Dataset Information

Low FVC/TLC in Preserved Ratio Impaired Spirometry (PRISm) is associated with features of and progression to obstructive lung disease.

ABSTRACT: One quarter of individuals with Preserved Ratio Impaired Spirometry (PRISm) will develop airflow obstruction, but there are no established methods to identify these individuals. We examined the utility of FVC/TLC in identifying features of obstructive lung disease. The ratio of post-bronchodilator FVC and TLC_CT from chest CT (FVC/TLC_CT) among current and former smokers with PRISm (FEV₁/FVC ≥ 0.7 and FEV1 < 80%) in COPDGene was used to stratify subjects into quartiles: very high, high, low, and very low. We examined the associations between FVC/TLC_CT quartiles and (1) baseline characteristics, (2) respiratory exacerbations, (3) progression to COPD at 5 years, and (4) all-cause mortality. Among participants with PRISm at baseline (n = 1,131), the very low FVC/TLC_CT quartile was associated with increased gas trapping and emphysema, and higher rates of progression to COPD at 5 years (36% versus 17%; p < 0.001) relative to the very high quartile. The very low FVC/TLC_CT quartile was associated with increased total (IRR = 1.65; 95% CI [1.07-2.54]) and severe (IRR = 2.24; 95% CI [1.29-3.89]) respiratory exacerbations. Mortality was lower in the very high FVC/TLC_CT quartile relative to the other quartiles combined. Reduced FVC/TLC_CT ratio in PRISm is associated with increased symptoms, radiographic emphysema and gas trapping, exacerbations, and progression to COPD.

SUBMITTER: Fortis S

PROVIDER: S-EPMC7083974 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Low FVC/TLC in Preserved Ratio Impaired Spirometry (PRISm) is associated with features of and progression to obstructive lung disease.

Fortis Spyridon S Comellas Alejandro A Kim Victor V Casaburi Richard R Hokanson John E JE Crapo James D JD Silverman Edwin K EK Wan Emily S ES

Scientific reports 20200320 1

One quarter of individuals with Preserved Ratio Impaired Spirometry (PRISm) will develop airflow obstruction, but there are no established methods to identify these individuals. We examined the utility of FVC/TLC in identifying features of obstructive lung disease. The ratio of post-bronchodilator FVC and TLCCT from chest CT (FVC/TLCCT) among current and former smokers with PRISm (FEV1/FVC ≥ 0.7 and FEV1 < 80%) in COPDGene was used to stratify subjects into quart ...[more]

PMID: 32198360

Similar Datasets

Project description:IntroductionTo analyse the relationship between diabetes, its severity (including blood glucose levels, disease duration, antidiabetic drug use and number of comorbidities) and preserved ratio impaired spirometry (PRISm) using data from the National Health and Nutrition Examination Survey (NHANES).MethodsThis cross-sectional study collected data from the NHANES database from 2007 to 2012. PRISm was defined as having a forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio ≥0.7 and an FEV1 predicted value <80%. We examined the relationship between diabetes duration, fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), log-transformed homeostasis model assessment for insulin resistance, C reactive protein and the number of comorbidities with PRISm in the entire population. We analysed the relationship between antidiabetic drug use and PRISm, specifically in the diabetes population. Logistic regression models were used, and results were reported as OR.ResultsA total of 5783 participants with normal spirometry or PRISm were included in the analysis. Diabetes was associated with 2.19 times higher odds of PRISm compared with non-diabetic participants. Longer disease duration increased PRISm odds by 2% per year. Each 1-unit increase in HbA1c and each 10 mg/dL increase in FPG were associated with 24% and 6% higher odds of PRISm, respectively. No relationship was found between insulin resistance and PRISm after adjusting for covariates. An increase of 1 mg/dL in CRP was associated with 18% higher odds of PRISm. A higher number of diabetes-related comorbidities was strongly associated with PRISm. No significant relationship was found between antidiabetic drug use and PRISm.ConclusionsSevere diabetes status, such as higher blood glucose levels, longer disease duration and a greater number of comorbidities, is associated with an increased risk of PRISm. Effective blood glucose control, self-management and regular monitoring of lung function are crucial for diabetes management.

Project description:BackgroundEmerging data from longitudinal studies suggest that preserved ratio impaired spirometry (PRISm), defined by proportionate reductions in FEV1 and FVC, is a heterogeneous population with frequent transitions to other lung function categories relative to individuals with normal and obstructive spirometry. Controversy regarding the clinical significance of these transitions exists (eg, whether transitions merely reflect measurement variability or noise).Research questionAre individuals with PRISm enriched for transitions associated with substantial changes in lung function?Study design and methodsCurrent and former smokers enrolled in the Genetic Epidemiology of COPD (COPDGene) study with spirometry available in phases 1 through 3 (enrollment, 5-year follow-up, and 10-year follow-up) were analyzed. Postbronchodilator lung function categories were as follows: PRISm (FEV1 < 80% predicted with FEV1/FVC ratio ≥ 0.7), Global Initiative for Chronic Obstructive Lung Disease grade 0 (FEV1 ≥ 80% predicted and FEV1/FVC ≥ 0.7), and obstruction (FEV1/FVC < 0.7). Significant transition status was affirmative if a subject belonged to two or more spirometric categories and had > 10% change in FEV1 % predicted and/or FVC % predicted between consecutive visits. Ever-PRISm was present if a subject had PRISm at any visit. Logistic regression examined the association between significant transitions and ever-PRISm status, adjusted for age, sex, race, FEV1 % predicted, current smoking, pack-years, BMI, and ever-positive bronchodilator response.ResultsAmong subjects with complete data (N = 1,775) over 10.1 ± 0.4 years of follow-up, the prevalence of PRISm remained consistent (10.4%-11.3%) between phases 1 through 3, but nearly one-half of subjects with PRISm transitioned into or out of PRISm at each visit. Among all subjects, 19.7% had a significant transition; ever-PRISm was a significant predictor of significant transitions (unadjusted OR, 10.3; 95% CI, 7.9-13.5; adjusted OR, 14.9; 95% CI, 10.9-20.7). Results were similar with additional adjustment for radiographic emphysema and gas trapping, when lower limit of normal criteria were used to define lung function categories, and when FEV1 alone (regardless of change in FVC % predicted) was used to define significant transitions.InterpretationPRISm is an unstable group, with frequent significant transitions to both obstruction and normal spirometry over time.Clinical trial registrationClinicalTrials.gov; No.: NCT000608764; URL: www.Clinicaltrialsgov.

Dataset Information

Low FVC/TLC in Preserved Ratio Impaired Spirometry (PRISm) is associated with features of and progression to obstructive lung disease.

Publications

Low FVC/TLC in Preserved Ratio Impaired Spirometry (PRISm) is associated with features of and progression to obstructive lung disease.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets