scholarly journals A Dyadic Growth Modeling Approach for Examining Associations Between Weight Gain and Lung Function Decline

2020 ◽  
Vol 189 (10) ◽  
pp. 1173-1184
Author(s):  
Talea Cornelius ◽  
Joseph E Schwartz ◽  
Pallavi Balte ◽  
Surya P Bhatt ◽  
Patricia A Cassano ◽  
...  
Keyword(s):  
Weight Gain ◽  
Lung Function ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Rapid Decline ◽  
Linear Modeling ◽  
Lung Function Decline ◽  
Related Factors ◽  
Modeling Approach ◽  
Residual Correlations

Abstract The relationship between body weight and lung function is complex. Using a dyadic multilevel linear modeling approach, treating body mass index (BMI; weight (kg)/height (m)2) and lung function as paired, within-person outcomes, we tested the hypothesis that persons with more rapid increase in BMI exhibit more rapid decline in lung function, as measured by forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and their ratio (FEV1:FVC). Models included random intercepts and slopes and adjusted for sociodemographic and smoking-related factors. A sample of 9,115 adults with paired measurements of BMI and lung function taken at ≥3 visits were selected from a pooled set of 5 US population-based cohort studies (1983–2018; mean age at baseline = 46 years; median follow-up, 19 years). At age 46 years, average annual rates of change in BMI, FEV1, FVC, and FEV1:FVC ratio were 0.22 kg/m2/year, −25.50 mL/year, −21.99 mL/year, and −0.24%/year, respectively. Persons with steeper BMI increases had faster declines in FEV1 (r = −0.16) and FVC (r = −0.26) and slower declines in FEV1:FVC ratio (r = 0.11) (all P values < 0.0001). Results were similar in subgroup analyses. Residual correlations were negative (P < 0.0001), suggesting additional interdependence between BMI and lung function. Results show that greater rates of weight gain are associated with greater rates of lung function loss.

scholarly journals Associations between blood eosinophils and decline in lung function among adults with and without asthma

2018 ◽  
Vol 51 (4) ◽  
pp. 1702536 ◽  
Author(s):  
Robert J. Hancox ◽  
Ian D. Pavord ◽  
Malcolm R. Sears
Keyword(s):  
Lung Function ◽  
Vital Capacity ◽  
Airflow Obstruction ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Lung Function Decline ◽  
Characteristic Features ◽  
Predicted Values ◽  
Blood Eosinophils ◽  
Eosinophil Counts

Eosinophilic inflammation and airway remodelling are characteristic features of asthma, but the association between them is unclear. We assessed associations between blood eosinophils and lung function decline in a population-based cohort of young adults.We used linear mixed models to analyse associations between blood eosinophils and spirometry at 21, 26, 32 and 38 years adjusting for sex, smoking, asthma and spirometry at age 18 years. We further analysed associations between mean eosinophil counts and changes in spirometry from ages 21 to 38 years.Higher eosinophils were associated with lower forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratios and lower FEV1 % predicted values for both pre- and post-bronchodilator spirometry (all p-values ≤0.048). Although eosinophil counts were higher in participants with asthma, the associations between eosinophils and spirometry were similar among participants without asthma or wheeze. Participants with mean eosinophil counts >0.4×109 cells·L−1 between 21 and 38 years had greater declines in FEV1/FVC ratios (difference 1.8%, 95% CI 0.7–2.9%; p=0.001) and FEV1 values (difference 3.4% pred, 95% CI 1.5–5.4% pred); p=0.001) than those with lower counts.Blood eosinophils are associated with airflow obstruction and enhanced decline in lung function, independently of asthma and smoking. Eosinophilia is a risk factor for airflow obstruction even in those without symptoms.

scholarly journals Lung function, forced expiratory volume in 1 s decline and COPD hospitalisations over 44 years of follow-up

2015 ◽  
Vol 47 (3) ◽  
pp. 742-750 ◽  
Author(s):  
Suneela Zaigham ◽  
Per Wollmer ◽  
Gunnar Engström
Keyword(s):  
Lung Function ◽  
Airflow Obstruction ◽  
Fixed Ratio ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Lung Function Decline ◽  
Obstructive Pulmonary Disease ◽  
Hazard Ratios

