Prevalence and Characteristics of Individuals with Preserved Ratio Impaired Spirometry (PRISm) and/or Impaired Lung Function in Japan: The OCEAN Study

Kaise, Toshihiko; Sakihara, Eishin; Tamaki, Kentaro; Matsubara, Hiroaki; Hirahara, Norimichi; Kirichek, Oksana; Tawara, Ryosuke; Akiyama, Shoko; Katsumata, Masayuki; Haruya, Mei; Ishii, Takeo; Miller, Bruce E.; Tal‐Singer, Ruth

doi:10.2147/copd.s322041

Cited by 20 publications

(32 citation statements)

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“…Chronic bronchitis and emphysema are frequent underlying conditions and historical subtypes of COPD, with shortness of breath and chronic cough, with or without mucus production, as main symptoms. A complementary category of patients with diminished lung function does not meet spirometric GOLD criteria for COPD: they have reductions in both FVC and FEV 1 but no major reduction in the FEV 1 /FVC ratio-a condition referred to as "restrictive", or also preserved ratio impaired spirometry (PRISm) (4)(5)(6)(7)(8). PRISm is a heterogeneous, often also unstable (5-7) condition marked by restricted expansibility of the lungs and reduced total lung capacity, with various underlying causes ranging from pulmonary parenchymal disease to reduced chest wall expansion resulting from obesity (9).…”

Section: Introductionmentioning

confidence: 99%

“…PRISm is a heterogeneous, often also unstable (5-7) condition marked by restricted expansibility of the lungs and reduced total lung capacity, with various underlying causes ranging from pulmonary parenchymal disease to reduced chest wall expansion resulting from obesity (9). COPD (10,11) and PRISm (8,(12)(13)(14) share an elevated prevalence among long-term, heavy smokers, and an association with cardiovascular, respiratory and other comorbidities (15,16). Additionally, PRISm was found to be associated with of obesity [higher average body mass index (BMI)] and diabetes (5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

“…COPD (10,11) and PRISm (8,(12)(13)(14) share an elevated prevalence among long-term, heavy smokers, and an association with cardiovascular, respiratory and other comorbidities (15,16). Additionally, PRISm was found to be associated with of obesity [higher average body mass index (BMI)] and diabetes (5)(6)(7)(8). Independently of smoking, obstructive (17) and restrictive (6,7,18) spirometry patterns are both associated with increased mortality due to cardiovascular disease, cancer, and other causes.…”

Section: Introductionmentioning

confidence: 99%

“…COPD ( 10 , 11 ) and PRISm ( 8 , 12 - 14 ) share an elevated prevalence among long-term, heavy smokers, and an association with cardiovascular, respiratory and other comorbidities ( 15 , 16 ). Additionally, PRISm was found to be associated with of obesity [higher average body mass index (BMI)] and diabetes ( 5 - 8 ).…”

Section: Introductionmentioning

confidence: 99%

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Lung function impairment in the German Lung Cancer Screening Intervention Study (LUSI): prevalence, symptoms, and associations with lung cancer risk, tumor histology and all-cause mortality

Kaaks¹,

Christodoulou²,

Motsch³

et al. 2022

Transl Lung Cancer Res

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Background: Lung cancer screening may provide a favorable opportunity for a spirometry examination, to diagnose participants with undiagnosed lung function impairments, or to improve targeting of computed tomography (CT) screening intensity in view of expected net benefit.Methods: Spirometry was performed in the CT screening arm (n=2,029) of the German Lung Cancer Screening Intervention Study (LUSI)-a trial examining the effects of annual CT screening on lung cancer mortality, in 50-69-year-old long-term smokers. Participants were classified as having chronic obstructive pulmonary disease (COPD; FEV 1 /FVC <0.7), preserved ratio impaired spirometry (PRISm; FEV 1 /FVC ≥0.7and FEV 1 % predicted <80%), or normal spirometry. Descriptive statistics were used to examine associations of COPD or PRISm with respiratory symptoms, and self-reported medical diagnoses of respiratory and other morbidities. Logistic regression and proportional hazards regression were used to examine associations of COPD and PRISm, as well as their self-reported medical diagnoses, with risks of lung cancer and all-cause mortality.Results: A total of 1,987 screening arm participants (98%) provided interpretable spirometry measurements; of these, 34.3% had spirometric patterns consistent with either COPD (18.6%) or PRISm (15.7%). Two thirds of participants with COPD or PRISm were asymptomatic, and only 23% reported a previous medical diagnosis concordant with COPD. Participants reporting a diagnosis tended to be more often current and heavier smokers, and more often had respiratory symptoms, cardiovascular comorbidities, or more severe lung function impairments. Independently of smoking history, moderate-to-severe (GOLD 2-4) COPD (OR =2.14; 95% CI: 1.54-2.98), and PRISm (OR =2.68; 95% CI: 1.61-4.40), were associated with increased lung cancer risk. Lung cancer patients with PRISm less frequently had adenocarcinomas, and more often squamous cell or small cell tumors, compared to those with normal spirometry (n=45), and both PRISm and COPD were associated with more advanced lung cancer tumor stage for screen-detected cancers.PRISm and COPD, depending on GOLD stage, were also associated with about 2-to 4-fold increases in risk of overall mortality, which to 87 percent had causes other than lung cancer.Conclusions: About one third of smokers eligible for lung cancer screening in Germany have COPD or PRISm. As these conditions were associated with detection of lung cancer, spirometry may help identify populations at high risk for death of lung cancer or other causes, and who might particularly benefit from CT screening.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lung function impairment in the German Lung Cancer Screening Intervention Study (LUSI): prevalence, symptoms, and associations with lung cancer risk, tumor histology and all-cause mortality

