Restricted spirometry and cardiometabolic comorbidities: results from the international population based BOLD study

Kulbacka-Ortiz, Katarzyna; Triest, Filip J.J.; Franssen, Frits M.E.; Wouters, Emiel F.M.; Studnicka, Michael; Vollmer, William M.; Lamprecht, Bernd; Burney, Peter; Amaral, André F.S.; Vanfleteren, Lowie E.G.W.

doi:10.1186/s12931-022-01939-5

Cited by 13 publications

(11 citation statements)

References 45 publications

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“…In terms of lung function, the FVC appears to have the strongest association with CVD [ 22 ]. The association of airflow obstruction with CVD is more ambiguous [ 27 ], while for measures of spirometric SAO, evidence is lacking.…”

Section: Discussionmentioning

confidence: 99%

“…They found that hypertensive individuals had a significantly lower FEF 25-75 compared to normotensive individuals. However, this finding was not adjusted for potential confounders, such as FVC [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…To assess the association of cardiometabolic diseases with spirometric SAO, we used multivariable logistic regression, adjusting for known cardiovascular risk factors [ 20 – 22 ]: sex, education level, BMI, age, smoking status, smoking pack-years and spirometric restriction.…”

Section: Methodsmentioning

confidence: 99%

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The association of spirometric small airways obstruction with respiratory symptoms, cardiometabolic diseases, and quality of life: results from the Burden of Obstructive Lung Disease (BOLD) study

et al. 2023

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Background Spirometric small airways obstruction (SAO) is common in the general population. Whether spirometric SAO is associated with respiratory symptoms, cardiometabolic diseases, and quality of life (QoL) is unknown. Methods Using data from the Burden of Obstructive Lung Disease study (N = 21,594), we defined spirometric SAO as the mean forced expiratory flow rate between 25 and 75% of the FVC (FEF25-75) less than the lower limit of normal (LLN) or the forced expiratory volume in 3 s to FVC ratio (FEV3/FVC) less than the LLN. We analysed data on respiratory symptoms, cardiometabolic diseases, and QoL collected using standardised questionnaires. We assessed the associations with spirometric SAO using multivariable regression models, and pooled site estimates using random effects meta-analysis. We conducted identical analyses for isolated spirometric SAO (i.e. with FEV1/FVC ≥ LLN). Results Almost a fifth of the participants had spirometric SAO (19% for FEF25-75; 17% for FEV3/FVC). Using FEF25-75, spirometric SAO was associated with dyspnoea (OR = 2.16, 95% CI 1.77–2.70), chronic cough (OR = 2.56, 95% CI 2.08–3.15), chronic phlegm (OR = 2.29, 95% CI 1.77–4.05), wheeze (OR = 2.87, 95% CI 2.50–3.40) and cardiovascular disease (OR = 1.30, 95% CI 1.11–1.52), but not hypertension or diabetes. Spirometric SAO was associated with worse physical and mental QoL. These associations were similar for FEV3/FVC. Isolated spirometric SAO (10% for FEF25-75; 6% for FEV3/FVC), was also associated with respiratory symptoms and cardiovascular disease. Conclusion Spirometric SAO is associated with respiratory symptoms, cardiovascular disease, and QoL. Consideration should be given to the measurement of FEF25-75 and FEV3/FVC, in addition to traditional spirometry parameters.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The association of spirometric small airways obstruction with respiratory symptoms, cardiometabolic diseases, and quality of life: results from the Burden of Obstructive Lung Disease (BOLD) study

et al. 2023

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“…This is well in agreement with the results of the previous studies, which revealed that CVD mortality is higher in PRISm subjects with low FVC than in those with normal FVC [ 10 , 22 ]. Given that the ratio of FEV 1 to FVC is preserved by the definition of PRISm, the majority of subjects with PRISm also have a low FVC and this low FVC subgroup mainly accounts for a higher risk of CVD [ 29 – 31 ]. Interestingly, while it is well known that up to half of individuals with PRISm can later develop COPD [ 2 , 3 , 7 , 10 ], PRISm with low FVC was more likely to transition to COPD GOLD 2–4, whereas mild PRISm was more likely to transition to normal spirometry [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of preserved ratio impaired spirometry on coronary artery calcium score progression: a longitudinal cohort study

