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.

scholarly journals Global Lung Function Initiative 2012 reference equations for spirometry in the Norwegian population

2016 ◽  
Vol 48 (6) ◽  
pp. 1602-1611 ◽  
Author(s):  
Arnulf Langhammer ◽  
Ane Johannessen ◽  
Turid L. Holmen ◽  
Hasse Melbye ◽  
Sanja Stanojevic ◽  
...  
Keyword(s):  
Lung Function ◽  
Reference Values ◽  
Vital Capacity ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Female Adolescents ◽  
Norwegian Population ◽  
Reference Equations ◽  
Z Scores ◽  
Lower Limit Of Normal

We studied the fit of the Global Lung Function Initiative (GLI) all-age reference values to Norwegians, compared them with currently used references (European Community for Steel and Coal (ECSC) and Zapletal) and estimated the prevalence of obstructive lung disease.Spirometry data collected in 30 239 subjects (51.7% females) aged 12–90 years in three population-based studies were converted to z-scores.We studied healthy non-smokers comprising 2438 adults (57.4% females) aged 20–90 years and 8725 (47.7% female) adolescents aged 12–19 years. The GLI-2012 prediction equations fitted the Norwegian data satisfactorily. Median±sd z-scores were respectively 0.02±1.03, 0.01±1.04 and −0.04±0.91 for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC in males, and −0.01±1.02, 0.07±0.97 and −0.21±0.82 in females. The ECSC and Zapletal references significantly underestimated FEV1 and FVC. Stricter criteria of obstruction (FEV1/FVC <GLI-2012 lower limit of normal (LLN)) carried a substantially higher risk of obstructive characteristics than FEV1/FVC <0.7 and >GLI-2012 LLN. Corresponding comparison regarding myocardial infarction showed a four-fold higher risk for women.The GLI-2012 reference values fit the Norwegian data satisfactorily and are recommended for use in Norway. Correspondingly, the FEV1/FVC GLI-2012 LLN identifies higher risk of obstructive characteristics than FEV1/FVC <0.7.

scholarly journals Thoracic dust exposure is associated with lung function decline in cement production workers

2016 ◽  
Vol 48 (2) ◽  
pp. 331-339 ◽  
Author(s):  
Karl-Christian Nordby ◽  
Hilde Notø ◽  
Wijnand Eduard ◽  
Marit Skogstad ◽  
Anne Kristin Fell ◽  
...  
Keyword(s):  
Lung Function ◽  
Mixed Model ◽  
Statistical Modelling ◽  
Forced Expiratory Volume ◽  
Dust Exposure ◽  
Lung Function Decline ◽  
Lung Volumes ◽  
Cement Production ◽  
Yearly Change ◽  
Predicted Values

We hypothesised that exposure to workplace aerosols may lead to lung function impairment among cement production workers.Our study included 4966 workers in 24 cement production plants. Based on 6111 thoracic aerosol samples and information from questionnaires we estimated arithmetic mean exposure levels by plant and job type. Dynamic lung volumes were assessed by repeated spirometry testing during a mean follow-up time of 3.5 years (range 0.7–4.6 years). The outcomes considered were yearly change of dynamic lung volumes divided by the standing height squared or percentage of predicted values. Statistical modelling was performed using mixed model regression. Individual exposure was classified into quintile levels limited at 0.09, 0.89, 1.56, 2.25, 3.36, and 14.6 mg·m−3, using the lowest quintile as the reference. Employees that worked in administration were included as a second comparison group.Exposure was associated with a reduction in forced expiratory volume in 1 s (FEV1), forced expiratory volume in 6 s and forced vital capacity. For FEV1% predicted a yearly excess decline of 0.84 percentage points was found in the highest exposure quintile compared with the lowest.Exposure at the higher levels found in this study may lead to a decline in dynamic lung volumes. Exposure reduction is therefore warranted.

scholarly journals Uncontrolled asthma from childhood to young adulthood associates with airflow obstruction

2021 ◽  
Vol 7 (4) ◽  
pp. 00179-2021
Author(s):  
Ida Mogensen ◽  
Jenny Hallberg ◽  
Sandra Ekström ◽  
Anna Bergström ◽  
Erik Melén ◽  
...  
Keyword(s):  
Lung Function ◽  
Young Adulthood ◽  
Regression Coefficient ◽  
Airflow Obstruction ◽  
Estimating Equation ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Active Management ◽  
Uncontrolled Asthma ◽  
Allergic Sensitisation