Kaaks¹,

Christodoulou²,

Motsch³

et al. 2022

Transl Lung Cancer Res

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“…PRISm is reported to be a risk factor in the development of COPD and increased respiratory symptoms and mortality; it is also associated with the risk of cardiovascular disease [1] [2] [3] [4] [5] [6]. Additionally, previous reports show that PRISm is associated with various characteristics including sex, smoking, age, metabolic syndrome, systemic in ammation, exposure to dust, history of tuberculosis, and asthma [1] [2] [4] [7] [8] [9]. These observations suggest that PRISm might include heterogenous groups of people with increased risk of respiratory disease and systemic comorbidities.…”

Section: Introductionmentioning

confidence: 99%

Preserved ratio impaired spirometry with or without restrictive spirometric abnormality

Miura

Iwamoto

Omori

et al. 2022

Preprint

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Background and objective: Preserved ratio impaired spirometry (PRISm) is defined by reduced FEV1 with a preserved FEV1/FVC ratio; some individuals with PRISm can also have restrictive ventilatory abnormality. There may be differences in clinical features between PRISm with and without a restrictive abnormality, but there has been no study to investigate them separately. The aim of this study was to clarify clinical features of restrictive and non-restrictive PRISm.Methods: In total, 11246 participants (mean, 49.1 years; range, 35–65 years) from five healthcare centres were included in this study. We evaluated baseline characteristics of participants with restrictive PRISm (FEV1/FVC ≥0.7, FEV1 <80% and FVC <80%) and non-restrictive PRISm (FEV1/FVC ≥0.7, FEV1 <80% and FVC ≥80%), and airflow obstruction (FEV1/FVC <0.7 independent of FVC values). We examined the longitudinal risk of developing airflow obstruction by comparing spirometry results at baseline and 5 years post-baseline among 2141 participants.Results: Multivariate analysis demonstrated that a history of asthma or smoking could constitute an independent risk factor for non-restrictive PRISm, and that non-restrictive PRISm was independently associated with the risk of developing airflow obstruction. In contrast, female sex, advanced age, and high BMI, but not history of asthma or smoking, were risk factors for restrictive PRISm. Restrictive PRISm was not associated with the development of airflow obstruction. Conclusions: PRISm can be categorized according to the presence or absence of restrictive abnormality. Increased risk of developing airflow obstruction was shown in non-restrictive PRISm, which is categorized as normal by the conventional criteria of obstructive and restrictive ventilatory abnormalities.

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Restrictive spirometry pattern among construction trade workers

Hines

Dement

Cloeren

et al. 2023

American J Industrial Med

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Background: Spirometry-based studies of occupational lung disease have mostly focused on obstructive or mixed obstructive/restrictive outcomes. We wanted to determine if restrictive spirometry pattern (RSP) is associated with occupation and increased mortality. Methods: Study participants included 18,145 workers with demographic and smoking data and repeatable spirometry. The mortality analysis cohort included 15,445 workers with known vital status and cause of death through December 31, 2016. Stratified analyses explored RSP prevalence by demographic and clinical variables and trade. Log-binomial regression models explored RSP risk factors while controlling for important confounders such as smoking, obesity, and comorbidities. Cox regression models explored mortality risk by spirometry category.Results: Prevalence of RSP was very high (28.6%). Mortality hazard ratios for RSP were 1.50 for all causes, 1.86 for cardiovascular diseases, 2.31 for respiratory diseases, and 1.66 for lung cancer. All construction trades except painters, machinists, and roofers had significantly elevated risk for RSP compared to our internal reference group. RSP was significantly associated with both parenchymal and pleural changes seen by chest X-ray.Conclusions: Construction trade workers are at significantly increased risk for RSP independent of obesity. Individuals with RSP are at increased risk for all-cause mortality as well as mortality attributable to respiratory diseases, cardiovascular diseases, and lung cancer. RSP deserves greater attention in occupational medicine and epidemiology.

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Prevalence and Characteristics of Individuals with Preserved Ratio Impaired Spirometry (PRISm) and/or Impaired Lung Function in Japan: The OCEAN Study

Cited by 20 publications

References 36 publications

Lung function impairment in the German Lung Cancer Screening Intervention Study (LUSI): prevalence, symptoms, and associations with lung cancer risk, tumor histology and all-cause mortality

Lung function impairment in the German Lung Cancer Screening Intervention Study (LUSI): prevalence, symptoms, and associations with lung cancer risk, tumor histology and all-cause mortality

Preserved ratio impaired spirometry with or without restrictive spirometric abnormality

Restrictive spirometry pattern among construction trade workers

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