Im,

Park,

Lee

et al. 2023

ERJ Open Res

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BackgroundPreserved Ratio Impaired Spirometry (PRISm) is associated with increased cardiovascular disease (CVD) risk and mortality. However, a causal relationship between PRISm and CVD remains unclear. We investigated the progression of coronary artery calcium (CAC) scores based on the presence of PRISm and reduced forced vital capacity (FVC).MethodsThis retrospective cohort study included 11 420 participants ≥40 years with forced expiratory volume in 1 s (FEV1)/FVC ≥0.7, who underwent at least two health screening examinations with coronary CT scan between 2003 and 2020, and are without a history of CVD or interstitial lung disease. Participants with PRISm, defined as FEV1/FVC≥0.7 and FEV1<80% predicted, were further divided by low FVC (FVC <80% predicted). We estimated the 5-year progression rates of CAC by comparing participants with and without PRISm at baseline using mixed linear models.ResultsOf the 11 420 participants, 8536 (75%), 811 (7%), and 2073 (18%) had normal spirometry, PRISm with normal FVC, and PRISm with low FVC, respectively. During the mean follow-up of 6.0 years (range 0.5–17.2), the multivariable adjusted ratio of 5-year CAC progression rates comparing participants with PRISm with those with normal spirometry was 1.08 (95% CI, 1.04–1.13). This rate was faster in participants with PRISm with low FVC (1.21; 95% CI, 1.12–1.30) than in those with normal FVC.ConclusionIn this longitudinal cohort study of subjects without a history of CVD, PRISm was significantly associated with CAC progression, which was more evident in the group with PRISm and low FVC.

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“…A public health project, "Screening and Early Diagnosing of COPD," was undertaken in the Department of Respiratory and Critical Medicine of Shenzhen Municipal Qianhai Shekou Free Trade Zone Hospital. COPD screening questionnaires (COPD-SQs) was based on the Burden of Obstructive Lung Disease (BOLD) study and the 2007 version of the Chinese Epidemiological Questionnaire (Zhong et al, 2007;Kulbacka-Ortiz et al, 2022). The risk factors in COPD-SQs included age, smoking package years, body mass index, chronic cough, shortness of breath, whether to use biofuel or coal for cooking or heating, and whether parents, brothers and sisters had chronic bronchitis, emphysema, asthma, and COPD history.…”

Section: Study Participantsmentioning

confidence: 99%

The correlation between a Th1/Th2 cytokines imbalance and vitamin D level in patients with early chronic obstructive pulmonary disease (COPD), based on screening results

et al. 2023

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Objective: This study explored the correlation between a Th1/Th2 cytokines imbalance and 25-hydroxy-vitamin D (vit D) level in early chronic obstructive pulmonary disease (COPD), provided experimental rationales for the role of vit D in the prevention and control of COPD, and elucidated the potential anti-inflammatory mechanism involved.Methods: This study was based on the results of the “Screening and Early Diagnosis of COPD” public health project conducted through Shenzhen Municipal Qianhai Shekou Free Trade Zone Hospital. Patients with early COPD were selected as study participants. A prospective, randomized, and controlled method was employed for assigning eligible participants into three groups, i.e., a COPD lung function (LF) I, COPD LF II, and a healthy group, respectively (n = 40 each). The serum content of tumor necrosis factor alpha (TNF-α), interferon-gamma (IFN-γ), interleukin 4 (IL-4), and IL-6 were measured by enzyme-linked immunosorbent assay, and the ratio of IFN-γ/IL-4 treated as a marker for Th1/Th2. The serum concentration of 25-hydroxyl-vit D (25 [OH]D) was quantified by a chemiluminescence assay. Statistical processing was performed, and the correlations between changes in the above parameters with vit D level and LF parameters were examined.Results: There were differences in FEV1pred%, FEV1/FVC, IFN-γ, IL-4, IL-6 and IFN-γ/IL-4 between the healthy group, the COPD LF I group and the COPD LF II group (p < 0.05). In early COPD, Th1/Th2 cytokines was positively correlated with forced expiratory volume/expected value (FEV1pred%) (r = 0.485, p < 0.001) and forced expiratory volume/forced vital capacity (FEV1/FVC) (r = 0.273, p = 0.018); Th1/Th2 cytokines levels positively correlated with vit D level (r = 0.27, p = 0.02), and 25(OH)D level positively correlated with FEV1pred% (r = 0.695, p < 0.001).Conclusion: Vitamin D deficiency was ubiquitous in patients with early COPD. It was positively correlated with the FEV1pred% and FEV1/FVC LF parameters. Accordingly, this study provides experimental rationales for the role of vit D in the prevention and control of COPD and the potential anti-inflammatory mechanisms involved.

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Restricted spirometry and cardiometabolic comorbidities: results from the international population based BOLD study

Cited by 13 publications

References 45 publications

The association of spirometric small airways obstruction with respiratory symptoms, cardiometabolic diseases, and quality of life: results from the Burden of Obstructive Lung Disease (BOLD) study

The association of spirometric small airways obstruction with respiratory symptoms, cardiometabolic diseases, and quality of life: results from the Burden of Obstructive Lung Disease (BOLD) study

Impact of preserved ratio impaired spirometry on coronary artery calcium score progression: a longitudinal cohort study

The correlation between a Th1/Th2 cytokines imbalance and vitamin D level in patients with early chronic obstructive pulmonary disease (COPD), based on screening results

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