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Restrictive Spirometric Pattern and Preserved Ratio Impaired Spirometry in a Population Aged 50–64 Years

Torén, Kjell ; Blomberg, Anders ; Schiöler, Linus ; Malinovschi, Andrei ; Backman, Helena ; Caidahl, Kenneth ; Carlhäll, Carl Johan ; Ekbom, Emil ; Ekström, Magnus LU orcid and Engström, Gunnar LU , et al. (2024) In Annals of the American Thoracic Society 21(11). p.1524-1532
Abstract

Rationale: Knowledge regarding the prevalence and shared and unique characteristics of the 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. Objectives: To investigate shared and unique features for RSP and PRISm. Methods: 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. Odds ratios with 95% confidence... (More)

Rationale: Knowledge regarding the prevalence and shared and unique characteristics of the 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. Objectives: To investigate shared and unique features for RSP and PRISm. Methods: 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. Odds ratios with 95% confidence intervals (CIs) were calculated using adjusted logistic regression. RSP was defined as forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) >0.70 and FVC,80%. PRISm was defined as FEV1/FVC >0.70 and FEV1 ,80%. A local reference equation was applied. Results: 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, bronchial wall thickening, interstitial lung abnormalities, and bronchiectasis. Emphysema was uniquely linked to PRISm (odds ratio, 1.69; 95% CI, 1.36–2.10) versus 1.10 (95% CI, 0.84–1.43) for RSP. Coronary artery calcification score >300 was related to PRISm, but not among never-smokers. Conclusions: PRISm and RSP have respiratory, cardiovascul 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 PRI may share more features than not.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
epidemiology, general population, lung function, never-smokers
in
Annals of the American Thoracic Society
volume
21
issue
11
pages
9 pages
publisher
American Thoracic Society
external identifiers
  • pmid:39079106
  • scopus:85208453210
ISSN
2329-6933
DOI
10.1513/AnnalsATS.202403-242OC
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2024 by the American Thoracic Society.
id
b7293b4d-c88f-4eb2-8106-6df3ab34bcf8
date added to LUP
2025-01-14 15:43:41
date last changed
2025-01-28 17:12:44
@article{b7293b4d-c88f-4eb2-8106-6df3ab34bcf8,
  abstract     = {{<p>Rationale: Knowledge regarding the prevalence and shared and unique characteristics of the 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. Objectives: To investigate shared and unique features for RSP and PRISm. Methods: 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. Odds ratios with 95% confidence intervals (CIs) were calculated using adjusted logistic regression. RSP was defined as forced expiratory volume in 1 second (FEV<sub>1</sub>)/forced vital capacity (FVC) &gt;0.70 and FVC,80%. PRISm was defined as FEV<sub>1</sub>/FVC &gt;0.70 and FEV<sub>1</sub> ,80%. A local reference equation was applied. Results: 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, bronchial wall thickening, interstitial lung abnormalities, and bronchiectasis. Emphysema was uniquely linked to PRISm (odds ratio, 1.69; 95% CI, 1.36–2.10) versus 1.10 (95% CI, 0.84–1.43) for RSP. Coronary artery calcification score &gt;300 was related to PRISm, but not among never-smokers. Conclusions: PRISm and RSP have respiratory, cardiovascul 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 PRI may share more features than not.</p>}},
  author       = {{Torén, Kjell and Blomberg, Anders and Schiöler, Linus and Malinovschi, Andrei and Backman, Helena and Caidahl, Kenneth and Carlhäll, Carl Johan and Ekbom, Emil and Ekström, Magnus and Engström, Gunnar and Engvall, Jan E. and Eriksson, Maria J. and Hamrefors, Viktor and Janson, Christer and Johnsson, Åse and Khalil, Mohammad and Kylhammar, David and Lindberg, Anne and Nilsson, Ulf and Olin, Anna Carin and Pesonen, Ida and Sjölund, Jessica and Sköld, C. Magnus and Svartengren, Magnus and Östgren, Carl Johan and Wollmer, Per}},
  issn         = {{2329-6933}},
  keywords     = {{epidemiology; general population; lung function; never-smokers}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1524--1532}},
  publisher    = {{American Thoracic Society}},
  series       = {{Annals of the American Thoracic Society}},
  title        = {{Restrictive Spirometric Pattern and Preserved Ratio Impaired Spirometry in a Population Aged 50–64 Years}},
  url          = {{http://dx.doi.org/10.1513/AnnalsATS.202403-242OC}},
  doi          = {{10.1513/AnnalsATS.202403-242OC}},
  volume       = {{21}},
  year         = {{2024}},
}