Common Lung Abnormality Found in 1 in 20 Middle-Aged Adults
Researchers identified two distinct patterns of abnormal lung function affecting about 5% of people aged 50-64, even among those who've never smoked. The findings could reshape how doctors screen for respiratory disease and help insurers and employers understand hidden health risks in their populations.
Originaltitel: Restrictive Spirometric Pattern and Preserved Ratio Impaired Spirometry in a Population 50-64 Years
<p><strong>RATIONALE:</strong> Knowledge regarding prevalence and shared and unique characteristics of Restrictive spirometric pattern (RSP) and Preserved ratio impaired spirometry (PRISm) is lacking for a general population investigated with post-bronchodilator spirometry and computed tomography of the lungs.</p><p><strong>OBJECTIVES:</strong> To investigate shared and unique features for RSP and PRISm.</p><p><strong>METHODS:</strong> In the Swedish CArdioPulmonary bioImage Study (SCAPIS), a general population sample of 28,555 people aged 50 - 64 years (including 14,558 never-smokers) was assessed. The participants answered a questionnaire and underwent computed tomography of the lungs, post-bronchodilator spirometry, and coronary artery calcification score (CACS). Odds ratios (OR) with 95% confidence intervals (CI) were calculated using adjusted logistic regression. RSP was defined as FEV<sub>1</sub>/FVC≥0.70 and FVC<80%. PRISm was defined as FEV<sub>1</sub>/FVC≥0.70 and FEV<sub>1</sub><80%. A local reference equation was applied.</p><p><strong>MEASUREMENTS AND RESULTS:</strong> The prevalence of RSP and PRISm were 5.1% (95% CI 4.9 - 5.4) and 5.1% (95% CI 4.8 - 5.3), respectively, with similar values seen in never-smokers. For RSP and PRISm, shared features were current smoking, dyspnea, chronic bronchitis, rheumatic disease, diabetes, ischemic heart disease (IHD), bronchial wall thickening, interstitial lung abnormalities (ILA), and bronchiectasis. Emphysema was uniquely linked to PRISm (OR 1.69, 1.36-2.10) vs 1.10 (0.84-1.43) for RSP. CACS≥300 was related to PRISm, but not among among never-smokers.</p><p><strong>CONCLUSIONS:</strong> PRISm and RSP have respiratory, cardiovascular, and metabolic conditions as shared features. Emphysema is only associated with PRISm. Coronary atherosclerosis may be associated with PRISm. Our results indicate that RSP and PRISm may share more features than not.</p>