence of an allergic asthma.
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Affiliation(s)
- Caspar Schiffers
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Correspondence: Caspar Schiffers, Ludwig Boltzmann Institute for Lung Health, Vienna, 1140, Austria, Email
| | - 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
| | - Roland Buhl
- Pulmonology Department, Mainz University Hospital, Mainz, Germany
| | - Wolfgang Pohl
- Karl Landsteiner Gesellschaft, Institute for Clinical and Experimental Pneumology, Vienna, Austria
| | - Charles G Irvin
- Pulmonary and Critical Care, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, 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 for Medicine, Vienna, Austria
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13
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Kölli F, Breyer MK, Hartl S, Burghuber O, Wouters EFM, Sigsgaard T, Pohl W, Kohlböck G, Breyer-Kohansal R. Aero-Allergen Sensitization in the General Population: Longitudinal Analyses of the LEAD (Lung Heart Social Body) Study. J Asthma Allergy 2022; 15:461-473. [PMID: 35431559 PMCID: PMC9012316 DOI: 10.2147/jaa.s349614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Franziska Kölli
- Sigmund Freud University, Faculty of Medicine, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Correspondence: Franziska Kölli, Ludwig Boltzmann Institute for Lung Health, Sanatroium Street 2, Vienna, 1140, Austria, Tel +436645127500, Email
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
| | - Sylvia Hartl
- Sigmund Freud University, Faculty of Medicine, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
| | - Otto Burghuber
- Sigmund Freud University, Faculty of Medicine, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Emiel F M Wouters
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- NUTRIM School of Nutrition and Translational Research in Metabolism, University Medical Center, Maastricht, The Netherlands
| | - Torben Sigsgaard
- Department of Public Health, Section of Environment, Occupation & Health, Aarhus University, Aarhus, Denmark
| | - Wolfgang Pohl
- Karl Landsteiner Institute for Clinical and Experimental Pneumology, Clinic Hietzing, Vienna, Austria
| | | | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
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14
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Wang G, Hallberg J, Charalampopoulos D, Sanahuja MC, Breyer-Kohansal R, Langhammer A, Granell R, Vonk JM, Mian A, Olvera N, Laustsen LM, Rönmark E, Abellan A, Agusti A, Arshad SH, Bergström A, Boezen HM, Breyer MK, Burghuber O, Bolund AC, Custovic A, Devereux G, Donaldson GC, Duijts L, Esplugues A, Faner R, Ballester F, Garcia-Aymerich J, Gehring U, Haider S, Hartl S, Backman H, Holloway JW, Koppelman GH, Lertxundi A, Holmen TL, Lowe L, Mensink-Bout SM, Murray CS, Roberts G, Hedman L, Schlünssen V, Sigsgaard T, Simpson A, Sunyer J, Torrent M, Turner S, Van den Berge M, Vermeulen RCH, Vikjord SAA, Wedzicha JA, Maitland van der Zee AH, Melén E. Spirometric phenotypes from early childhood to young adulthood: a Chronic Airway Disease Early Stratification study. ERJ Open Res 2021; 7:00457-2021. [PMID: 34881328 PMCID: PMC8646001 DOI: 10.1183/23120541.00457-2021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/25/2021] [Indexed: 02/05/2023] Open
Abstract
Background The prevalences of obstructive and restrictive spirometric phenotypes, and their relation to early-life risk factors from childhood to young adulthood remain poorly understood. The aim was to explore these phenotypes and associations with well-known respiratory risk factors across ages and populations in European cohorts. Methods We studied 49 334 participants from 14 population-based cohorts in different age groups (≤10, >10–15, >15–20, >20–25 years, and overall, 5–25 years). The obstructive phenotype was defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) z-score less than the lower limit of normal (LLN), whereas the restrictive phenotype was defined as FEV1/FVC z-score ≥LLN, and FVC z-score <LLN. Results The prevalence of obstructive and restrictive phenotypes varied from 3.2–10.9% and 1.8–7.7%, respectively, without clear age trends. A diagnosis of asthma (adjusted odds ratio (aOR=2.55, 95% CI 2.14–3.04), preterm birth (aOR=1.84, 1.27–2.66), maternal smoking during pregnancy (aOR=1.16, 95% CI 1.01–1.35) and family history of asthma (aOR=1.44, 95% CI 1.25–1.66) were associated with a higher prevalence of obstructive, but not restrictive, phenotype across ages (5–25 years). A higher current body mass index (BMI was more often observed in those with the obstructive phenotype but less in those with the restrictive phenotype (aOR=1.05, 95% CI 1.03–1.06 and aOR=0.81, 95% CI 0.78–0.85, per kg·m−2 increase in BMI, respectively). Current smoking was associated with the obstructive phenotype in participants older than 10 years (aOR=1.24, 95% CI 1.05–1.46). Conclusion Obstructive and restrictive phenotypes were found to be relatively prevalent during childhood, which supports the early origins concept. Several well-known respiratory risk factors were associated with the obstructive phenotype, whereas only low BMI was associated with the restrictive phenotype, suggesting different underlying pathobiology of these two phenotypes. Obstructive and restrictive phenotypes are present from childhood to adulthood but without age trends. Established risk factors for airway disease are associated with the obstructive phenotype, whereas low BMI is associated with the restrictive.https://bit.ly/3BMoMtI
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Affiliation(s)
- Gang Wang
- Dept of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Sichuan, China.,Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Shared first authors
| | - Jenny Hallberg
- Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.,Shared first authors
| | - Dimitrios Charalampopoulos
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Maribel Casas Sanahuja
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.,Dept of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
| | - Arnulf Langhammer
- Dept of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Levanger, Norway
| | - Raquel Granell
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Judith M Vonk
- Dept of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, University of Groningen, Groningen, The Netherlands
| | - Annemiek Mian
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Division of Respiratory Medicine and Allergology, and Neonatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Núria Olvera
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Institut d'investigacions biomediques August Pi I Sunyer, Barcelona, Spain
| | - Lisbeth Mølgaard Laustsen
- Dept of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Eva Rönmark
- Dept of Public Health and Clinical Medicine, Section for Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Alicia Abellan
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain
| | - Alvar Agusti
- Institut d'investigacions biomediques August Pi I Sunyer, Barcelona, Spain.,Respiratory Institute, Hospital Clinic, Univ. Barcelona, Barcelona, Spain.,CIBERESP (ISCiii), Barcelona, Spain
| | - Syed Hasan Arshad
- David Hide Asthma and Allergy Research Centre, Newport, UK.,NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK.,Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - H Marike Boezen
- Dept of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.,Dept of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
| | - Otto Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.,Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - Anneli Clea Bolund
- Dept of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Gavin C Donaldson
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Division of Respiratory Medicine and Allergology, and Neonatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Division of Neonatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ana Esplugues
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Nursing Department, Faculty of Nursing and Chiropody, Universitat de València, Valencia, Spain.,Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Rosa Faner
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ferran Ballester
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Nursing Department, Faculty of Nursing and Chiropody, Universitat de València, Valencia, Spain.,Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Sadia Haider
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.,Dept of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria.,Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - Helena Backman
- Dept of Public Health and Clinical Medicine, Section for Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - John W Holloway
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK.,Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Gerard H Koppelman
- University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, University of Groningen, Groningen, The Netherlands.,Dept of Pediatric Pulmonology and Pediatric Allergology, University Medical Center Groningen, Beatrix Children's Hospital, University of Groningen, Groningen, The Netherlands
| | - Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Dept of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa, Spain.,BIODONOSTIA Health Research Institute, Donostia-San Sebastian, Spain
| | - Turid Lingaas Holmen
- Dept of Public Health and General Practice, HUNT Research Center, NTNU, Levanger, Norway
| | - Lesley Lowe
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester Academic Health Science Centre, NIHR, Manchester, UK.,Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Sara M Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Clare S Murray
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester Academic Health Science Centre, NIHR, Manchester, UK.,Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Graham Roberts
- David Hide Asthma and Allergy Research Centre, Newport, UK.,NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK.,Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Linnea Hedman
- Dept of Public Health and Clinical Medicine, Section for Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Vivi Schlünssen
- Dept of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Torben Sigsgaard
- Dept of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Angela Simpson
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester Academic Health Science Centre, NIHR, Manchester, UK.,Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,IMIM-Parc Salut Mar, Barcelona, Spain
| | | | - Stephen Turner
- Royal Aberdeen Children's Hospital NHS Grampian, Aberdeen, UK
| | - Maarten Van den Berge
- University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, University of Groningen, Groningen, The Netherlands.,Dept of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Roel C H Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Sigrid Anna Aalberg Vikjord
- Dept of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Levanger, Norway.,Dept of Medicine and Rehabilitation, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | | | - Anke H Maitland van der Zee
- Dept of Respiratory Medicine, Amsterdam University Medical Centers (UMC), University of Amsterdam.,Pediatric Respiratory Medicine, Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands.,Shared last authors
| | - Erik Melén
- Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.,Shared last authors
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15
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Ofenheimer A, Breyer-Kohansal R, Hartl S, Burghuber OC, Krach F, Franssen FME, Wouters EFM, Breyer MK. Using Body Composition Groups to Identify Children and Adolescents at Risk of Dyslipidemia. Children 2021; 8:children8111047. [PMID: 34828760 PMCID: PMC8625256 DOI: 10.3390/children8111047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/04/2021] [Accepted: 11/11/2021] [Indexed: 12/11/2022]
Abstract
The impact of body composition on the early origin of chronic diseases is an increasingly appreciated phenomenon. Little is known about the characteristics of children with varying body composition. The aim of this study was to investigate serum lipid profiles and other characteristics in relation to body composition. The data of 1394 participants (aged 6 to <18 years) of the observational general population-based Austrian LEAD Study have been analyzed. Body composition groups were defined by appendicular lean mass (ALMI) and fat mass (FMI) indices assessed by DXA. Serum lipid profiles (triglycerides, LDL-c, HDL-c) and other characteristics (e.g., prematurity, smoke exposure, physical activity, nutrition) were investigated in these body composition groups. Different body composition groups, which are not distinguishable by BMI, exist. Children with high ALMI and high FMI showed higher triglycerides and LDL-c, but lower HDL-c levels. In contrast, levels did not differ between those with high FMI but low (or normal) ALMI, and other body composition groups. BMI should be interpreted cautiously, and body composition should be measured by more precise techniques. In particular, children and adolescents with high FMI who have concomitantly high ALMI should be followed closely in future studies to investigate whether they are at increased risk of cardiovascular problems.
