Prevalence, risk factors, and clinical implications of preserved ratio impaired spirometry:a UK Biobank cohort analysis
| Autor: | George Davey Smith, James W. Dodd, Daniel H Higbee, Raquel Granell |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Pulmonary and Respiratory Medicine
Spirometry Adult Male medicine.medical_specialty Vital capacity Population Vital Capacity Cohort Studies FEV1/FVC ratio Pulmonary Disease Chronic Obstructive Risk Factors Internal medicine Forced Expiratory Volume medicine Prevalence Humans education Lung Survival analysis Biological Specimen Banks education.field_of_study COPD medicine.diagnostic_test business.industry Odds ratio medicine.disease United Kingdom Female business Cohort study |
| Zdroj: | Higbee, D H, Granell, R, Davey Smith, G & Dodd, J 2022, ' Prevalence, risk factors, and clinical implications of preserved ratio impaired spirometry : a UK Biobank cohort analysis ', Lancet Respiratory Medicine, vol. 10, no. 2, pp. 149-157 . https://doi.org/10.1016/S2213-2600(21)00369-6 |
| DOI: | 10.1016/S2213-2600(21)00369-6 |
| Popis: | BackgroundPreserved ratio impaired spirometry (PRISm) is defined as a FEV1 of less than 80% predicted and a FEV1/forced vital capacity (FVC) ratio of 0·70 or higher. Previous research has indicated that PRISm is associated with respiratory symptoms and is a precursor of chronic obstructive pulmonary disease (COPD). However, these findings are based on relatively small selective cohorts with short follow-up. We aimed to determine the prevalence, risk factors, clinical implications, and mortality of PRISm in a large adult general population.MethodsFor this cohort analysis, we used data from the UKBiobank to assess PRISm prevalence, risk factors and associated symptoms, and associated comorbidities in a large adult population. Participants with spirometry deemed acceptable by an investigator (best measure FEV1 and FVC values) at baseline were included. Participants were excluded if they did not have acceptable spirometry or were missing data on body-mass index or smoking status. Control spirometry was defined as a FEV1 of 80% or more predicted and a FEV1/FVC ratio of 0·70 or higher. Airflow obstruction was defined as a FEV1/FVC ratio of less than 0·70. We used multivariable regression to determine risk factors for PRISm and associated comorbidities. Individuals who lived within close proximity to an assessment centre were invited for follow-up, with repeat spirometry. Only participants who had been included at baseline were examined in follow-up. This allowed for a longitudinal analysis of PRISm over time and risk factors for transition to airflow obstruction. We also did the survival analysis for a 12-year period.FindingsParticipants were recruited by UK Biobank between Dec 19, 2006, and Oct 10, 2010. We included 351 874 UK Biobank participants (189 247 women and 162 627 men) in our study, with a median follow-up of 9·0 years (IQR 8·0–10·0). 38 639 (11·0%) of 351 874 participants had PRISm at baseline. After adjustment, PRISm was strongly associated with obesity (odds ratio [OR] 2·40 [2·26–2·55], pInterpretationPRISm was associated with breathlessness, multimorbidity, and increased risk of death, which does not seem to be explained by smoking, obesity, or existing lung disease. Although for many patients PRISm is transient, it is important to understand which individuals are at risk of progressive lung function abnormalities. Further research into the genetic, structural and functional pathophysiology of PRISm is warranted.FundingUK Medical Research Council and University of Bristol. |
| Databáze: | OpenAIRE |
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