IntroductionLung function development from childhood to young adulthood is important for lung health later in life. We investigated the association between asthma control and lung function from 8 to 24 years of age.MethodsA total of 668 participants from the population-based BAMSE cohort study, with persistent or incidental asthma and between 8 and 24 years of age, were included. Asthma was defined as controlled or uncontrolled at each examination based on the Global Initiative for Asthma (GINA) criteria. Dynamic spirometry was performed at 8, 16 and 24 years of age. Associations between uncontrolled asthma and pre-bronchodilation forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio were evaluated with a generalised estimating equation model, as overall associations and at each examination. Unadjusted and adjusted (for sex, current asthma, allergic sensitisation, body mass index, smoking, smoke exposure, inhaled corticosteroid use) analyses were done; and were thereafter stratified by sex, elevated blood eosinophils (≥0.3×109 cells·µL−1), elevated FENO (≥25 ppb), allergic sensitisation and ever/never smoking.ResultsUncontrolled asthma was associated with a lower overall FEV1/FVC z-score from 8 to 24 years of age (adjusted regression coefficient −0.11; 95% CI (−0.20 to −0.02; p=0.016). After stratification, this association was primarily seen among females (adjusted regression coefficient −0.170; 95% CI (−0.298 to −0.044; p=0.009) and participants with elevated FENO (regression coefficient −0.207; 95% CI −0.342 to −0.073; p=0.002), in contrast to males and participants with normal FENO.ConclusionUncontrolled asthma is associated with airflow obstruction from childhood to young adulthood. This highlights the importance of active management of asthma during growth.

scholarly journals Cohort profile: The Chikwawa lung health cohort; a population-based observational non-communicable respiratory disease study of adults in Malawi

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242226
Author(s):  
Martin W. Njoroge ◽  
Sarah Rylance ◽  
Rebecca Nightingale ◽  
Stephen Gordon ◽  
Kevin Mortimer ◽  
...  
Keyword(s):  
Lung Function ◽  
Low Income ◽  
Respiratory Symptoms ◽  
Airflow Obstruction ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Sub Saharan Africa ◽  
Rural Setting ◽  
Lung Health

Purpose The aim of this article is to provide a detailed description of the Chikwawa lung health cohort which was established in rural Malawi to prospectively determine the prevalence and causes of lung disease amongst the general population of adults living in a low-income rural setting in Sub-Saharan Africa. Participants A total of 1481 participants were randomly identified and recruited in 2014 for the baseline study. We collected data on demographic, socio-economic status, respiratory symptoms and potentially relevant exposures such as smoking, household fuels, environmental exposures, occupational history/exposures, dietary intake, healthcare utilization, cost (medication, outpatient visits and inpatient admissions) and productivity losses. Spirometry was performed to assess lung function. At baseline, 56.9% of the participants were female, mean age was 43.8 (SD:17.8) and mean body mass index (BMI) was 21.6 Kg/m2 (SD: 3.46) Findings to date The cohort has reported the prevalence of chronic respiratory symptoms (13.6%, 95% confidence interval [CI], 11.9–15.4), spirometric obstruction (8.7%, 95% CI, 7.0–10.7), and spirometric restriction (34.8%, 95% CI, 31.7–38.0). Additionally, an annual decline in forced expiratory volume in one second [FEV1] of 30.9mL/year (95% CI: 21.6 to 40.1) and forced vital capacity [FVC] by 38.3 mL/year (95% CI: 28.5 to 48.1) has been reported. Future plans The ongoing phases of follow-up will determine the annual rate of decline in lung function as measured through spirometry and the development of airflow obstruction and restriction, and relate these to morbidity, mortality and economic cost of airflow obstruction and restriction. Population-based mathematical models will be developed driven by the empirical data from the cohort and national population data for Malawi to assess the effects of interventions and programmes to address the lung burden in Malawi. The present follow-up study started in 2019.

scholarly journals Chronic Respiratory Symptoms and Lung Function of Farmer and Breeder in UTU Village, Tabanan, Bali

2020 ◽  
Vol 8 (B) ◽  
pp. 709-715
Author(s):  
Ni Luh Putu Eka Arisanti ◽  
Ni Putu Ayu Widiasari ◽  
Ida Bagus Ngurah Rai
Keyword(s):  
Lung Function ◽  
Respiratory Symptoms ◽  
Vital Capacity ◽  
Cross Sectional Study ◽  
Forced Expiratory Volume ◽  
Smoking History ◽  
Sectional Study ◽  
Lung Function Decline ◽  
Cross Sectional ◽  
Passive Smoker

AIM: The objective of the study was to determine chronic respiratory symptoms and lung function of farmers. METHODS: The study was conducted in Utu Village, Tabanan, Bali with 84 subjects. This research was observational analytic cross sectional study. RESULTS: Three dominant chronic respiratory symptoms in farmers were coughing (15.1%), dyspnea (13.1%), and phlegm (13.1%). Average values of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC were 83.75 ± 34.42, respectively, 81.62 ± 34.30 and 104.90 ± 13.90, respectively. Cough was dominant experiencing by smokers (p = 0.008). Mean of FEV1% prediction and FVC% prediction value was lower in passive smoker group than no smoker group (p = 0.005 and p = 0.03). CONCLUSION: Occupational exposure while farming and raising livestock can cause chronic respiratory symptom and lung function decline in farmers and can be influenced by smoking history and secondhand smoke exposure.

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 Dietary antioxidants and 10-year lung function decline in adults from the ECRHS survey

2017 ◽  
Vol 50 (6) ◽  
pp. 1602286 ◽  
Author(s):  
Vanessa Garcia-Larsen ◽  
James F. Potts ◽  
Ernst Omenaas ◽  
Joachim Heinrich ◽  
Cecilie Svanes ◽  
...  
Keyword(s):  
Lung Function ◽  
Multiple Testing ◽  
Vital Capacity ◽  
Respiratory Health ◽  
Forced Expiratory Volume ◽  
Lung Function Decline ◽  
Dietary Antioxidants ◽  
Food Frequency ◽  
Multivariable Analyses ◽  
The Relationship

The relationship between lung function decline and dietary antioxidants over 10 years in adults from three European countries was investigated.In 2002, adults from three participating countries of the European Community Respiratory Health Survey (ECRHS) answered a questionnaire and underwent spirometry (forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)), which were repeated 10 years later. Dietary intake was estimated at baseline with food frequency questionnaires (FFQ). Associations between annual lung function decline (mL) and diet (tertiles) were examined with multivariable analyses. Simes’ procedure was applied to control for multiple testing.A total of 680 individuals (baseline mean age 43.8±6.6 years) were included. A per-tertile increase in apple and banana intake was associated with a 3.59 mL·year−1 (95% CI 0.40, 7.68) and 3.69 mL·year−1 (95% CI 0.25, 7.14) slower decline in FEV1 and FVC, respectively. Tomato intake was also associated with a slower decline in FVC (4.5 mL·year−1; 95% CI 1.28, 8.02). Only the association with tomato intake remained statistically significant after the Simes’ procedure was performed. Subgroup analyses showed that apple, banana and tomato intake were all associated with a slower decline in FVC in ex-smokers.Intake of fruits and tomatoes might delay lung function decline in adults, particularly in ex-smokers.

scholarly journals Pulmonary impairment after tuberculosis in a South African population

2016 ◽  
Vol 72 (1) ◽  
Author(s):  
Gibwa Cole ◽  
Duncan Miller ◽  
Tasneem Ebrahim ◽  
Tannith Dreyden ◽  
Rory Simpson ◽  
...  
Keyword(s):  
Lung Function ◽  
Pulmonary Tuberculosis ◽  
South African ◽  
Pulmonary Rehabilitation ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Predicted Values

Background: In South Africa, pulmonary tuberculosis (PTB) remains a problem of epidemic proportions. Despite evidence demonstrating persistent lung impairment after PTB cure, few population-based South African studies have investigated this finding. Pulmonary rehabilitation post-cure is not routinely received.Objectives: To determine the effects of PTB on lung function in adults with current or past PTB. To determine any association between PTB and chronic obstructive pulmonary disease (COPD). Methods: This study was observational and cross-sectional in design. Participants (n = 55) were included if they were HIV positive on treatment, had current PTB and were on treatment, and/or had previous PTB and completed treatment or if they were healthy adult subjects with no history of PTB. A sample of convenience was used with participants coming from a similar socio-economic background and undergoing spirometry testing. Multiple regression analyses were conducted on each lung function variable.Results: Compared to normal percentage-predicted values, forced expiratory volume in 1 second (FEV1 ), forced vital capacity (FVC) and FEV1 :FVC were significantly reduced in those with current PTB by 23.39%, 15.99% and 6.4%, respectively. Both FEV1 and FVC were significantly reduced in those with past PTB by 11.76% and 10.79%, respectively. There was no association between PTB and COPD – those with previous PTB having a reduced FEV1 :FVC (4.88% less than the norm), which was just short of significance (p = 0.059).Conclusions: Lung function is reduced both during and after treatment for PTB and these deficits may persist. This has implications regarding the need for pulmonary rehabilitation even after medical cure.Keywords: Lung function, pulmonary, tuberculosis

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