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Affiliation(s)
- Alina Ofenheimer
- Ludwig Boltzmann Institute for Lung Health, 1140 Vienna, Austria; (R.B.-K.); (S.H.); (O.C.B.); (E.F.M.W.); (M.-K.B.)
- NUTRIM, Maastricht University Medical Center, 6200 MD Maastricht, The Netherlands;
- Correspondence:
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, 1140 Vienna, Austria; (R.B.-K.); (S.H.); (O.C.B.); (E.F.M.W.); (M.-K.B.)
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, 1140 Vienna, Austria
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, 1140 Vienna, Austria; (R.B.-K.); (S.H.); (O.C.B.); (E.F.M.W.); (M.-K.B.)
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, 1140 Vienna, Austria
- Medical School, Sigmund Freud University, 1020 Vienna, Austria
| | - Otto C. Burghuber
- Ludwig Boltzmann Institute for Lung Health, 1140 Vienna, Austria; (R.B.-K.); (S.H.); (O.C.B.); (E.F.M.W.); (M.-K.B.)
- Medical School, Sigmund Freud University, 1020 Vienna, Austria
| | - Florian Krach
- Department of Mathematics, ETH Zürich, 8092 Zurich, Switzerland;
| | - Frits M. E. Franssen
- NUTRIM, Maastricht University Medical Center, 6200 MD Maastricht, The Netherlands;
- Department of Research and Education, CIRO, 6085 NM Horn, The Netherlands
| | - Emiel F. M. Wouters
- Ludwig Boltzmann Institute for Lung Health, 1140 Vienna, Austria; (R.B.-K.); (S.H.); (O.C.B.); (E.F.M.W.); (M.-K.B.)
- NUTRIM, Maastricht University Medical Center, 6200 MD Maastricht, The Netherlands;
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, 1140 Vienna, Austria; (R.B.-K.); (S.H.); (O.C.B.); (E.F.M.W.); (M.-K.B.)
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, 1140 Vienna, Austria
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16
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Allinson JP, Afzal S, Çolak Y, Jarvis D, Backman H, van den Berge M, Boezen HM, Breyer MK, Breyer-Kohansal R, Brusselle G, Burghuber OC, Faner R, Hartl S, Lahousse L, Langhammer A, Lundbäck B, Nwaru BI, Rönmark E, Vikjord SAA, Vonk JM, Wijnant SRA, Lange P, Nordestgaard BG, Olvera N, Agusti A, Donaldson GC, Wedzicha JA, Vestbo J, Vanfleteren LEGW. Changes in lung function in European adults born between 1884 and 1996 and implications for the diagnosis of lung disease: a cross-sectional analysis of ten population-based studies. Lancet Respir Med 2021; 10:83-94. [PMID: 34619103 DOI: 10.1016/s2213-2600(21)00313-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/10/2021] [Accepted: 06/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND During the past century, socioeconomic and scientific advances have resulted in changes in the health and physique of European populations. Accompanying improvements in lung function, if unrecognised, could result in the misclassification of lung function measurements and misdiagnosis of lung diseases. We therefore investigated changes in population lung function with birth year across the past century, accounting for increasing population height, and examined how such changes might influence the interpretation of lung function measurements. METHODS In our analyses of cross-sectional data from ten European population-based studies, we included individuals aged 20-94 years who were born between 1884 and 1996, regardless of previous respiratory diagnoses or symptoms. FEV1, forced vital capacity (FVC), height, weight, and smoking behaviour were measured between 1965 and 2016. We used meta-regression to investigate how FEV1 and FVC (adjusting for age, study, height, sex, smoking status, smoking pack-years, and weight) and the FEV1/FVC ratio (adjusting for age, study, sex, and smoking status) changed with birth year. Using estimates from these models, we graphically explored how mean lung function values would be expected to progressively deviate from predicted values. To substantiate our findings, we used linear regression to investigate how the FEV1 and FVC values predicted by 32 reference equations published between 1961 and 2015 changed with estimated birth year. FINDINGS Across the ten included studies, we included 243 465 European participants (mean age 51·4 years, 95% CI 51·4-51·5) in our analysis, of whom 136 275 (56·0%) were female and 107 190 (44·0%) were male. After full adjustment, FEV1 increased by 4·8 mL/birth year (95% CI 2·6-7·0; p<0·0001) and FVC increased by 8·8 mL/birth year (5·7-12·0; p<0·0001). Birth year-related increases in the FEV1 and FVC values predicted by published reference equations corroborated these findings. This height-independent increase in FEV1 and FVC across the last century will have caused mean population values to progressively exceed previously predicted values. However, the population mean adjusted FEV1/FVC ratio decreased by 0·11 per 100 birth years (95% CI 0·09-0·14; p<0·0001). INTERPRETATION If current diagnostic criteria remain unchanged, the identified shifts in European values will allow the easier fulfilment of diagnostic criteria for lung diseases such as chronic obstructive pulmonary disease, but the systematic underestimation of lung disease severity. FUNDING The European Respiratory Society, AstraZeneca, Chiesi Farmaceutici, GlaxoSmithKline, Menarini, and Sanofi-Genzyme.
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Affiliation(s)
- James P Allinson
- Department of Respiratory Medicine, Royal Brompton Hospital, London, UK; National Heart and Lung Institute, Imperial College London, London, UK.
| | - Shoaib Afzal
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yunus Çolak
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Department of Internal Medicine, Section of Respiratory Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Debbie Jarvis
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Helena Backman
- Department of Public Health and Clinical Medicine, The OLIN Unit, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Maarten van den Berge
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - H Marike Boezen
- Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
| | - Guy Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; Department of Respiratory Medicine, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands
| | - Otto C Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - Rosa Faner
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomedica en Red Enfermedades Respiratorias, Barcelona, Spain
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria; Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - Lies Lahousse
- Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Levanger, Norway; Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Bo Lundbäck
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Bright I Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, The OLIN Unit, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Sigrid A Aalberg Vikjord
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Levanger, Norway; Department of Medicine and Rehabilitation, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Judith M Vonk
- Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Sara R A Wijnant
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Peter Lange
- Department of Internal Medicine, Section of Respiratory Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nuria Olvera
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomedica en Red Enfermedades Respiratorias, Barcelona, Spain
| | - Alvar Agusti
- Càtedra Salut Respiratòria, Universitat Barcelona, Spain; Respiratory Institute, Hospital Clinic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomedica en Red Enfermedades Respiratorias, Barcelona, Spain
| | - Gavin C Donaldson
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK; North West Lung Centre, Manchester University National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Lowie E G W Vanfleteren
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; COPD Centre, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden
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17
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Breyer MK, Breyer-Kohansal R, Hartl S, Kundi M, Weseslindtner L, Stiasny K, Puchhammer-Stöckl E, Schrott A, Födinger M, Binder M, Fiedler M, Wouters EFM, Burghuber OC. Low SARS-CoV-2 seroprevalence in the Austrian capital after an early governmental lockdown. Sci Rep 2021; 11:10158. [PMID: 33980950 PMCID: PMC8115109 DOI: 10.1038/s41598-021-89711-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/27/2021] [Indexed: 01/08/2023] Open
Abstract
We analyzed SARS-CoV-2 seroprevalence in a large, well-described representative Viennese cohort after an early governmental lockdown with respect to the occurrence of symptoms and household transmission. Participants of the LEAD Study, a population-based cohort study from Vienna, Austria, were invited along with their household members (April 20th to May20th 2020). Sera were analyzed using anti-SARS-CoV-2 immunoassay including a neutralization test as a confirmatory assay. A total of 12,419 individuals participated (5984 LEAD participants; 6435 household members), 163 (1.31%; 59 LEAD cohort members) of whom were SARS-CoV-2 antibody positive. The estimated number of COVID-19 cases projected from our findings by age and sex for Vienna was 21,504 (1.13%). Cumulative number of positively tested cases in Vienna until May 20th 2020 was 3020, hence 7.1 times (95% confidence interval 5.5-9.1) lower than projected. Relative risk (RR) of seropositivity by age was highest for children aged 6-9 years [RR compared to age group 20-49: 1.21 (CI 0.37-4.01)], lowest for ≥ 65 years [RR 0.47 (CI 0.21-1.03)]. Half of the positive individuals developed no or mild symptoms. In a multivariate analysis, taste and smell disturbances were most strongly related to SARS-CoV-2 positivity. Infection probability within households with one confirmed SARS-CoV-2-specific antibody-positive person was 31%. Although seroprevalence was very low (1.13%) for a central European capital city, due to an early governmental lockdown, SARS-CoV-2 infections were more prevalent than officially reported polymerase chain reaction-positive cases. Of note, seroprevalence was highest in young children. Half of SARS-CoV-2 antibody-positive subjects had no or only mild symptoms. Taste and smell disturbances were most prominent, possibly guiding clinicians in diagnosing SARS-CoV-2 infection.