The use of baseline lung function in the prediction of chronic obstructive pulmonary disease (COPD) hospitalisations, all-cause mortality and lung function decline was assessed in the population-based “Men Born in 1914” cohort.Spirometry was assessed at age 55 years in 689 subjects, of whom 392 had spirometry reassessed at age 68  years. The cohort was divided into three groups using fixed ratio (FR) and lower limit of normal (LLN) criterion: forced expiratory volume in 1 s (FEV1)/vital capacity (VC) ≥70%, FEV1/VC <70% but ≥LLN (FR+LLN−), and FEV1/VC <70% and <LLN (FR+LLN+).Over 44 years of follow-up, 88 men were hospitalised due to COPD and 686 died. Hazard ratios (95% CI) for incident COPD hospitalisation were 4.15 (2.24–7.69) for FR+LLN− and 7.88 (4.82–12.87) for FR+LLN+ (reference FEV1/VC ≥70%). Hazard ratios for death were 1.30 (0.98–1.72) for FR+LLN− and 1.58 (1.25–2.00) for FR+LLN+. The adjusted FEV1 decline between 55 and 68 years of age was higher for FR+LLN− and FR+LLN+ relative to the reference. Of those with FR+LLN− at 55 years, 53% had progressed to the FR+LLN+ group at 68 years.Airflow obstruction at age 55 years is a powerful risk factor for future COPD hospitalisations. The FR+LLN− group should be carefully evaluated in clinical practice in relation to future risks and potential benefit from early intervention. This is reinforced by the increased FEV1 decline in this group.

High eosinophil counts predict decline in FEV1: Results from the CanCOLD study

2020 ◽  
pp. 2000838 ◽  
Author(s):  
Wan C. Tan ◽  
Jean Bourbeau ◽  
Gilbert Nadeau ◽  
Wendy Wang ◽  
Neil Barnes ◽  
...  
Keyword(s):  
Lung Function ◽  
Reference Group ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Blood Eosinophil ◽  
Lung Function Decline ◽  
Quantitative Ct ◽  
Ct Measurements ◽  
History Of ◽  
Airway Abnormalities

IntroductionThe aim of this study was to examine the association between blood eosinophil (EOS) levels and the decline in lung function in individuals over the age of 40 from the general population.MethodsThe study evaluated the EOS counts from thawed blood in 1120 participants (mean age 65 years) from the prospective population-based Canadian Cohort of Obstructive Lung Disease (CanCOLD) study. Participants answered interviewer-administered respiratory questionnaires and performed pre-/post-bronchodilator spirometric tests at 18-month intervals; computed tomography (CT) imaging was performed at baseline. Statistical analyses to describe the relationship between EOS levels and decline in forced expiratory volume in 1 s (FEV1) were performed using random mixed effects regression models with adjustments for demographics, smoking, baseline FEV1, ever-asthma and history of exacerbations in the previous 12 months. CT measurements were compared between EOS subgroups using an analysis of variance.ResultsParticipants who had a peripheral EOS count of ≥300 cells·µL−1 (n=273) had a greater decline in FEV1 compared with those with EOS counts of <150 cells·µL−1 (n=430) [p=0.003] (reference group) and 150 to <300 cells·µL−1 (n=417) [p=0.003]. The absolute change in FEV1 was −32.99 mL·year−1 for participants with EOS counts <150 cells·µL−1; −38.78 mL·year−1 for those with 150 to <300 cells·µL−1; and −67.30 mL·year−1 for participants with ≥300 cells·µL−1. In COPD, higher EOS count was associated with quantitative CT measurements reflecting both small and large airway abnormalities.ConclusionA blood EOS count of ≥300 cells·µL−1 is an independent risk factor for accelerated lung function decline in older adults and is related to undetected structural airway abnormalities.

scholarly journals Trajectory and mortality of preserved ratio impaired spirometry: the Rotterdam Study

2019 ◽  
Vol 55 (1) ◽  
pp. 1901217 ◽  
Author(s):  
Sara Renata Alex Wijnant ◽  
Emmely De Roos ◽  
Maryam Kavousi ◽  
Bruno Hugo Stricker ◽  
Natalie Terzikhan ◽  
...  
Keyword(s):  
Lung Function ◽  
Chronic Obstructive Lung Disease ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Rotterdam Study ◽  
Lung Function Decline ◽  
Cardiovascular Comorbidities ◽  
Age Related

