Anders Blomberg, Kjell Torén, Per Liv, Gabriel Granåsen, Anders Andersson, Annelie Behndig, Göran Bergström, John Brandberg, Kenneth Caidahl, Kerstin Cederlund, Arne Egesten, Magnus Ekström, Maria J Eriksson, Emil Hagström, Christer Janson, Tomas Jernberg, David Kylhammar, Lars Lind, Anne Lindberg, Eva Lindberg, Claes-Göran Löfdahl, Andrei Malinovschi, Maria Mannila, Lars T Nilsson, Anna-Carin Olin, Anders Persson, Hans Lennart Persson, Annika Rosengren, Johan Sundström, Eva Swahn, Stefan Söderberg, Jenny Vikgren, Per Wollmer, Carl Johan Östgren, Jan Engvall, C Magnus Sköld
{"title":"瑞典中年人群的慢性气流受限、肺气肿和弥散能力受损与吸烟习惯的关系。","authors":"Anders Blomberg, Kjell Torén, Per Liv, Gabriel Granåsen, Anders Andersson, Annelie Behndig, Göran Bergström, John Brandberg, Kenneth Caidahl, Kerstin Cederlund, Arne Egesten, Magnus Ekström, Maria J Eriksson, Emil Hagström, Christer Janson, Tomas Jernberg, David Kylhammar, Lars Lind, Anne Lindberg, Eva Lindberg, Claes-Göran Löfdahl, Andrei Malinovschi, Maria Mannila, Lars T Nilsson, Anna-Carin Olin, Anders Persson, Hans Lennart Persson, Annika Rosengren, Johan Sundström, Eva Swahn, Stefan Söderberg, Jenny Vikgren, Per Wollmer, Carl Johan Östgren, Jan Engvall, C Magnus Sköld","doi":"10.1513/AnnalsATS.202402-122OC","DOIUrl":null,"url":null,"abstract":"<p><p><b>Rationale:</b> Chronic obstructive pulmonary disease (COPD) includes respiratory symptoms and chronic airflow limitation (CAL). In some cases, emphysema and impaired diffusing capacity of the lung for carbon monoxide (Dl<sub>CO</sub>) are present, but characteristics and symptoms vary with smoking exposure. <b>Objective:</b> To study the prevalence of CAL, emphysema, and impaired Dl<sub>CO</sub> in relation to smoking and respiratory symptoms in a middle-aged population. <b>Methods:</b> We investigated 28,746 randomly invited individuals (52% women) aged 50-64 years across six Swedish sites. We performed spirometry, Dl<sub>CO</sub> testing, and high-resolution computed tomography and asked for smoking habits and respiratory symptoms. CAL was defined as post-bronchodilator forced expiratory volume in 1 second divided by forced vital capacity (FEV<sub>1</sub>/FVC) < 0.7. <b>Results:</b> The overall prevalence was 8.8% for CAL, 5.7% for impaired Dl<sub>CO</sub> (Dl<sub>CO</sub> < LLN), and 8.8% for emphysema, with a higher prevalence in current smokers than in ex-smokers and never-smokers. The proportion of never-smokers among those with CAL, emphysema, and impaired Dl<sub>CO</sub> was 32%, 19%, and 31%, respectively. Regardless of smoking habits, the prevalence of respiratory symptoms was higher among people with CAL and impaired Dl<sub>CO</sub> than those with normal lung function. Asthma prevalence in never-smokers with CAL was 14%. In this group, asthma was associated with lower FEV<sub>1</sub> and more respiratory symptoms. <b>Conclusions:</b> In this large population-based study of middle-aged people, CAL and impaired Dl<sub>CO</sub> were associated with common respiratory symptoms. Self-reported asthma was not associated with CAL in never-smokers. Our findings suggest that CAL in never-smokers signifies a separate clinical phenotype that may be monitored and, possibly, treated differently from smoking-related COPD.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1678-1687"},"PeriodicalIF":0.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622819/pdf/","citationCount":"0","resultStr":"{\"title\":\"Chronic Airflow Limitation, Emphysema, and Impaired Diffusing Capacity in Relation to Smoking Habits in a Swedish Middle-aged Population.\",\"authors\":\"Anders Blomberg, Kjell Torén, Per Liv, Gabriel Granåsen, Anders Andersson, Annelie Behndig, Göran Bergström, John Brandberg, Kenneth Caidahl, Kerstin Cederlund, Arne Egesten, Magnus Ekström, Maria J Eriksson, Emil Hagström, Christer Janson, Tomas Jernberg, David Kylhammar, Lars Lind, Anne Lindberg, Eva Lindberg, Claes-Göran Löfdahl, Andrei Malinovschi, Maria Mannila, Lars T Nilsson, Anna-Carin Olin, Anders Persson, Hans Lennart Persson, Annika Rosengren, Johan Sundström, Eva Swahn, Stefan Söderberg, Jenny Vikgren, Per Wollmer, Carl Johan Östgren, Jan Engvall, C Magnus Sköld\",\"doi\":\"10.1513/AnnalsATS.202402-122OC\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Rationale:</b> Chronic obstructive pulmonary disease (COPD) includes respiratory symptoms and chronic