The ratio FEV<sub>1</sub>/FVC and its association to respiratory symptoms—A Swedish general population study

Torén, Kjell; Schiöler, Linus; Lindberg, Anne; Andersson, Anders; Behndig, Annelie F.; Bergström, Göran; Blomberg, Anders; Caidahl, Kenneth; Engvall, Jan E.; Eriksson, Maria J.; Hamrefors, Viktor; Janson, Christer; Kylhammar, David; Lindberg, Eva; Lindén, Anders; Malinovschi, Andrei; Lennart Persson, Hans; Sandelin, Martin; Eriksson Ström, Jonas; Tanash, Hanan; Vikgren, Jenny; Johan Östgren, Carl; Wollmer, Per; Sköld, C. Magnus

The ratio FEV₁/FVC and its association to respiratory symptoms—A Swedish general population study

Mark

Torén, Kjell ; Schiöler, Linus ; Lindberg, Anne ; Andersson, Anders ; Behndig, Annelie F. ; Bergström, Göran ; Blomberg, Anders ; Caidahl, Kenneth ; Engvall, Jan E. and Eriksson, Maria J. , et al. (2021) In Clinical Physiology and Functional Imaging 41(2). p.181-191

Abstract: Chronic airflow limitation (CAL) can be defined as fixed ratio of forced expiratory volume in 1 s (FEV₁)/forced vital capacity (FVC) < 0.70 after bronchodilation. It is unclear which is the most optimal ratio in relation to respiratory morbidity. The aim was to investigate to what extent different ratios of FEV₁/FVC were associated with any respiratory symptom. In a cross-sectional general population study, 15,128 adults (50–64 years of age), 7,120 never-smokers and 8,008 ever-smokers completed a respiratory questionnaire and performed FEV₁ and FVC after bronchodilation. We calculated different ratios of FEV₁/FVC from 0.40 to 1.0 using 0.70 as reference category. We analysed odds ratios... (More); Chronic airflow limitation (CAL) can be defined as fixed ratio of forced expiratory volume in 1 s (FEV₁)/forced vital capacity (FVC) < 0.70 after bronchodilation. It is unclear which is the most optimal ratio in relation to respiratory morbidity. The aim was to investigate to what extent different ratios of FEV₁/FVC were associated with any respiratory symptom. In a cross-sectional general population study, 15,128 adults (50–64 years of age), 7,120 never-smokers and 8,008 ever-smokers completed a respiratory questionnaire and performed FEV₁ and FVC after bronchodilation. We calculated different ratios of FEV₁/FVC from 0.40 to 1.0 using 0.70 as reference category. We analysed odds ratios (OR) between different ratios and any respiratory symptom using adjusted multivariable logistic regression. Among all subjects, regardless of smoking habits, the lowest odds for any respiratory symptom was at FEV₁/FVC = 0.82, OR 0.48 (95% CI 0.41–0.56). Among never-smokers, the lowest odds for any respiratory symptom was at FEV₁/FVC = 0.81, OR 0.53 (95% CI 0.41–0.70). Among ever-smokers, the odds for any respiratory symptom was lowest at FEV₁/FVC = 0.81, OR 0.43 (95% CI 0.16–1.19), although the rate of inclining in odds was small in the upper part, that is FEV₁/FVC = 0.85 showed similar odds, OR 0.45 (95% CI 0.38–0.55). We concluded that the odds for any respiratory symptoms continuously decreased with higher FEV₁/FVC ratios and reached a minimum around 0.80–0.85, with similar results among never-smokers. These results indicate that the optimal threshold associated with respiratory symptoms may be higher than 0.70 and this should be further investigated in prospective longitudinal studies.
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Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/53e790a9-a17e-43e6-a4f1-f7b829247508

author

Torén, Kjell ; Schiöler, Linus ; Lindberg, Anne ; Andersson, Anders ; Behndig, Annelie F. ; Bergström, Göran ; Blomberg, Anders ; Caidahl, Kenneth ; Engvall, Jan E. and Eriksson, Maria J. , et al. (More)

Torén, Kjell ; Schiöler, Linus ; Lindberg, Anne ; Andersson, Anders ; Behndig, Annelie F. ; Bergström, Göran ; Blomberg, Anders ; Caidahl, Kenneth ; Engvall, Jan E. ; Eriksson, Maria J. ; Hamrefors, Viktor ^LU

; Janson, Christer ; Kylhammar, David ^LU ; Lindberg, Eva ; Lindén, Anders ; Malinovschi, Andrei ^LU ; Lennart Persson, Hans ; Sandelin, Martin ; Eriksson Ström, Jonas ; Tanash, Hanan ^LU ; Vikgren, Jenny ; Johan Östgren, Carl ^LU ; Wollmer, Per ^LU and Sköld, C. Magnus (Less)

organization

publishing date

2021

type

Contribution to journal

publication status

published

subject

Respiratory Medicine and Allergy

keywords

chronic airflow limitation, COPD, cough with phlegm, dyspnoea, GOLD, SCAPIS, wheeze

in

Clinical Physiology and Functional Imaging

volume

41

issue

2

pages

181 - 191

publisher

John Wiley & Sons Inc.

external identifiers

scopus:85097904007
pmid:33284499

ISSN

1475-0961

DOI

10.1111/cpf.12684

language

English

LU publication?

yes

id

53e790a9-a17e-43e6-a4f1-f7b829247508

date added to LUP

2021-01-11 10:33:49

date last changed

2024-06-13 04:06:39

@article{53e790a9-a17e-43e6-a4f1-f7b829247508,
  abstract     = {{<p>Chronic airflow limitation (CAL) can be defined as fixed ratio of forced expiratory volume in 1 s (FEV<sub>1</sub>)/forced vital capacity (FVC) &lt; 0.70 after bronchodilation. It is unclear which is the most optimal ratio in relation to respiratory morbidity. The aim was to investigate to what extent different ratios of FEV<sub>1</sub>/FVC were associated with any respiratory symptom. In a cross-sectional general population study, 15,128 adults (50–64 years of age), 7,120 never-smokers and 8,008 ever-smokers completed a respiratory questionnaire and performed FEV<sub>1</sub> and FVC after bronchodilation. We calculated different ratios of FEV<sub>1</sub>/FVC from 0.40 to 1.0 using 0.70 as reference category. We analysed odds ratios (OR) between different ratios and any respiratory symptom using adjusted multivariable logistic regression. Among all subjects, regardless of smoking habits, the lowest odds for any respiratory symptom was at FEV<sub>1</sub>/FVC = 0.82, OR 0.48 (95% CI 0.41–0.56). Among never-smokers, the lowest odds for any respiratory symptom was at FEV<sub>1</sub>/FVC = 0.81, OR 0.53 (95% CI 0.41–0.70). Among ever-smokers, the odds for any respiratory symptom was lowest at FEV<sub>1</sub>/FVC = 0.81, OR 0.43 (95% CI 0.16–1.19), although the rate of inclining in odds was small in the upper part, that is FEV<sub>1</sub>/FVC = 0.85 showed similar odds, OR 0.45 (95% CI 0.38–0.55). We concluded that the odds for any respiratory symptoms continuously decreased with higher FEV<sub>1</sub>/FVC ratios and reached a minimum around 0.80–0.85, with similar results among never-smokers. These results indicate that the optimal threshold associated with respiratory symptoms may be higher than 0.70 and this should be further investigated in prospective longitudinal studies.</p>}},
  author       = {{Torén, Kjell and Schiöler, Linus and Lindberg, Anne and Andersson, Anders and Behndig, Annelie F. and Bergström, Göran and Blomberg, Anders and Caidahl, Kenneth and Engvall, Jan E. and Eriksson, Maria J. and Hamrefors, Viktor and Janson, Christer and Kylhammar, David and Lindberg, Eva and Lindén, Anders and Malinovschi, Andrei and Lennart Persson, Hans and Sandelin, Martin and Eriksson Ström, Jonas and Tanash, Hanan and Vikgren, Jenny and Johan Östgren, Carl and Wollmer, Per and Sköld, C. Magnus}},
  issn         = {{1475-0961}},
  keywords     = {{chronic airflow limitation; COPD; cough with phlegm; dyspnoea; GOLD; SCAPIS; wheeze}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{181--191}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Clinical Physiology and Functional Imaging}},
  title        = {{The ratio FEV<sub>1</sub>/FVC and its association to respiratory symptoms—A Swedish general population study}},
  url          = {{http://dx.doi.org/10.1111/cpf.12684}},
  doi          = {{10.1111/cpf.12684}},
  volume       = {{41}},
  year         = {{2021}},
}

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The ratio FEV₁/FVC and its association to respiratory symptoms—A Swedish general population study