Rationale and design of the Early Chronic Obstructive Pulmonary Disease (ECOPD) study in Guangdong, China: a prospective observational cohort study

Wu, Fan; Zhou, Yumin; Peng, Jieqi; Deng, Zhishan; Wen, Xiang; Wang, Zihui; Zheng, Yuzhen; Tian, Heshen; Yang, Huajing; Huang, Peiyu; Zhao, Ningning; Sun, Ruiting; Chen, Rongchang; Ran, Pixin

doi:10.21037/jtd-21-1379

Cited by 16 publications

(37 citation statements)

References 60 publications

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“…This was a prospective observational cohort study (ECOPD cohort) in Guangdong ( Wu et al, 2021 ). The subjects were continuously recruited and tested in Wengyuan,Lianping countryside and Guangzhou city, Guangdong Province from July 2019 to August 2021.…”

Section: Methodsmentioning

confidence: 99%

Discordant Spirometry and Impulse Oscillometry Assessments in the Diagnosis of Small Airway Dysfunction

Peng

Zhao

et al. 2022

Front. Physiol.

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Background and objective: Spirometry is commonly used to assess small airway dysfunction (SAD). Impulse oscillometry (IOS) can complement spirometry. However, discordant spirometry and IOS in the diagnosis of SAD were not uncommon. We examined the association between spirometry and IOS within a large cohort of subjects to identify variables that may explain discordant spirometry and IOS findings.Methods: 1,836 subjects from the ECOPD cohort underwent questionnaires, symptom scores, spirometry, and IOS, and 1,318 subjects were examined by CT. We assessed SAD with R5-R20 > the upper limit of normal (ULN) by IOS and two of the three spirometry indexes (maximal mid-expiratory flow (MMEF), forced expiratory flow (FEF)50%, and FEF75%) < 65% predicted. Multivariate regression analysis was used to analyze factors associated with SAD diagnosed by only spirometry but not IOS (spirometry-only SAD) and only IOS but not spirometry (IOS-only SAD), and line regression was used to assess CT imaging differences.Results: There was a slight agreement between spirometry and IOS in the diagnosis of SAD (kappa 0.322, p < 0.001). Smoking status, phlegm, drug treatment, and family history of respiratory disease were factors leading to spirometry-only SAD. Spirometry-only SAD had more severe emphysema and gas-trapping than IOS-only SAD in abnormal lung function. However, in normal lung function subjects, there was no statistical difference in emphysema and gas-trapping between discordant groups. The number of IOS-only SAD was nearly twice than that of spirometry.Conclusion: IOS may be more sensitive than spirometry in the diagnosis of SAD in normal lung function subjects. But in patients with abnormal lung function, spirometry may be more sensitive than IOS to detect SAD patients with clinical symptoms and CT lesions.

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Section: Methodsmentioning

confidence: 99%

Discordant Spirometry and Impulse Oscillometry Assessments in the Diagnosis of Small Airway Dysfunction

Peng

Zhao

et al. 2022

Front. Physiol.

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“…Baseline enrollment ended in August 2021. Details regarding rationale, design, and inclusion as well as exclusion criteria have been illustrated elsewhere previously [ 12 ]. Briefly, approximately 2000 participants aged 40–80 years were recruited voluntarily in Guangdong, China.…”

Section: Methodsmentioning

confidence: 99%

“…Education level was categorized into primary school or below, middle or high school, and college or above. Except for these two parameters, definitions of the other variables were the same as those described before [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

“…We used a multidetector-row CT scanner (Siemens Definition AS Plus 128-slicers and United-imaging uCT 760 128-slicers) to get the images. Complete details of the CT protocol and quality control have been outlined previously [ 12 ]. Quantitative analysis of CT images was performed using Chest Imaging Platform ( https://www.chestimagingplatform.org ) on the semi-automated 3D Slicer 4.11 software ( https://www.slicer.org ) [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

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The association between small airway dysfunction and aging: a cross-sectional analysis from the ECOPD cohort