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Affiliation(s)
- Marie-Kathrin Breyer
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria.
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.
- Ludwig Boltzmann Institute for Lung Health, The Austrian LEAD Study, Klink Penzing, Gebäude G, 2. Stock, Sanatoriumstrasse 2, 1140, Vienna, Austria.
| | - Robab Breyer-Kohansal
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Sylvia Hartl
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Sigmund Freud University, Faculty of Medicine, Vienna, Austria
| | - Michael Kundi
- Center for Public Health, Medical University of Vienna, Vienna, Austria
| | | | - Karin Stiasny
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | | | - Andrea Schrott
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Manuela Födinger
- Sigmund Freud University, Faculty of Medicine, Vienna, Austria
- Institute of Laboratory Diagnostics, Clinic Favoriten, Vienna, Austria
| | | | - Markus Fiedler
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | | | - Otto C Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Sigmund Freud University, Faculty of Medicine, Vienna, Austria
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18
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Klausberger M, Duerkop M, Haslacher H, Wozniak-Knopp G, Cserjan-Puschmann M, Perkmann T, Lingg N, Aguilar PP, Laurent E, De Vos J, Hofner M, Holzer B, Stadler M, Manhart G, Vierlinger K, Egger M, Milchram L, Gludovacz E, Marx N, Köppl C, Tauer C, Beck J, Maresch D, Grünwald-Gruber C, Strobl F, Satzer P, Stadlmayr G, Vavra U, Huber J, Wahrmann M, Eskandary F, Breyer MK, Sieghart D, Quehenberger P, Leitner G, Strassl R, Egger AE, Irsara C, Griesmacher A, Hoermann G, Weiss G, Bellmann-Weiler R, Loeffler-Ragg J, Borth N, Strasser R, Jungbauer A, Hahn R, Mairhofer J, Hartmann B, Binder NB, Striedner G, Mach L, Weinhäusel A, Dieplinger B, Grebien F, Gerner W, Binder CJ, Grabherr R. A comprehensive antigen production and characterisation study for easy-to-implement, specific and quantitative SARS-CoV-2 serotests. EBioMedicine 2021; 67:103348. [PMID: 33906067 PMCID: PMC8099623 DOI: 10.1016/j.ebiom.2021.103348] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/15/2021] [Accepted: 04/02/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Antibody tests are essential tools to investigate humoral immunity following SARS-CoV-2 infection or vaccination. While first-generation antibody tests have primarily provided qualitative results, accurate seroprevalence studies and tracking of antibody levels over time require highly specific, sensitive and quantitative test setups. METHODS We have developed two quantitative, easy-to-implement SARS-CoV-2 antibody tests, based on the spike receptor binding domain and the nucleocapsid protein. Comprehensive evaluation of antigens from several biotechnological platforms enabled the identification of superior antigen designs for reliable serodiagnostic. Cut-off modelling based on unprecedented large and heterogeneous multicentric validation cohorts allowed us to define optimal thresholds for the tests' broad applications in different aspects of clinical use, such as seroprevalence studies and convalescent plasma donor qualification. FINDINGS Both developed serotests individually performed similarly-well as fully-automated CE-marked test systems. Our described sensitivity-improved orthogonal test approach assures highest specificity (99.8%); thereby enabling robust serodiagnosis in low-prevalence settings with simple test formats. The inclusion of a calibrator permits accurate quantitative monitoring of antibody concentrations in samples collected at different time points during the acute and convalescent phase of COVID-19 and disclosed antibody level thresholds that correlate well with robust neutralization of authentic SARS-CoV-2 virus. INTERPRETATION We demonstrate that antigen source and purity strongly impact serotest performance. Comprehensive biotechnology-assisted selection of antigens and in-depth characterisation of the assays allowed us to overcome limitations of simple ELISA-based antibody test formats based on chromometric reporters, to yield comparable assay performance as fully-automated platforms. FUNDING WWTF, Project No. COV20-016; BOKU, LBI/LBG.
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Affiliation(s)
- Miriam Klausberger
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria
| | - Mark Duerkop
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; Novasign GmbH Vienna, Austria
| | - Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Gordana Wozniak-Knopp
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; CD Laboratory for innovative Immunotherapeutics, Vienna, Austria
| | - Monika Cserjan-Puschmann
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria
| | - Thomas Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Nico Lingg
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria
| | - Patricia Pereira Aguilar
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria
| | - Elisabeth Laurent
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; BOKU Core Facility Biomolecular & Cellular Analysis, University of Natural Resources and Life Sciences (BOKU),Vienna, Austria
| | - Jelle De Vos
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; Department of Chemical Engineering, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Manuela Hofner
- Competence Unit Molecular Diagnostics, Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Barbara Holzer
- Austrian Agency for Health and Food Safety (AGES), Department for Animal Health, Moedling, Austria
| | - Maria Stadler
- Institute of Immunology, University of Veterinary Medicine, Vienna, Austria
| | - Gabriele Manhart
- Institute for Medical Biochemistry, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria
| | - Klemens Vierlinger
- Competence Unit Molecular Diagnostics, Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Margot Egger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz and Ordensklinikum Linz Barmherzige Schwestern, Linz, Austria
| | - Lisa Milchram
- Competence Unit Molecular Diagnostics, Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Elisabeth Gludovacz
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria
| | - Nicolas Marx
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria
| | - Christoph Köppl
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria
| | - Christopher Tauer
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria
| | - Jürgen Beck
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria
| | - Daniel Maresch
- BOKU Core Facility Mass Spectrometry, University of Natural Resources and Life Sciences (BOKU), Vienna, Austria
| | - Clemens Grünwald-Gruber
- BOKU Core Facility Mass Spectrometry, University of Natural Resources and Life Sciences (BOKU), Vienna, Austria; Department of Chemistry, University of Natural Resources and Life Sciences (BOKU) Vienna, Austria
| | | | - Peter Satzer
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria
| | - Gerhard Stadlmayr
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; CD Laboratory for innovative Immunotherapeutics, Vienna, Austria
| | - Ulrike Vavra
- Department of Applied Genetics and Cell Biology, University of Natural Resources and Life Sciences (BOKU) Vienna, Austria
| | - Jasmin Huber
- Competence Unit Molecular Diagnostics, Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Markus Wahrmann
- Department of Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Austria
| | - Farsad Eskandary
- Department of Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Austria
| | - Marie-Kathrin Breyer
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for Lung Health, Otto Wagner Hospital, Vienna, Austria
| | - Daniela Sieghart
- Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Austria
| | - Peter Quehenberger
- Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Gerda Leitner
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Austria
| | - Robert Strassl
- Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Alexander E Egger
- Central Institute for Medical and Chemical Laboratory Diagnosis, Innsbruck University Hospital, Innsbruck, Austria
| | - Christian Irsara
- Central Institute for Medical and Chemical Laboratory Diagnosis, Innsbruck University Hospital, Innsbruck, Austria
| | - Andrea Griesmacher
- Central Institute for Medical and Chemical Laboratory Diagnosis, Innsbruck University Hospital, Innsbruck, Austria
| | - Gregor Hoermann
- Central Institute for Medical and Chemical Laboratory Diagnosis, Innsbruck University Hospital, Innsbruck, Austria; MLL Munich Leukemia Laboratory, Munich, Germany
| | - Günter Weiss
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Rosa Bellmann-Weiler
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Judith Loeffler-Ragg
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Nicole Borth
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria
| | - Richard Strasser
- Department of Applied Genetics and Cell Biology, University of Natural Resources and Life Sciences (BOKU) Vienna, Austria
| | - Alois Jungbauer
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria
| | - Rainer Hahn
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria
| | | | - Boris Hartmann
- Austrian Agency for Health and Food Safety (AGES), Department for Animal Health, Moedling, Austria
| | - Nikolaus B Binder
- Technoclone Herstellung von Diagnostika und Arzneimitteln GmbH, Vienna, Austria
| | - Gerald Striedner
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; Novasign GmbH Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria; enGenes Biotech GmbH, Vienna, Austria
| | - Lukas Mach
- Department of Applied Genetics and Cell Biology, University of Natural Resources and Life Sciences (BOKU) Vienna, Austria
| | - Andreas Weinhäusel
- Competence Unit Molecular Diagnostics, Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Benjamin Dieplinger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz and Ordensklinikum Linz Barmherzige Schwestern, Linz, Austria
| | - Florian Grebien
- Institute for Medical Biochemistry, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria.