Preserved ratio impaired spirometry (PRISm) is a heterogeneous condition but its course and disease progression remain to be elucidated. We aimed to examine its prevalence, trajectories and prognosis in the general population.In the Rotterdam Study (population-based prospective cohort) we examined prevalence, trajectories and prognosis of subjects with normal spirometry (controls; forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ≥0.7, FEV1  ≥80%), PRISm (FEV1/FVC ≥0.7, FEV1 <80%) and chronic obstructive pulmonary disease (COPD) (FEV1/FVC <0.7) at two study visits. Hazard ratios with 95% confidence intervals for mortality (until December 30, 2018) were adjusted for age, sex, body mass index, current smoking and pack-years.Of 5487 subjects (age 69.1±8.9 years; 7.1% PRISm), 1603 were re-examined after 4.5 years. Of the re-examined PRISm subjects, 15.7% transitioned to normal spirometry and 49.4% to COPD. Median lung function decline was highest in subjects with incident PRISm (FEV1 −92.8 mL·year−1, interquartile range (IQR) −131.9– −65.8 mL·year−1; FVC −93.3 mL·year−1, IQR −159.8– −49.1 mL·year−1), but similar in persistent PRISm (FEV1 −30.2 mL·year−1, IQR −67.9– −7.5 mL·year−1; FVC −20.1 mL·year−1, IQR −47.7–21.7 mL·year−1) and persistent controls (FEV1 −39.6 mL·year−1, IQR −64.3–−12.7 mL·year−1; FVC −20.0 mL·year−1, IQR −55.4–18.8 mL·year−1). Of 5459 subjects with informed consent for follow-up, 692 (12.7%) died during 9.3 years (maximum) follow-up: 10.3% of controls, 18.7% of PRISm subjects and 20.8% of COPD subjects. Relative to controls, subjects with PRISm and COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2–4 had increased all-cause mortality (PRISm: HR 1.6, 95% CI 1.2–2.0; COPD GOLD 2–4: HR 1.7, 95% CI 1.4–2.1) and cardiovascular mortality (PRISm: HR 2.8, 95% CI 1.5–5.1; COPD 2–4: HR 2.1, 95% CI 1.2–3.6). Mortality within <1 year was highest in PRISm, with patients often having cardiovascular comorbidities (heart failure or coronary heart disease; 70.0%).PRISm is associated with increased mortality and this population encompasses at least three distinct subsets: one that develops COPD during follow-up, a second with high cardiovascular burden and early mortality, and a third with persistent PRISm and normal age-related lung function decline.

scholarly journals Lung function changes over 8 years and testosterone markers in both sexes: UK Biobank

2020 ◽  
Vol 6 (3) ◽  
pp. 00070-2020
Author(s):  
Alexandra Lenoir ◽  
Elaine Fuertes ◽  
Francisco Gómez-Real ◽  
Benedicte Leynaert ◽  
Diana A. van der Plaat ◽  
...  
Keyword(s):  
Lung Function ◽  
Free Testosterone ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Uk Biobank ◽  
Lung Function Decline ◽  
Cross Sectional ◽  
Physically Active

Higher levels of testosterone have been associated with better lung function in cross-sectional population-based studies. The role of testosterone in lung function in women and in lung function decline in men or women is unclear.We studied 5114 men and 5467 women in the UK Biobank with high-quality spirometry at baseline (2006–2010) and 8.4 years later. We studied cross-sectional associations of total testosterone (TT), calculated free testosterone (cFT), free androgen index (FAI) and sex hormone-binding globulin (SHBG) with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC using linear regression and associations of baseline markers with lung function decline using linear mixed-effects regression.Men with higher levels of TT had higher FEV1 (27.56 mL per interquartile range increase TT, 95% CI 5.43–49.68) and FVC (48.06 mL, 95% CI 22.07–74.06) at baseline. Higher cFT levels were associated with higher FEV1 and FVC among physically active men only. In women, higher FAI and cFT levels were associated with lower lung function at baseline and higher levels of TT, cFT and FAI were associated with slightly attenuated FEV1 and FVC decline. Higher levels of SHBG were associated with better lung function in both sexes but slightly accelerated decline in men.In this population-based sample, higher levels of TT were associated with better lung function in men and higher levels of cFT with better lung function in physically active men. A small attenuation of lung function decline with higher levels of TT, cFT and FAI was seen in women only.

scholarly journals Non-communicable respiratory disease and air pollution exposure in Malawi: a prospective cohort study

Thorax ◽  
2020 ◽  
Vol 75 (3) ◽  
pp. 220-226 ◽  
Author(s):  
Sarah Rylance ◽  
Chris Jewell ◽  
Andrew Naunje ◽  
Frank Mbalume ◽  
John D Chetwood ◽  
...  
Keyword(s):  
Air Pollution ◽  
Lung Function ◽  
Fine Particulate Matter ◽  
Likelihood Estimation ◽  
Personal Exposure ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Sub Saharan Africa ◽  
Reference Ranges ◽  
Lung Function Decline

RationaleThere are no population-based studies from sub-Saharan Africa describing longitudinal lung function in adults.ObjectivesTo explore the lung function trajectories and their determinants, including the effects of air pollution exposures and the cleaner-burning biomass-fuelled cookstove intervention of the Cooking and Pneumonia Study (CAPS), in adults living in rural Malawi.MethodsWe assessed respiratory symptoms and exposures, spirometry and measured 48-hour personal exposure to fine particulate matter (PM2.5) and carbon monoxide (CO), on three occasions over 3 years. Longitudinal data were analysed using mixed-effects modelling by maximum likelihood estimation.Measurements and main resultsWe recruited 1481 adults, mean (SD) age 43.8 (17.8) years, including 523 participants from CAPS households (271 intervention; 252 controls), and collected multiple spirometry and air pollution measurements for 654 (44%) and 929 (63%), respectively. Compared with Global Lung Function Initiative African-American reference ranges, mean (SD) FEV1 (forced expiratory volume in 1 s) and FVC (forced vital capacity) z-scores were −0.38 (1.14) and −0.19 (1.09). FEV1 and FVC were determined by age, sex, height, previous TB and body mass index, with FEV1 declining by 30.9 mL/year (95% CI: 21.6 to 40.1) and FVC by 38.3 mL/year (95% CI: 28.5 to 48.1). There was decreased exposure to PM2.5 in those with access to a cookstove but no effect on lung function.ConclusionsWe did not observe accelerated lung function decline in this cohort of Malawian adults, compared with that reported in healthy, non-smoking populations from high-income countries; this suggests that the lung function deficits we measured in adulthood may have origins in early life.

scholarly journals 12-year adherence to inhaled corticosteroids in adult-onset asthma

2020 ◽  
Vol 6 (1) ◽  
pp. 00324-2019
Author(s):  
Iida Vähätalo ◽  
Pinja Ilmarinen ◽  
Leena E. Tuomisto ◽  
Minna Tommola ◽  
Onni Niemelä ◽  
...  
Keyword(s):  
Lung Function ◽  
Inhaled Corticosteroids ◽  
Immunoglobulin E ◽  
Linear Regression Analysis ◽  
Forced Expiratory Volume ◽  
Rapid Decline ◽  
Blood Eosinophil ◽  
Adult Onset ◽  
Lung Function Decline ◽  
Adult Asthma

Adherence to inhaled corticosteroids (ICS) has been suggested to be poor but long-term follow-ups are lacking. The objective of the present study was to assess adherence to ICS treatment in patients with adult-onset asthma during 12-year follow-up.A total of 181 patients with clinically confirmed, new-onset adult asthma were followed for 12 years as part of the Seinäjoki Adult Asthma Study. Adherence to ICS was assessed individually as the percentage of true dispensed ICS in micrograms per true prescribed daily ICS in micrograms over 12 years.Mean 12-year adherence to ICS was 69% (mean±sd dispensed 2.5±1.8 g and prescribed 3.6±1.5 g budesonide equivalent per patient for 12 years), annual adherence varying between 81% (year 1) and 67% (year 12). Patients with good 12-year adherence (≥80%) used oral corticosteroids more often, and had add-on drugs in use and asthma-related visits to healthcare more often. In addition, they showed less reversibility in forced expiratory volume in 1 s and had higher peripheral blood neutrophil counts. However, lung function decline was steeper in patients with poorer adherence (<80%) and this association remained in multiple linear regression analysis. No difference was found in symptom scores, blood eosinophil counts, exhaled nitric oxide or immunoglobulin E between the patients with different levels of adherence.In patients with adult-onset asthma, adherence to ICS was moderate. Poorer adherence (<80%) to ICS was associated with more rapid decline in lung function but was not associated to symptoms or markers of inflammatory endotypes.

scholarly journals Improving lung function in adolescents with CF by tracking annual rate of lung function decline

2021 ◽  
Vol 10 (3) ◽  
pp. e001199
Author(s):  
Sydney Schiff ◽  
Miah Starks ◽  
Rachel W Linnemann
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Forced Expiratory Volume ◽  
Rapid Decline ◽  
Lung Function Decline ◽  
Progressive Decline ◽  
Individual Patient Level ◽  
Proactive Approach ◽  
Level Data ◽  
Lung Health

BackgroundFor patients with cystic fibrosis (CF), sustaining lung function through the adolescent years is crucial to slow the progressive decline that leads to significant morbidity and early mortality. This holds true for patients with high per cent predicted forced expiratory volume in 1 s (ppFEV1), as they may receive less vigilant monitoring and treatment. Early identification of lung function decline followed by aggressive treatment can lead to preservation of lung function.InterventionThe Emory+Children’s Pediatric Cystic Fibrosis Program implemented multiple quality improvement (QI) initiatives to identify and aggressively treat adolescent patients with a rapid decline in lung function. These initiatives included (1) lung zones to categorise and highlight lung function decline, (2) individual lung decline tables for quick reference, (3) a lung health algorithm to encourage uniformity, (4) a rapid decliner checklist to identify potential reasons for individual decline and (5) an automated individual patient-level data report and centre scorecard. We tested these interventions with plan–do–study–act cycles and refined as needed.ResultsImplementation of these QI initiatives resulted in overall improvement in lung function and slowing of lung function decline among adolescents with CF . This improvement could be attributed to the more standardised and proactive approach to decreases in lung function and the increased clinician attention to patients with rapid decline, especially for patients with high baseline ppFEV1.

scholarly journals Risk Factors of Rapid Lung Function Decline in COPD Patients of Real World

2021 ◽  
Author(s):  
Hyun Woo Lee ◽  
Jung-Kyu Lee ◽  
Myung Goo Lee ◽  
Kyung-Chul Shin ◽  
Seung Won Ra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Function ◽  
Forced Expiratory Volume ◽  
Current Smoker ◽  
Rapid Decline ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Lung Function Decline ◽  
Obstructive Pulmonary Disease ◽  
Triple Combination Therapy

Abstract Background: Rapid lung function decliners have been considered a unique subgroup of patients with chronic obstructive pulmonary disease (COPD). A rapid decline manifests early and is related with a poor prognosis. Therefore, pre-emptive identification of risk factors for rapid decliner is necessary. We aimed to determine those risk factors in Korean patients.Methods: A longitudinal, observational study was conducted on the KOCOSS cohort (NCT02800499), consisting of patients assessed from January 2012 to December 2019 at 54 medical centers in South Korea. Eligible patients were adults followed up for 3 years with serial spirometric tests. We calculated the annualized percentage change in lung function from baseline. Rapid decliners were defined as the quartile of patients with the highest annualized percentage decline in lung function. Results: Among the 518 included patients, 130 were rapid decliners. Rapid decliners lost 6.2%/year and 100 ml/year of forced expiratory volume in 1 second from baseline. Rapid decliners had a higher rate of severe exacerbations than non-rapid decliners (0.2/year vs. 0.1/year, P=0.032). Upon multivariable logistic regression, male sex, being a current smoker, a blood eosinophil count <150/µl, and a high forced vital capacity were independent risk factors for a rapid decline. In rapid decliners, lung function deteriorated more rapidly in current smokers and patients with more severe dyspnea, while triple combination therapy attenuated lung function decline compared to mono-bronchodilator therapy.Conclusions: Identification of risk and aggravating factors for rapid lung function decline may assist physicians in providing earlier intervention for high-risk patients with COPD.

scholarly journals Lung function decline is associated with serum uric acid in Korean health screening individuals

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyung-Min Ahn ◽  
Suh-Young Lee ◽  
So-Hee Lee ◽  
Sun-Sin Kim ◽  
Heung-Woo Park
Keyword(s):  
Uric Acid ◽  
Lung Function ◽  
Serum Uric Acid ◽  
Uric Acid Level ◽  
Acid Level ◽  
Serum Uric Acid Level ◽  
Forced Expiratory Volume ◽  
Linear Regression Models ◽  
Lung Function Decline ◽  
Health Screenings

AbstractWe performed a retrospective cohort study of 19,237 individuals who underwent at least three health screenings with follow-up periods of over 5 years to find a routinely checked serum marker that predicts lung function decline. Using linear regression models to analyze associations between the rate of decline in the forced expiratory volume in 1 s (FEV1) and the level of 10 serum markers (calcium, phosphorus, uric acid, total cholesterol, total protein, total bilirubin, alkaline phosphatase, aspartate aminotransferase, creatinine, and C-reactive protein) measured at two different times (at the first and third health screenings), we found that an increased uric acid level was significantly associated with an accelerated FEV1 decline (P = 0.0014 and P = 0.037, respectively) and reduced FEV1 predicted % (P = 0.0074 and P = 8.64 × 10–7, respectively) at both visits only in non-smoking individuals. In addition, we confirmed that accelerated forced vital capacity (FVC) and FEV1/FVC ratio declines were observed in non-smoking individuals with increased serum uric acid levels using linear mixed models. The serum uric acid level thus potentially predicts an acceleration in lung function decline in a non-smoking general population.

Sign in / Sign up

Export Citation Format

Share Document