Clinical relevance of multiple confirmed preserved ratio impaired spirometry cases in adults |
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Affiliation: | 1. Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan;2. Medical Examination Center, Takeda Hospital, 277 Aburanokoji-cho, Shimogyo-ku, Kyoto 600-8231, Japan;3. Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, Kyoto, Japan;4. Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;1. Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, Kyoto, Japan;2. Department of Clinical Laboratory, Kyoto University Hospital, Kyoto, Japan;3. Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan;4. Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan;5. Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan;1. Pneumology Department from Mureș; County Clinical Hospital, Gheorghe Marinescu Street Number 5, Târgu Mureș, Postal code 540098, Romania;2. ‘George Emil Palade’ University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, Gheorghe Marinescu Street Number 38, Postal code 540139, Romania;3. Anesthesiology and Intensive Therapy Department from Emergency Mureș; County Clinical Hospital, Gheorghe Marinescu Street Number 50, Târgu Mureș, Postal code 540136, Romania;4. University Hospital Lewisham & Greenwich, Owen Centre Lewisham Hospital Lewisham High Street, London SE13 6LH, UK;1. Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;2. Department of Thoracic Surgery, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan;3. Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;4. Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan |
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Abstract: | BackgroundPreserved ratio impaired spirometry (PRISm) is a common spirometry finding, but its heterogeneous manifestations and frequent transitions to airflow limitation (AFL), chronic obstructive pulmonary disease, or normal spirometry hinder establishing an appropriate management strategy. This study examined whether transition to AFL and baseline comorbidities are more frequent in subjects with definite PRISm (PRISm confirmed on both current and past two spirometry tests) versus incident PRISm (PRISm confirmed only on a current test with past normal spirometry records) than in normal spirometry.MethodsArchived medical check-up data of subjects aged ≥40 years (n = 10828) with two past spirometry records, in a Japanese hospital, were cross-sectionally analyzed. Among them, data from those with follow-up spirometry after three years (n = 6467) were used to evaluate transition to AFL. PRISm was defined as forced volume in 1 s (FEV1)/forced vital capacity ≥0.7 and % predicted FEV1 < 80%.ResultsOverall PRISm prevalence was 6.5%. In multivariable models adjusted for age, sex, smoking status, and body mass index, definite PRISm (n = 290), but not incident PRISm (n = 183), was associated with elevated hemoglobin A1c and C-reactive protein levels, and higher rates of asthma, hypertension, hyperlipidemia, and diabetes than was consistent normal spirometry (n = 9694). The transition to AFL after three years was more frequent in definite PRISm, but not incident PRISm, than in normal spirometry (adjusted hazard ratio [95% confidence interval] = 6.21 [3.42–10.71] and 1.45 [0.23–4.73], respectively).ConclusionsMultiple confirmed PRISm on past and baseline spirometry is closely associated with metabolic syndrome factors, asthma history, and future AFL development. |
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Keywords: | Spirometry Preserved ratio impaired spirometry Airflow limitation Chronic obstructive pulmonary disease PRISm" },{" #name" :" keyword" ," $" :{" id" :" pc_qmQa2mGSJP" }," $$" :[{" #name" :" text" ," _" :" Preserved ratio impaired spirometry Forced expiratory volume in 1 s FVC" },{" #name" :" keyword" ," $" :{" id" :" pc_s0mfm9iDay" }," $$" :[{" #name" :" text" ," _" :" Forced vital capacity COPD" },{" #name" :" keyword" ," $" :{" id" :" pc_DQDaVKndAY" }," $$" :[{" #name" :" text" ," _" :" Chronic obstructive pulmonary disease AFL" },{" #name" :" keyword" ," $" :{" id" :" pc_slxLygQVBQ" }," $$" :[{" #name" :" text" ," _" :" Airflow limitation BMI" },{" #name" :" keyword" ," $" :{" id" :" pc_n57oMXK3Ze" }," $$" :[{" #name" :" text" ," _" :" Body mass index |
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