| | - Wilhelm Gerner
- Institute of Immunology, University of Veterinary Medicine, Vienna, Austria; Christian Doppler Laboratory for an Optimized Prediction of Vaccination Success in Pigs, University of Veterinary Medicine, Vienna, Austria; Present address: The Pirbright Institute, Pirbright, United Kingdom
| | - Christoph J Binder
- Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Reingard Grabherr
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria.
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Breyer-Kohansal R, Breyer MK, Wouters EF. Day-to-day variability of forced oscillatory mechanics for early detection of acute exacerbations in COPD. Eur Respir J 2020. [DOI: 10.1183/13993003.03849-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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20
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Perkmann T, Perkmann-Nagele N, Breyer MK, Breyer-Kohansal R, Burghuber OC, Hartl S, Aletaha D, Sieghart D, Quehenberger P, Marculescu R, Mucher P, Strassl R, Wagner OF, Binder CJ, Haslacher H. Side-by-Side Comparison of Three Fully Automated SARS-CoV-2 Antibody Assays with a Focus on Specificity. Clin Chem 2020; 66:1405-1413. [PMID: 32777031 PMCID: PMC7454460 DOI: 10.1093/clinchem/hvaa198] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/30/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND In the context of the COVID-19 pandemic, numerous new serological test systems for the detection of anti-SARS-CoV-2 antibodies rapidly have become available. However, the clinical performance of many of these is still insufficiently described. Therefore, we compared 3 commercial CE-marked, SARS-CoV-2 antibody assays side by side. METHODS We included a total of 1154 specimens from pre-COVID-19 times and 65 samples from COVID-19 patients (≥14 days after symptom onset) to evaluate the test performance of SARS-CoV-2 serological assays by Abbott, Roche, and DiaSorin. RESULTS All 3 assays presented with high specificities: 99.2% (98.6-99.7) for Abbott, 99.7% (99.2-100.0) for Roche, and 98.3% (97.3-98.9) for DiaSorin. In contrast to the manufacturers' specifications, sensitivities only ranged from 83.1% to 89.2%. Although the 3 methods were in good agreement (Cohen's Kappa 0.71-0.87), McNemar tests revealed significant differences between results obtained from Roche and DiaSorin. However, at low seroprevalences, the minor differences in specificity resulted in profound discrepancies of positive predictive values at 1% seroprevalence: 52.3% (36.2-67.9), 77.6% (52.8-91.5), and 32.6% (23.6-43.1) for Abbott, Roche, and DiaSorin, respectively. CONCLUSION We found diagnostically relevant differences in specificities for the anti-SARS-CoV-2 antibody assays by Abbott, Roche, and DiaSorin that have a significant impact on the positive predictive values of these tests.
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Affiliation(s)
- Thomas Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Marie-Kathrin Breyer
- Department of Respiratory and Critical Care Medicine, Otto Wagner Hospital, Vienna, Austria and Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Robab Breyer-Kohansal
- Department of Respiratory and Critical Care Medicine, Otto Wagner Hospital, Vienna, Austria and Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Otto C Burghuber
- Sigmund Freud University, Medical School and Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Sylvia Hartl
- Department of Respiratory and Critical Care Medicine, Otto Wagner Hospital, Vienna, Austria and Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.,Sigmund Freud University, Medical School and Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Daniel Aletaha
- Divison of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Daniela Sieghart
- Divison of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Peter Quehenberger
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Rodrig Marculescu
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Patrick Mucher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Robert Strassl
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Oswald F Wagner
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Christoph J Binder
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
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21
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Burghuber OC, Kirchbacher K, Mohn-Staudner A, Hochmair M, Breyer MK, Studnicka M, Mueller MR, Feurstein P, Schrott A, Lamprecht B, Eckmayr J, Renner F, Bolitschek J, Pohl W, Schenk P, Errhalt P, Cerkl P, Baumgartner B, Kneussl M, Hartl S. Results of the Austrian National Lung Cancer Audit. Clin Med Insights Oncol 2020; 14:1179554920950548. [PMID: 32963472 PMCID: PMC7488615 DOI: 10.1177/1179554920950548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/06/2020] [Indexed: 12/25/2022]
Abstract
Objectives: The Austrian Lung Cancer Audit (ALCA) is a pilot study to evaluate clinical and organizational factors related to lung cancer care across Austria. Materials and methods: The ALCA is a prospective, observational, noninterventional cohort study conducted in 17 departments in Austria between September 2013 and March 2015. Participating departments were selected based on an annual case load of >50 patients with lung cancer. Results: The ALCA included 745 patients, representing 50.5% of all newly diagnosed cancer cases during that time period. In 75.8% of patients, diagnosis was based on histology, and in 24.2% on cytology; 83.1% had non-small-cell lung cancer, 16.9% small-cell lung cancer; and only 4.6% had to be classified as not otherwise specified cancers. The median time elapsed between first presentation at hospital and diagnosis was 8 days (interquartile range [IQR]: 4-15; range: 0-132); between diagnosis and start of treatment it was 15 days for chemotherapy (IQR: 9-27; range: 0-83), 21 days (IQR: 10-35; range: 0-69) for radiotherapy, and 24 days (IQR: 11-36; range: 0-138) for surgery, respectively. In 150 patients undergoing surgical treatment, only 3 (2.0%; n = 147, 3 missings) were seen with postoperative restaging indicating unjustified surgery. One-year follow-up data were available for 723 patients, indicating excellent 49.8% survival; however, a wide range of survival between departments (range: 37.8-66.7) was seen. Conclusions: The ALCA conducted in high case load departments indicated management of lung cancer in accordance with international guidelines, and overall excellent 1-year survival.
