International journal of chronic obstructive pulmonary disease · 2025
Reduced FEV3/FVC as an Early Indicator of COPD in Individuals with Normal Spirometry: A Prospective Analysis from the ECOPD Study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Li Yuemao, Li Jingwen, Huang Suyin, Wu Fan, Deng Zhishan, Peng Jieqi, Zhou Kunning, Tang Gaoying, Wan Qi, Dai Cuiqiong, Lu Lifei, Wu Xiaohui, Zeng Xianliang, Wu Fangyan, Yang Changli, Chen Shengtang, Huang Yongqing, Yu Shuqing, Zhou Yumin, Ran Pixin
Аннотация
PURPOSE: This study aimed to evaluate the association between the forced expiratory volume in 3 s (FEV3) to forced vital capacity (FVC) and computed tomography (CT)-defined abnormalities, and to assess its potential value in predicting incident chronic obstructive pulmonary disease (COPD) over a 3-year period.
PARTICIPANTS AND METHODS: This 3-year community-based cohort study enrolled participants with normal lung function (post-bronchodilator FEV1/FVC ≥ 0.70 and FEV1 ≥ 80% predicted). Baseline assessments included questionnaires, spirometry, CT scans, and impulse oscillometry. Participants were stratified by post-bronchodilator FEV3/FVC tertiles. Outcomes included acute respiratory events, annual lung function decline, and COPD incidence. Data were analyzed using mixed-effects models, log-binomial regression, and zero-inflated negative binomial models.
RESULTS: Of the 981 participants with normal baseline lung function stratified by post-bronchodilator FEV3/FVC tertiles (high: ≥95.5%, medium: 91.9-95.4%, low: ≤91.8%), 807 completed the 3-year follow-up. Compared to the high-FEV3/FVC group, participants in the low-FEV3/FVC group tended to be older (60.5 vs 55.7 years) and included more males (80.4% vs 38.8%) and smokers. The low-FEV3/FVC group also demonstrated a lower baseline post-bronchodilator FEV1/FVC (74.0% vs 85.1%) and higher prevalence of emphysema (53.5% vs 18.3%). Longitudinal analysis revealed a greater annual post-bronchodilator FEV1 decline in the low-FEV3/FVC group (adjusted mean difference: 10 mL, 95% confidence interval [CI]: 0 to 21mL; p = 0.043) and an increased risk of developing COPD (19.4% versus 1.9%; adjusted relative risk: 4.96, 95% CI: 1.96-12.51; p = 0.001) than the high-FEV3/FVC group, with no difference in acute respiratory events.
CONCLUSION: A reduced FEV3/FVC ratio was associated with an increased risk of accelerated lung function decline and progression to COPD in individuals with normal spirometry. As a readily accessible measure derived from routine spirometry, FEV3/FVC may have a role in early COPD detection.
PARTICIPANTS AND METHODS: This 3-year community-based cohort study enrolled participants with normal lung function (post-bronchodilator FEV1/FVC ≥ 0.70 and FEV1 ≥ 80% predicted). Baseline assessments included questionnaires, spirometry, CT scans, and impulse oscillometry. Participants were stratified by post-bronchodilator FEV3/FVC tertiles. Outcomes included acute respiratory events, annual lung function decline, and COPD incidence. Data were analyzed using mixed-effects models, log-binomial regression, and zero-inflated negative binomial models.
RESULTS: Of the 981 participants with normal baseline lung function stratified by post-bronchodilator FEV3/FVC tertiles (high: ≥95.5%, medium: 91.9-95.4%, low: ≤91.8%), 807 completed the 3-year follow-up. Compared to the high-FEV3/FVC group, participants in the low-FEV3/FVC group tended to be older (60.5 vs 55.7 years) and included more males (80.4% vs 38.8%) and smokers. The low-FEV3/FVC group also demonstrated a lower baseline post-bronchodilator FEV1/FVC (74.0% vs 85.1%) and higher prevalence of emphysema (53.5% vs 18.3%). Longitudinal analysis revealed a greater annual post-bronchodilator FEV1 decline in the low-FEV3/FVC group (adjusted mean difference: 10 mL, 95% confidence interval [CI]: 0 to 21mL; p = 0.043) and an increased risk of developing COPD (19.4% versus 1.9%; adjusted relative risk: 4.96, 95% CI: 1.96-12.51; p = 0.001) than the high-FEV3/FVC group, with no difference in acute respiratory events.
CONCLUSION: A reduced FEV3/FVC ratio was associated with an increased risk of accelerated lung function decline and progression to COPD in individuals with normal spirometry. As a readily accessible measure derived from routine spirometry, FEV3/FVC may have a role in early COPD detection.