Dai

Wang

et al. 2022

Respir Res

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Background Aging has been evidenced to bring about some structural and functional lung changes, especially in COPD. However, whether aging affects SAD, a possible precursor of COPD, has not been well characterized. Objective We aimed to comprehensively assess the relationship between aging and SAD from computed tomography, impulse oscillometry, and spirometry perspectives in Chinese. Methods We included 1859 participants from ECOPD, and used a linear-by-linear association test for evaluating the prevalence of SAD across various age subgroups, and multivariate regression models for determining the impact of age on the risk and severity of SAD. We then repeated the analyses in these subjects stratified by airflow limitation. Results The prevalence of SAD increases over aging regardless of definitional methods. After adjustment for other confounding factors, per 10-yrs increase in age was significantly associated with the risk of CT-defined SAD (OR 2.57, 95% CI 2.13 to 3.10) and the increase in the severity of air trapping (β 2.09, 95% CI − 0.06 to 4.25 for LAA-856), airway reactance (β − 0.02, 95% CI − 0.04 to − 0.01 for X5; β 0.30, 95% CI 0.13 to 0.47 for AX; β 1.75, 95% CI 0.85 to 2.66 for Fres), as well as the decrease in expiratory flow rates (β − 3.95, 95% CI − 6.19 to − 1.71 for MMEF%predicted; β − 5.42, 95% CI − 7.88 to − 2.95 for FEF50%predicted) for SAD. All these associations were generally maintained in SAD defined by IOS or spirometry. After stratification of airflow limitation, we further found that the effect of age on LAA-856 was the most significant among almost all subgroups. Conclusions Aging is significantly associated with the prevalence, increased risk, as well as worse severity of SAD. CT may be a more optimal measure to assess aging-related SAD. The molecular mechanisms for the role of aging in SAD need to be explored in the future. Trialregistration Chinese Clinical Trial Registry ChiCTR1900024643. Registered on 19 July 2019

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“…The details of these two cohorts have been reported previously. 15 , 16 Briefly, two cohorts recruited participants aged 20 years or older and completed bilirubin measurement, questionnaires, and lung function tests at baseline. Subjects included in this study completed spirometric measurements again for an interval of 7 to 9 years follow-up duration in 2012–2015 Program as well as 1 to 2 years in ECOPD.…”

Section: Methodsmentioning

confidence: 99%

Association Between Serum Total Bilirubin Level and Lung Function Decline in Patients with COPD: Results from a Pooled Study

Dai¹,

Wang²,

Deng³

et al. 2022

COPD

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Background Serum total bilirubin has been reported to have antioxidant properties against chronic respiratory diseases. The objective of our study is to evaluate the association of total bilirubin (TB) with annual lung function decline in COPD patients with different GOLD stages. Methods This study used pooled data from two observational and prospective cohorts of 612 COPD patients whose TB levels were measured at baseline. The associations between TB and postbronchodilator FEV 1 , FEV 1 pred, FVC, FVCpred, FEV 1 /FVC, and the rate of their decline were all determined using linear regression models in the total population and strata of GOLD stages. Results Serum TB was positively related to FEV 1 and FVC in the total group (β 0.02, 95% CI 0.001~0.02, P = 0.025 and β 0.02, 95% CI 0.002~0.03, P = 0.022, respectively). Additionally, TB was inversely associated with the annual decline in FEV 1 and FEV 1 pred (β 4.91, 95% CI 1.68~8.14, P = 0.025 and β 0.21, 95% CI 0.06~0.36, P = 0.022, respectively) when adjusted for multivariables. After stratification, the significant associations merely persisted in COPD patients with GOLD 2 and GOLD 3–4. Conclusion Increased TB level was related to less annual decline in FEV 1 as well as FEV 1 pred in moderate-to-severe COPD but not mild COPD, which indicated the different status of TB in different COPD severity and the possible role as potential biomarker merely in moderate-to-severe COPD. Future researches to determine whether TB could be served as biomarker for COPD and the mechanisms should be focused on some target patients with a certain disease severity.

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Rationale and design of the Early Chronic Obstructive Pulmonary Disease (ECOPD) study in Guangdong, China: a prospective observational cohort study

Cited by 16 publications

References 60 publications

Discordant Spirometry and Impulse Oscillometry Assessments in the Diagnosis of Small Airway Dysfunction

Discordant Spirometry and Impulse Oscillometry Assessments in the Diagnosis of Small Airway Dysfunction

The association between small airway dysfunction and aging: a cross-sectional analysis from the ECOPD cohort

Association Between Serum Total Bilirubin Level and Lung Function Decline in Patients with COPD: Results from a Pooled Study

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