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Affiliation(s)
- Otto C Burghuber
- First Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria.,Medical School, Sigmund Freud University, Vienna, Austria
| | - Klaus Kirchbacher
- Second Medical Department with Pneumology, Wilhelminenspital, Vienna, Austria
| | - Andrea Mohn-Staudner
- Second Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Maximilian Hochmair
- First Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Marie-Kathrin Breyer
- Second Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Michael Studnicka
- Department of Pneumology, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria
| | - Michael Rolf Mueller
- Medical School, Sigmund Freud University, Vienna, Austria.,Department of Thoracic Surgery and Karl Landsteiner Institute for Thoracic Oncology, Otto Wagner Hospital, Vienna, Austria
| | - Petra Feurstein
- Department of Radio-Oncology, Wilhelminenspital, Vienna, Austria
| | - Andrea Schrott
- First Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Bernd Lamprecht
- Department of Pneumology, General Hospital Linz, Linz, Austria
| | - Josef Eckmayr
- Department of Pneumology, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Friedrich Renner
- Department of Internal Medicine, Krankenhaus der Barmherzigen Schwestern Ried/Innkreis, Ried im Innkreis, Austria
| | - Josef Bolitschek
- Department of Pneumology, Krankenhaus der Elisabethinen, Linz, Austria.,Department of Pneumology, Klinikum Steyr, Steyr, Austria
| | - Wolfgang Pohl
- Department of Pneumology and Respiratory Diseases, Krankenhaus Hietzing-Rosenhügel, Vienna, Austria
| | - Peter Schenk
- Department of Pulmonology, Landesklinikum Hochegg, Hochegg, Austria
| | - Peter Errhalt
- Clinical Department of Pneumology, Landesklinikum Krems, Krems, Austria
| | - Peter Cerkl
- Department of Pulmonology, Landeskrankenhaus Hohenems, Hohenems, Austria
| | - Bernhard Baumgartner
- Department of Pulmonology, Salzkammergut Klinikum Vöcklabruck, Vöcklabruck, Austria
| | - Meinhard Kneussl
- Second Medical Department with Pneumology, Wilhelminenspital, Vienna, Austria
| | - Sylvia Hartl
- Second Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
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22
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Ofenheimer A, Breyer-Kohansal R, Hartl S, Burghuber OC, Altziebler J, Schrott A, Franssen FM, Wouters EF, Harreiter J, Kautzky-Willer A, Breyer MK. Metabolic syndrome and visceral adipose tissue (VAT) are associated with obstructive and restrictive lung function impairment. Epidemiology 2020. [DOI: 10.1183/13993003.congress-2020.2065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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23
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Breyer-Kohansal R, Faner R, Breyer MK, Ofenheimer A, Schrott A, Studnicka M, Wouters EFM, Burghuber OC, Hartl S, Agusti A. Factors Associated with Low Lung Function in Different Age Bins in the General Population. Am J Respir Crit Care Med 2020; 202:292-296. [DOI: 10.1164/rccm.202001-0172le] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Robab Breyer-Kohansal
- Otto Wagner HospitalVienna, Austria
- Ludwig Boltzmann Institute for COPD and Respiratory EpidemiologyVienna, Austria
| | - Rosa Faner
- CIBER Enfermedades RespiratoriasBarcelona, Spain
- Institut d’Investigacions Biomediques August Pi I SunyerBarcelona, Spain
| | - Marie-Kathrin Breyer
- Otto Wagner HospitalVienna, Austria
- Ludwig Boltzmann Institute for COPD and Respiratory EpidemiologyVienna, Austria
| | - Alina Ofenheimer
- Ludwig Boltzmann Institute for COPD and Respiratory EpidemiologyVienna, Austria
- Sigmund Freud UniversityVienna, Austria
- Maastricht University Medical CenterMaastricht, the Netherlands
| | - Andrea Schrott
- Ludwig Boltzmann Institute for COPD and Respiratory EpidemiologyVienna, Austria
| | | | | | - Otto C. Burghuber
- Ludwig Boltzmann Institute for COPD and Respiratory EpidemiologyVienna, Austria
- Sigmund Freud UniversityVienna, Austria
| | - Sylvia Hartl
- Otto Wagner HospitalVienna, Austria
- Ludwig Boltzmann Institute for COPD and Respiratory EpidemiologyVienna, Austria
- Sigmund Freud UniversityVienna, Austria
| | - Alvar Agusti
- CIBER Enfermedades RespiratoriasBarcelona, Spain
- Institut d’Investigacions Biomediques August Pi I SunyerBarcelona, Spain
- Hospital Clinic, University of BarcelonaBarcelona, Spain
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24
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Schnaubelt S, Breyer MK, Siller-Matula J, Domanovits H. Atrial fibrillation: a risk factor for unfavourable outcome in COVID-19? A case report. Eur Heart J Case Rep 2020; 4:1-6. [PMID: 33089045 PMCID: PMC7337643 DOI: 10.1093/ehjcr/ytaa166] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 04/21/2020] [Accepted: 05/19/2020] [Indexed: 12/31/2022]
Abstract
Background Fulminant cardiac involvement in COVID-19 patients has been reported; the underlying suspected mechanisms include myocarditis, arrhythmia, and cardiac tamponade. In parallel, atrial fibrillation is common in the elderly population which is at particularly high risk for COVID-19 morbidity and mortality. Case summary A 72-year-old male SARS-CoV2-positive patient was admitted to the intensive care unit due to delirium and acute respiratory failure. Atrial fibrillation known from history was exacerbated, and made complex rate and rhythm control necessary. Progressive heart failure with haemodynamic deterioration and acute kidney injury with the need for continuous renal replacement therapy were further aggravated by pericardial tamponade. Discussion Treatment of acute heart failure in COVID-19 patients with a cytokine storm complicated by tachycardic atrial fibrillation should include adequate rate or rhythm control, and potentially immunomodulation.
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Affiliation(s)
| | | | - Jolanta Siller-Matula
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.,Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CEPT), Medical University of Warsaw, Warsaw, Poland
| | - Hans Domanovits
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
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25
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Hartl S, Breyer MK, Burghuber OC, Ofenheimer A, Schrott A, Urban MH, Agusti A, Studnicka M, Wouters EFM, Breyer-Kohansal R. Blood eosinophil count in the general population: typical values and potential confounders. Eur Respir J 2020; 55:13993003.01874-2019. [PMID: 32060069 DOI: 10.1183/13993003.01874-2019] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 01/28/2020] [Indexed: 01/30/2023]
Abstract
There is growing interest in blood eosinophil counts in the management of chronic respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). Despite this, typical blood eosinophil levels in the general population, and the impact of potential confounders on these levels have not been clearly defined.We measured blood eosinophil counts in a random sample of 11 042 subjects recruited from the general population in Austria. We then: 1) identified factors associated with high blood eosinophil counts (>75th percentile); and 2) excluded subjects with these factors to estimate median blood eosinophil counts in a "healthy" sub-population (n=3641).We found that: 1) in the entire cohort, age ≤18 years (OR 2.41), asthma (OR 2.05), current smoking (OR 1.72), positive skin prick test (OR 1.64), COPD (OR 1.56), metabolic syndrome (OR 1.41), male sex (OR 1.36) and obesity (OR 1.16) were significantly (p<0.05) associated with high blood eosinophil counts (binary multivariable logistic regression analysis), and had an additive effect; and 2) after excluding these factors, in those older than 18 years, blood eosinophil counts were higher in males than in females (median 120 (5%-95% CI: 30-330) versus 100 (30-310) cells·µL-1, respectively) and did not change with age.Median blood eosinophil counts in adults are considerably lower than those currently regarded as normal, do not change with age beyond puberty, but are significantly influenced by a variety of factors which have an additive effect. These observations will contribute to the interpretation of blood eosinophil levels in clinical practice.
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Affiliation(s)
- Sylvia Hartl
- Second Dept of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria .,Sigmund Freud Medical University, Vienna, Austria
| | - Marie-Kathrin Breyer
- First Dept of Respiratory Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Otto C Burghuber
- Sigmund Freud Medical University, Vienna, Austria.,First Dept of Respiratory Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | | | - Andrea Schrott
- Second Dept of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Matthias H Urban
- First Dept of Respiratory Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Alvar Agusti
- Respiratory Institute, Hospital Clinic, IDIBAPS, University of Barcelona and National Spanish Network for Respiratory Research (CIBERES), Barcelona, Spain
| | - Michael Studnicka
- Dept of Respiratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Emiel F M Wouters
- Dept of Respiratory Medicine, MUMC, Maastricht University, Maastricht, The Netherlands
| | - Robab Breyer-Kohansal
- Second Dept of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
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26
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Ofenheimer A, Breyer-Kohansal R, Hartl S, Burghuber OC, Krach F, Schrott A, Wouters EFM, Franssen FME, Breyer MK. Reference values of body composition parameters and visceral adipose tissue (VAT) by DXA in adults aged 18-81 years-results from the LEAD cohort. Eur J Clin Nutr 2020; 74:1181-1191. [PMID: 32123345 PMCID: PMC7402993 DOI: 10.1038/s41430-020-0596-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/05/2020] [Accepted: 02/19/2020] [Indexed: 11/21/2022]
Abstract
Background Increasing attention has been drawn on the assessment of body composition phenotypes, since the distribution of soft tissue influences cardio-metabolic risk. Dual-energy X-ray absorptiometry (DXA) is a validated technique to assess body composition. European reference values from population-based cohorts are rare. Aims To provide age- and sex-related reference values of body composition parameters and visceral adipose tissue (VAT) mass, and for lean mass index (LMI) with regard to fat mass index (FMI) quantities and BMI categories. Methods GE-Lunar Prodigy DXA scans of 10.894 participants, aged 18–81 years, recruited from 2011 to 2019 by the Austrian LEAD study, a population-based cohort study, have been used to construct reference curves using the LMS method. Parameters assessed are FMI, LMI, appendicular LMI, fat mass ratios android/gynoid and trunk/limbs, and VAT. Results All lean mass and fat mass parameters indicating central fat accumulation were higher in men, whereas other fat mass indices were higher in women. LMI differed between each FMI subgroup (low vs. normal, low vs. high, normal vs. high), and BMI category in all ages and LMI increased with FMI and BMI classes. VAT mass was higher in men compared with women and increased across all age groups within both sexes. Conclusion The present study provides age- and sex-related reference values for European adults aged 18–81 years for body composition parameters and VAT mass for Lunar Prodigy DXA. In addition, this study reports LMI reference values with regard to fat mass quantities, showing a positive association with increasing FMI percentiles and BMI categories.
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Affiliation(s)
- Alina Ofenheimer
- NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands.,Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria.,Medical School, Sigmund Freud University, Vienna, Austria
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria.,Department for Respiratory and Critical Care Medicine, Otto Wagner Hospital, Vienna, Austria
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria.,Medical School, Sigmund Freud University, Vienna, Austria.,Department for Respiratory and Critical Care Medicine, Otto Wagner Hospital, Vienna, Austria
| | - Otto C Burghuber
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria.,Medical School, Sigmund Freud University, Vienna, Austria
| | - Florian Krach
- Department of Mathematics, ETH Zurich, Zurich, Switzerland
| | - Andrea Schrott
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Emiel F M Wouters
- NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands.,Department of Research and Education, CIRO, Horn, the Netherlands
| | - Frits M E Franssen
- NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands.,Department of Research and Education, CIRO, Horn, the Netherlands
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria. .,Department for Respiratory and Critical Care Medicine, Otto Wagner Hospital, Vienna, Austria.
