Lung function decline in relation to diagnostic criteria for airflow obstruction in respiratory symptomatic subjects

BMC Pulmonary Medicine

Tjard R Schermer²  Chris van Weel²  Yvonne F Heijdra³  Joke G Grootens-Stekelenburg²  Bart P Thoonen⁵  Annelies E Lucas¹  Ivo J Smeele⁴  Marvin A Berrevoets²  Reinier P Akkermans² 

[1] Diagnostiek voor U (DCE), P.O. Box 6274, 5600 HG Eindhoven, the Netherlands;Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands;Department of Chest Diseases, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands;COPD and Asthma General Practitioner Advisory Group (CAHAG), P.O. Box 3231, 3502 GE Utrecht, the Netherlands;General Practice Laboratory Foundation East (SHO), Velp, the Netherlands; Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands

关键词: Spirometry;    Primary care;    Lung function decline;    Diagnosis;    Chronic obstructive pulmonary disease;    Airflow obstruction;   

Others  :  1172485
DOI  :  10.1186/1471-2466-12-12

 received in 2011-06-24, accepted in 2012-03-22,  发布年份 2012

【 摘 要 】

Background

Current COPD guidelines advocate a fixed < 0.70 FEV1/FVC cutpoint to define airflow obstruction. We compared rate of lung function decline in respiratory symptomatic 40+ subjects who were 'obstructive' or 'non-obstructive' according to the fixed and/or age and gender specific lower limit of normal (LLN) FEV1/FVC cutpoints.

Methods

We studied 3,324 respiratory symptomatic subjects referred to primary care diagnostic centres for spirometry. The cohort was subdivided into four categories based on presence or absence of obstruction according to the fixed and LLN FEV1/FVC cutpoints. Postbronchodilator FEV1 decline served as primary outcome to compare subjects between the respective categories.

Results

918 subjects were obstructive according to the fixed FEV1/FVC cutpoint; 389 (42%) of them were non-obstructive according to the LLN cutpoint. In smokers, postbronchodilator FEV1 decline was 21 (SE 3) ml/year in those non-obstructive according to both cutpoints, 21 (7) ml/year in those obstructive according to the fixed but not according to the LLN cutpoint, and 50 (5) ml/year in those obstructive according to both cutpoints (p = 0.004).

Conclusion

This study showed that respiratory symptomatic 40+ smokers and non-smokers who show FEV1/FVC values below the fixed 0.70 cutpoint but above their age/gender specific LLN value did not show accelerated FEV1 decline, in contrast with those showing FEV1/FVC values below their LLN cutpoint.

【 授权许可】

   
2012 Akkermans et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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