airflow limitation (CAL). In some cases, emphysema and impaired diffusing capacity of the lung for carbon monoxide (Dl<sub>CO</sub>) are present, but characteristics and symptoms vary with smoking exposure. <b>Objective:</b> To study the prevalence of CAL, emphysema, and impaired Dl<sub>CO</sub> in relation to smoking and respiratory symptoms in a middle-aged population. <b>Methods:</b> We investigated 28,746 randomly invited individuals (52% women) aged 50-64 years across six Swedish sites. We performed spirometry, Dl<sub>CO</sub> testing, and high-resolution computed tomography and asked for smoking habits and respiratory symptoms. CAL was defined as post-bronchodilator forced expiratory volume in 1 second divided by forced vital capacity (FEV<sub>1</sub>/FVC) < 0.7. <b>Results:</b> The overall prevalence was 8.8% for CAL, 5.7% for impaired Dl<sub>CO</sub> (Dl<sub>CO</sub> < LLN), and 8.8% for emphysema, with a higher prevalence in current smokers than in ex-smokers and never-smokers. The proportion of never-smokers among those with CAL, emphysema, and impaired Dl<sub>CO</sub> was 32%, 19%, and 31%, respectively. Regardless of smoking habits, the prevalence of respiratory symptoms was higher among people with CAL and impaired Dl<sub>CO</sub> than those with normal lung function. Asthma prevalence in never-smokers with CAL was 14%. In this group, asthma was associated with lower FEV<sub>1</sub> and more respiratory symptoms. <b>Conclusions:</b> In this large population-based study of middle-aged people, CAL and impaired Dl<sub>CO</sub> were associated with common respiratory symptoms. Self-reported asthma was not associated with CAL in never-smokers. Our findings suggest that CAL in never-smokers signifies a separate clinical phenotype that may be monitored and, possibly, treated differently from smoking-related COPD.</p>\",\"PeriodicalId\":93876,\"journal\":{\"name\":\"Annals of the American Thoracic Society\",\"volume\":\" \",\"pages\":\"1678-1687\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622819/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of the American Thoracic Society\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1513/AnnalsATS.202402-122OC\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of the American Thoracic Society","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1513/AnnalsATS.202402-122OC","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Chronic Airflow Limitation, Emphysema, and Impaired Diffusing Capacity in Relation to Smoking Habits in a Swedish Middle-aged Population.
Rationale: Chronic obstructive pulmonary disease (COPD) includes respiratory symptoms and chronic airflow limitation (CAL). In some cases, emphysema and impaired diffusing capacity of the lung for carbon monoxide (DlCO) are present, but characteristics and symptoms vary with smoking exposure. Objective: To study the prevalence of CAL, emphysema, and impaired DlCO in relation to smoking and respiratory symptoms in a middle-aged population. Methods: We investigated 28,746 randomly invited individuals (52% women) aged 50-64 years across six Swedish sites. We performed spirometry, DlCO testing, and high-resolution computed tomography and asked for smoking habits and respiratory symptoms. CAL was defined as post-bronchodilator forced expiratory volume in 1 second divided by forced vital capacity (FEV1/FVC) < 0.7. Results: The overall prevalence was 8.8% for CAL, 5.7% for impaired DlCO (DlCO < LLN), and 8.8% for emphysema, with a higher prevalence in current smokers than in ex-smokers and never-smokers. The proportion of never-smokers among those with CAL, emphysema, and impaired DlCO was 32%, 19%, and 31%, respectively. Regardless of smoking habits, the prevalence of respiratory symptoms was higher among people with CAL and impaired DlCO than those with normal lung function. Asthma prevalence in never-smokers with CAL was 14%. In this group, asthma was associated with lower FEV1 and more respiratory symptoms. Conclusions: In this large population-based study of middle-aged people, CAL and impaired DlCO were associated with common respiratory symptoms. Self-reported asthma was not associated with CAL in never-smokers. Our findings suggest that CAL in never-smokers signifies a separate clinical phenotype that may be monitored and, possibly, treated differently from smoking-related COPD.