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27
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Breyer MK, Ofenheimer A, Altziebler J, Hartl S, Burghuber OC, Studnicka M, Purin D, Heinzle C, Drexel H, Franssen FME, Wouters EFM, Harreiter J, Kautzky-Willer A, Breyer-Kohansal R. Marked differences in prediabetes- and diabetes-associated comorbidities between men and women-Epidemiological results from a general population-based cohort aged 6-80 years-The LEAD (Lung, hEart, sociAl, boDy) study. Eur J Clin Invest 2020; 50:e13207. [PMID: 31997311 DOI: 10.1111/eci.13207] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 12/29/2019] [Accepted: 01/25/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Based on biological and behavioural diversity sex and gender may affect comorbidities associated with prediabetes and diabetes. Besides evaluating the prevalence of prediabetes and diabetes (using fasting plasma glucose and HbA1c levels), the primary aim of the study is to investigate sex and gender differences in the prevalence of comorbidities in subjects with prediabetes and diabetes and to identify possible risk factors associated with prediabetes and diabetes. DESIGN This observational, population-based cohort study included 11.014 subjects aged 6-80 years. Examinations included blood samples, ankle-brachial index, ECG, dual-energy X-ray absorptiometry scan and an interviewer-administered questionnaire. RESULTS Across all ages, prevalence of prediabetes was 20.2% (male 23.6%; female 17.1%), and 5.4% for diabetes (male 7.3%; female 3.7%). The prevalence of prediabetes ranged from 4.4% (6-<10 years) up to 40.4% (70+ years) in men and from 4.8% up to 42.3% in women. Comorbidity profile was markedly different between male and female, particularly in those with prediabetes: women more often suffered from arrhythmia, noncoronary artery disease, osteoporosis, increased systemic inflammatory biomarkers and depression, while men with prediabetes more often showed angina pectoris, myocardial infarction and media sclerosis. CONCLUSIONS The unexpected 4.6% prevalence of prediabetes in children aged 6-10 underscores the need for population-based studies across all ages and the onset of prevention of diabetes at a young age. Marked differences have been found in comorbidities as men with prediabetes and diabetes more often suffer from cardiovascular disease, while women more often show arrhythmia, noncoronary artery disease, increased systemic inflammatory biomarkers and depression.
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Affiliation(s)
- Marie-Kathrin Breyer
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Alina Ofenheimer
- Sigmund Freud University, Medical School and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Julia Altziebler
- Karl Landsteiner University, Human Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Sylvia Hartl
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria.,Sigmund Freud University, Medical School and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Otto C Burghuber
- Sigmund Freud University, Medical School and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Michael Studnicka
- Department of Respiratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Daniela Purin
- Vivit-Institute, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Christine Heinzle
- Vivit-Institute, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Heinz Drexel
- Vivit-Institute, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Frits M E Franssen
- Department of Respiratory Medicine+, MUMC+, Maastricht University, Maastricht, The Netherlands
| | - Emiel F M Wouters
- Department of Respiratory Medicine+, MUMC+, Maastricht University, Maastricht, The Netherlands
| | - Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Robab Breyer-Kohansal
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
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Breyer-Kohansal R, Hartl S, Burghuber OC, Urban M, Schrott A, Agusti A, Sigsgaard T, Vogelmeier C, Wouters E, Studnicka M, Breyer MK. The LEAD (Lung, Heart, Social, Body) Study: Objectives, Methodology, and External Validity of the Population-Based Cohort Study. J Epidemiol 2019; 29:315-324. [PMID: 30344197 PMCID: PMC6614076 DOI: 10.2188/jea.je20180039] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 07/08/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The Lung, hEart, sociAl, boDy (LEAD) Study (ClinicalTrials.gov; NCT01727518; http://clinicaltrials.gov) is a longitudinal, observational, population-based Austrian cohort that aims to investigate the relationship between genetic, environmental, social, developmental and ageing factors influencing respiratory health and comorbidities through life. The general working hypothesis of LEAD is the interaction of these genetic, environmental and socioeconomic factors influences lung development and ageing, the risk of occurrence of several non-communicable diseases (respiratory, cardiovascular, metabolic and neurologic), as well as their phenotypic (ie, clinical) presentation. METHODS LEAD invited from 2011-2016 a random sample (stratified by age, gender, residential area) of Vienna inhabitants (urban cohort) and all the inhabitants of six villages from Lower Austria (rural cohort). Participants will be followed-up every four years. A number of investigations and measurements were obtained in each of the four domains of the study (Lung, hEart, sociAl, boDy) including data to screen for lung, cardiovascular and metabolic diseases, osteoporosis, and cognitive function. Blood and urine samples are stored in a biobank for future investigations. RESULTS A total of 11.423 males (47.6%) and females (52.4%), aged 6-80 years have been included in the cohort. Compared to governmental statistics, the external validity of LEAD with respect to age, gender, citizenship, and smoking status was high. CONCLUSIONS In conclusion, the LEAD cohort has been established following high quality standards; it is representative of the Austrian population and offers a platform to understand lung development and ageing as a key mechanism of human health both in early and late adulthood.
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Affiliation(s)
- Robab Breyer-Kohansal
- First Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Sylvia Hartl
- Second Department of Respiratory Medicine, Otto Wagner Hospital, Vienna, Austria
| | - Otto Chris Burghuber
- First Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, and Sigmund Freud University, Medical School, Vienna, Austria
| | - Matthias Urban
- First Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Andrea Schrott
- First Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Alvar Agusti
- Respiratory Institute, Hospital Clinic, IDIBAPS, University of Barcelona and National Spanish Network for Respiratory Research (CIBERES), Barcelona, Spain
| | - Torben Sigsgaard
- Institute of Public Health, Environmental and Occupational Medicine, Aarhus University, Aarhus, Denmark
| | - Claus Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Marburg, Germany
| | - Emiel Wouters
- Department of Respiratory Medicine+, MUMC+, Maastricht University, Maastricht, the Netherlands
| | - Michael Studnicka
- Department of Respiratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Marie-Kathrin Breyer
- First Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
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Breyer-Kohansal R, Hartl S, Breyer MK, Schrott A, Studnicka M, Neunhäuserer D, Fülöp G, Burghuber OC. The European COPD audit : Adherence to guidelines, readmission risk and hospital care for acute exacerbations in Austria. Wien Klin Wochenschr 2019; 131:97-103. [PMID: 30689047 DOI: 10.1007/s00508-019-1441-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 01/05/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are the major reason for COPD hospitalization and increased risk for readmissions. The organizational structure of Austrian hospitals provides the opportunity to investigate the impact of specialized respiratory care compared to general care on adherence to guidelines and readmission in AECOPD. METHODS The data from the European COPD audit, a prospective observational non-interventional cohort trial were analyzed. In total, 823 patients admitted due to AECOPD in 26 hospitals (specialized respiratory care vs. general care) within Austria were included. Patients characteristics and outcomes (length of stay, readmission rate, and mortality) were analyzed in relation to hospital resources (personnel and equipment) and adherence to international guidelines. RESULTS Patients admitted to general care had more comorbidities (Charlson comorbidity index: 2.6 ± 1.7 vs. 2.0 ± 1.4; p < 0.05) and a shorter length of stay (10.7 ± 7.8 days vs. 12.0 ± 10.2 days; p < 0.05). Patients admitted to specialized respiratory care more often underwent blood gas analysis and non-invasive ventilation (98.4% vs. 81.5% and 68.6% vs. 26.7%, p < 0.01; respectively). In multivariate analysis, the risk for AECOPD readmission was lower (odds ratio, OR 0.72 [0.51;0.91]; p < 0.05) in patients admitted to specialized respiratory care. CONCLUSION A greater adherence to COPD guidelines with respect to blood gas analysis and non-invasive ventilation and decreased AECOPD readmission risk was observed for patients admitted to specialized respiratory care. Adherence to guidelines may have the potential to decrease COPD readmission rates.
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Affiliation(s)
- Robab Breyer-Kohansal
- 1st Department of Respiratory and Critical Care Medicine, Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Sanatoriumstraße 2, 1140, Vienna, Austria.
| | - Sylvia Hartl
- 2nd Department of Respiratory and Critical Care Medicine, Otto Wagner Hospital, Vienna, Austria.,Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - Marie-Kathrin Breyer
- 1st Department of Respiratory and Critical Care Medicine, Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Sanatoriumstraße 2, 1140, Vienna, Austria
| | | | - Michael Studnicka
- University Clinic of Respiratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Daniel Neunhäuserer
- University Clinic of Respiratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | | | - Otto Chris Burghuber
- 1st Department of Respiratory and Critical Care Medicine, Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Sanatoriumstraße 2, 1140, Vienna, Austria.,Faculty of Medicine, Sigmund Freud University, Vienna, Austria
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Fazekas AS, Aboulghaith M, Kriz RC, Urban M, Breyer MK, Breyer-Kohansal R, Burghuber OC, Hartl S, Funk GC. Long-term outcomes after acute hypercapnic COPD exacerbation : First-ever episode of non-invasive ventilation. Wien Klin Wochenschr 2018; 130:561-568. [PMID: 30066095 PMCID: PMC6209011 DOI: 10.1007/s00508-018-1364-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 07/04/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Non-invasive ventilation (NIV) is used to treat acute hypercapnic respiratory failure (AHRF) in patients with chronic obstructive pulmonary disease (COPD); however, long-term outcomes following discharge are largely unknown. This study aimed to characterize long-term outcomes and identify associated markers in patients with COPD after surviving the first episode of HRF requiring NIV. METHODS This study retrospectively analyzed 122 patients, mean age 62 ± 8 years, 52% female and forced expiratory volume in 1 s (FEV1) predicted 30 ± 13%, admitted with an acute hypercapnic exacerbation of COPD and receiving a first-ever NIV treatment between 2000 and 2012. RESULTS A total of 40% of the patients required hospital readmission due to respiratory reasons within 1 year. Persistent hypercapnia leading to the prescription of domiciliary NIV, older age and lower body mass index (BMI) were risk factors for readmission due to respiratory reasons. Survival rates were 79% and 63% at 1 and 2 years after discharge, respectively. A shorter time to readmission and recurrent hypercapnic failure, lower BMI and acidemia on the first admission, as well as hypercapnia at hospital discharge were correlated with a decreased long-term survival. CONCLUSION Patients with COPD surviving their first episode of AHRF requiring NIV are at high risk for readmission and death. Severe respiratory acidosis, chronic respiratory failure and a lower BMI imply shorter long-term survival.
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Affiliation(s)
- Andreas S Fazekas
- Department of Respiratory Medicine and Critical Care, Otto Wagner Hospital, Baumgartner Höhe 1, 1140, Vienna, Austria
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Mei Aboulghaith
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Ruxandra C Kriz
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Matthias Urban
- Department of Respiratory Medicine and Critical Care, Otto Wagner Hospital, Baumgartner Höhe 1, 1140, Vienna, Austria
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Marie-Kathrin Breyer
- Department of Respiratory Medicine and Critical Care, Otto Wagner Hospital, Baumgartner Höhe 1, 1140, Vienna, Austria
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Robab Breyer-Kohansal
- Department of Respiratory Medicine and Critical Care, Otto Wagner Hospital, Baumgartner Höhe 1, 1140, Vienna, Austria
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Otto-Chris Burghuber
- Department of Respiratory Medicine and Critical Care, Otto Wagner Hospital, Baumgartner Höhe 1, 1140, Vienna, Austria
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Sylvia Hartl
- Department of Respiratory Medicine and Critical Care, Otto Wagner Hospital, Baumgartner Höhe 1, 1140, Vienna, Austria
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Georg-Christian Funk
- Department of Respiratory Medicine and Critical Care, Otto Wagner Hospital, Baumgartner Höhe 1, 1140, Vienna, Austria.
- Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria.
- Medical University of Vienna, Vienna, Austria.
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Ofenheimer A, Breyer MK, Urban M, Hartl S, Burghuber OC, Schrott A, Breyer-Kohansal R. Risk factors of abnormal lung function in children and adolescents – data from the LEAD (Lung, hEart, sociAl, boDy) Study. Epidemiology 2018. [DOI: 10.1183/13993003.congress-2018.pa4482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Breyer-Kohansal R, Breyer MK, Hartl S, Burghuber OC. [The Austrian LEAD (Lung hEart sociAL boDy) Study: Background of the Austrian Longitudinal Cohort Study]. Pneumologie 2015; 69:459-62. [PMID: 26258419 DOI: 10.1055/s-0034-1392516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
More research is needed to elucidate natural history and underlying pathomechanisms of the most common airway diseases, Asthma and COPD. In the last decade risk factors affecting the natural history of lung function, defined by the decline of lung function over time, have been evaluated. Moreover, scientific methods have been extended and novel biomarkers, genetics, metabolomics, and epidemiology are dominant tools for investigating the natural history of lung function and potential risk factors. Evidence shows that lung function in childhood is a predictor for lung function in adulthood and risk factors starting in utero contribute to lung function decline during life. Therefore, recently it has been hypothesized that COPD begins in childhood. Thus, prospective investigation of lung function changes including novel scientific methodology has been advocated. The Austrian LEAD study has been initiated in the general population 2012 to investigate the natural history of obstructive airway diseases.
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Affiliation(s)
- R Breyer-Kohansal
- Ludwig Boltzmann Institut für COPD und pneumologische Epidemiologie, Wien, Österreich
| | - M K Breyer
- Ludwig Boltzmann Institut für COPD und pneumologische Epidemiologie, Wien, Österreich
| | - S Hartl
- Ludwig Boltzmann Institut für COPD und pneumologische Epidemiologie, Wien, Österreich
| | - O C Burghuber
- Ludwig Boltzmann Institut für COPD und pneumologische Epidemiologie, Wien, Österreich
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Breyer MK, Spruit MA, Hanson CK, Franssen FME, Vanfleteren LEGW, Groenen MTJ, Bruijnzeel PLB, Wouters EFM, Rutten EPA. Prevalence of metabolic syndrome in COPD patients and its consequences. PLoS One 2014; 9:e98013. [PMID: 24950070 PMCID: PMC4064974 DOI: 10.1371/journal.pone.0098013] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/28/2014] [Indexed: 11/19/2022] Open
Abstract
Background The prevalence of metabolic syndrome in COPD patients and its impact on patient related outcomes has been little studied. We evaluated the prevalence of metabolic syndrome and clinical and functional characteristics in patients with COPD and healthy subjects. Methods 228 COPD patients and 156 healthy subjects were included. Metabolic syndrome was defined using criteria of the IDF. In all patients spirometry, body composition, functional exercise performance, and mood and health status were assessed. Groups were stratified for BMI and gender. Results Metabolic syndrome was present in 57% of the COPD patients and 40% of the healthy subjects. After stratification for BMI, presence of metabolic syndrome in patients with a BMI ≥25 kg/m2 was higher than in healthy peers. Patients with metabolic syndrome and a BMI <25 kg/m2 had higher BMI, fat free mass index and bone mineral density, and a lower 6MWD than the BMI matched patients without metabolic syndrome. Spirometry, maximal ergometry, mood and health status, and blood gases were not different between those groups. In COPD patients with metabolic syndrome self-reported co-morbidities and medication use were higher than in those without. Conclusion Metabolic syndrome is more prevalent in overweight or obese COPD patients than in BMI matched healthy subjects. Metabolic syndrome did not additionally impact patients' functional outcomes, but did impact the prevalence of co-morbidities.
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Affiliation(s)
- Marie-Kathrin Breyer
- Department of Respiratory Medicine, Maastricht University Medical Center + (MUMC+), Maastricht, the Netherlands
- Program Development Center (CIRO), Center of expertise for chronic organ failure, Horn, the Netherlands
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Pulmonary Epidemiology, Otto Wagner Hospital, Vienna, Austria
- * E-mail:
| | - Martijn A. Spruit
- Program Development Center (CIRO), Center of expertise for chronic organ failure, Horn, the Netherlands
| | - Corrine K. Hanson
- Division of Medical Nutrition Education, School of Allied Health Professions, University of Nebraska Medical Center, Ohmaha, Nebraska, United States of America
| | - Frits M. E. Franssen
- Program Development Center (CIRO), Center of expertise for chronic organ failure, Horn, the Netherlands
| | | | - Miriam T. J. Groenen
- Program Development Center (CIRO), Center of expertise for chronic organ failure, Horn, the Netherlands
| | | | - Emiel F. M. Wouters
- Department of Respiratory Medicine, Maastricht University Medical Center + (MUMC+), Maastricht, the Netherlands
- Program Development Center (CIRO), Center of expertise for chronic organ failure, Horn, the Netherlands
| | - Erica P. A. Rutten
- Program Development Center (CIRO), Center of expertise for chronic organ failure, Horn, the Netherlands
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Abstract
BACKGROUND Research concerning the involvement of body composition and systemic inflammatory markers in adipokine metabolism in chronic obstructive pulmonary disease (COPD) is still limited. Therefore, we primarily aimed to investigate the adipokine metabolism in relation to these systemic inflammatory biomarkers and to evaluate possible gender-related differences in the adipokine metabolism in patients with COPD. MATERIALS AND METHODS One hundred and eighty-six subjects with COPD [mean (SD) FEV(1) %pred: 50 (±16)] and 113 controls, matched for age, gender and body composition were selected from the ECLIPSE cohort. The following serological data were collected: serum levels of leptin, adiponectin and systemic inflammatory biomarkers such as C-reactive protein (CRP), Interleukin-6 (IL-6) and fibrinogen. RESULTS Compared with controls, patients with COPD had higher levels of CRP, IL-6, fibrinogen and adiponectin. After stratification for gender, men with COPD had higher CRP, IL6 and fibrinogen levels compared with male controls, while women with COPD had higher levels of CRP and fibrinogen compared with the female controls. Moreover, in both female controls and patients with COPD, leptin correlated with CRP and fibrinogen, while leptin only correlated with CRP in male controls. Adiponectin correlated negatively with CRP, only in patients with COPD. Body mass index and gender were the strongest determinants for both leptin and adiponectin. CONCLUSIONS This study shows a gender-dependent dysregulation of adipokine metabolism in patients with COPD compared with BMI-matched controls. Furthermore, results from this study suggest a more prominent role of adiponectin in the systemic response to COPD.
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Affiliation(s)
- Marie-Kathrin Breyer
- Department of Respiratory Medicine, Maastricht University Medical Centre+ (MUMC+) Centre of Expertise for Chronic Organ Failure (Ciro), Horn, the Netherlands
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Breyer MK, Rutten EP, Vernooy JH, Spruit MA, Dentener MA, van der Kallen C, vanGreevenbroek MM, Wouters EF. Gender differences in the adipose secretome system in chronic obstructive pulmonary disease (COPD): A pivotal role of leptin. Respir Med 2011; 105:1046-53. [DOI: 10.1016/j.rmed.2011.02.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2010] [Revised: 01/27/2011] [Accepted: 02/03/2011] [Indexed: 11/30/2022]
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Funk GC, Breyer MK, Burghuber OC, Kink E, Kirchheiner K, Kohansal R, Schmidt I, Hartl S. Long-term non-invasive ventilation in COPD after acute-on-chronic respiratory failure. Respir Med 2011; 105:427-34. [PMID: 21111590 DOI: 10.1016/j.rmed.2010.09.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 08/06/2010] [Accepted: 09/06/2010] [Indexed: 10/18/2022]
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Breyer MK, Breyer-Kohansal R, Funk GC, Dornhofer N, Spruit MA, Wouters EFM, Burghuber OC, Hartl S. Nordic walking improves daily physical activities in COPD: a randomised controlled trial. Respir Res 2010; 11:112. [PMID: 20727209 PMCID: PMC2933683 DOI: 10.1186/1465-9921-11-112] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Accepted: 08/22/2010] [Indexed: 11/14/2022] Open
Abstract
Background In patients with COPD progressive dyspnoea leads to a sedentary lifestyle. To date, no studies exist investigating the effects of Nordic Walking in patients with COPD. Therefore, the aim was to determine the feasibility of Nordic Walking in COPD patients at different disease stages. Furthermore we aimed to determine the short- and long-term effects of Nordic Walking on COPD patients' daily physical activity pattern as well as on patients exercise capacity. Methods Sixty COPD patients were randomised to either Nordic Walking or to a control group. Patients of the Nordic Walking group (n = 30; age: 62 ± 9 years; FEV1: 48 ± 19% predicted) underwent a three-month outdoor Nordic Walking exercise program consisting of one hour walking at 75% of their initial maximum heart rate three times per week, whereas controls had no exercise intervention. Primary endpoint: daily physical activities (measured by a validated tri-axial accelerometer); secondary endpoint: functional exercise capacity (measured by the six-minute walking distance; 6MWD). Assessment time points in both groups: baseline, after three, six and nine months. Results After three month training period, in the Nordic Walking group time spent walking and standing as well as intensity of walking increased (Δ walking time: +14.9 ± 1.9 min/day; Δ standing time: +129 ± 26 min/day; Δ movement intensity: +0.40 ± 0.14 m/s2) while time spent sitting decreased (Δ sitting time: -128 ± 15 min/day) compared to baseline (all: p < 0.01) as well as compared to controls (all: p < 0.01). Furthermore, 6MWD significantly increased compared to baseline (Δ 6MWD: +79 ± 28 meters) as well as compared to controls (both: p < 0.01). These significant improvements were sustained six and nine months after baseline. In contrast, controls showed unchanged daily physical activities and 6MWD compared to baseline for all time points. Conclusions Nordic Walking is a feasible, simple and effective physical training modality in COPD. In addition, Nordic Walking has proven to positively impact the daily physical activity pattern of COPD patients under short- and long-term observation. Clinical trial registration Nordic Walking improves daily physical activities in COPD: a randomised controlled trial - ISRCTN31525632
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Affiliation(s)
- Marie-Kathrin Breyer
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Sanatoriumstreet 2, 1140 Vienna, Austria.
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Breyer MK, Spruit MA, Celis AP, Rutten EP, Janssen PP, Wouters EF. Highly elevated C-reactive protein levels in obese patients with COPD: A fat chance? Clin Nutr 2009; 28:642-7. [DOI: 10.1016/j.clnu.2009.05.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Revised: 04/07/2009] [Accepted: 05/06/2009] [Indexed: 10/20/2022]
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Kaufmann M, Hartl S, Geyer K, Breyer MK, Burghuber OC. Measuring FEV(6) for detecting early airway obstruction in the primary care setting. Quality and utility of the new PiKo-6 device. ACTA ACUST UNITED AC 2009; 78:161-7. [PMID: 19174602 DOI: 10.1159/000197466] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2008] [Accepted: 11/12/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND The prevalence of asthma and chronic obstructive pulmonary disease (COPD) is high ( approximately 7.4-18%) in the general population, but less than half are diagnosed. Several studies have shown FEV(6) as a good surrogate marker for forced vital capacity (FVC) to detect airflow limitations. OBJECTIVES The aim of this study was to evaluate if it is possible to simplify and improve the diagnosis of so far undiagnosed asthma or COPD in the primary care setting by measuring FEV(6) with a new simple screening device (PiKo-6). METHODS 507 patients were recruited from three general practices from May to June 2005. Patients with any known pulmonary disease were excluded by questionnaire. FEV(1), FEV(6) and FEV(1)/FEV(6) were determined using a PiKo-6 device. Patients with an FEV(1)/FEV(6) <80% (PiKo positive) were invited to a standardized pulmonary function test to confirm or rule out airflow limitation. RESULTS 401 (79.1%) patients showed FEV(1)/FEV(6) > or =80% (PiKo negative), and 106 (20.9%) patients were PiKo positive. Of the 106 PiKo-positive patients, 74 patients (14.7% of total) agreed to further studies and 18 patients (3.6%) of them suffered from COPD [COPD 0: 5 (1.0%); COPD I: 9 (1.8%); COPD II: 4 (0.8%), and none with COPD III or IV] and 14 patients (2.8%) suffered from bronchial hyperresponsiveness or asthma. In 42 patients (8.3%), the pulmonary function test was normal. CONCLUSIONS Measurement of FEV(6) using a new simple screening device (PiKo-6) may improve the detection rate of undiagnosed airflow limitation in the primary care setting. However, patients should be carefully selected.
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Affiliation(s)
- M Kaufmann
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD, Otto Wagner Hospital, Vienna, Austria.
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Pitta F, Breyer MK, Hernandes NA, Teixeira D, Sant'Anna TJP, Fontana AD, Probst VS, Brunetto AF, Spruit MA, Wouters EFM, Burghuber OC, Hartl S. Comparison of daily physical activity between COPD patients from Central Europe and South America. Respir Med 2008; 103:421-6. [PMID: 19006659 DOI: 10.1016/j.rmed.2008.09.019] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Revised: 09/20/2008] [Accepted: 09/24/2008] [Indexed: 02/08/2023]
Abstract
BACKGROUND In healthy elderly and adults, lower physical activity level in daily life has been associated with lower socio-economic level and non-Caucasian race. The objective of this study was to determine if this is also applicable in chronic obstructive pulmonary disease (COPD) by comparing physical activity levels in daily life in stable patients from two countries (Austria and Brazil) with different socio-economic and ethnic characteristics. METHODS Physical activity in daily life was objectively assessed in 40 Austrian and 40 Brazilian COPD patients. Groups were matched for age, gender, body mass index, disease severity, smoking history, presence of concomitant heart disease, lung function, dyspnea and functional exercise capacity. In addition, climatic conditions were similar during the period of data collection in the two groups. RESULTS In comparison to Brazilian patients, Austrian patients had a significantly lower walking time (p=0.04), higher sitting time (p=0.02) and lower movement intensity (p=0.0001). The proportion of patients who did not reach an average of 30min of walking per day was 48% in the Austrian group and 23% in the Brazilian group. CONCLUSIONS Austrian patients with COPD showed a significantly lower daily physical activity level in comparison to matched Brazilian patients. Socio-economic and ethnic factors appear to influence stable COPD patients differently than described in previous studies including healthy subjects.
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Affiliation(s)
- Fábio Pitta
- Departamento de Fisioterapia, Universidade Estadual de Londrina, Brazil.
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