Chronic obstructive pulmonary diseases (Miami, Fla.) · 2026
Clinical Significance of Reduced Forced Expiratory Volume in 3 Seconds to Forced Expiratory Volume in 6 Seconds in Adults.
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Liao Siman, Liang Juncheng, Ou Jie, Peng Ranxi, Zhang Shiyu, Tang Leheng, Zhou Qiaorui, Chen Yingtong, Guo Xiaozi, Chen Jingxian, Wan Qi, Wang Zihui, Deng Zhishan, Zhou Yumin, Wu Fan
Аннотация
BACKGROUND: The forced expiratory volume in 3 seconds (FEV3) to forced expiratory volume in 6 seconds (FEV6) ratio is a novel spirometry measure that identifies early airflow abnormalities, but its long-term prognosis value in the general population remains unclear. We aimed to evaluate the long-term all-cause mortality risk among participants with a reduced FEV3/FEV6.
METHODS: Data were obtained from the National Health and Nutrition Examination Survey cycles 1988–1994 and 2007–2012. Reduced FEV3/FEV6 was defined as an FEV3/FEV6 less than the lower limit of normal. Multivariable logistic regression was used to assess the relationship of reduced FEV3/FEV6 with comorbidities and chronic respiratory symptoms. The relationship between reduced FEV3/FEV6 and all-cause mortality was evaluated using Cox regression models. The nonlinear relationship between FEV3/FEV6 and all-cause mortality was assessed using restricted cubic splines. Subgroup analyses were conducted to validate the robustness of the relationship.
RESULTS: Overall, 25,159 participants were enrolled in the 308-month median follow-up analysis, of whom 8.8% (2225/25,159) had reduced FEV3/FEV6. Participants with reduced FEV3/FEV6 exhibited increased risks of congestive heart failure, asthma, chronic bronchitis, emphysema, respiratory symptoms, and all-cause mortality risk (adjusted hazard ratio=1.23, 95% confidence interval: 1.13–1.34, P<0.001). The findings remained consistent across subgroups. A nonlinear U-shaped association was observed between FEV3/FEV6 and all-cause mortality, with the turning point at 1.04.
CONCLUSION: Participants with reduced FEV3/FEV6 had worse respiratory health outcomes, suggesting that FEV3/FEV6 can be used as a prognostic spirometry indicator.
METHODS: Data were obtained from the National Health and Nutrition Examination Survey cycles 1988–1994 and 2007–2012. Reduced FEV3/FEV6 was defined as an FEV3/FEV6 less than the lower limit of normal. Multivariable logistic regression was used to assess the relationship of reduced FEV3/FEV6 with comorbidities and chronic respiratory symptoms. The relationship between reduced FEV3/FEV6 and all-cause mortality was evaluated using Cox regression models. The nonlinear relationship between FEV3/FEV6 and all-cause mortality was assessed using restricted cubic splines. Subgroup analyses were conducted to validate the robustness of the relationship.
RESULTS: Overall, 25,159 participants were enrolled in the 308-month median follow-up analysis, of whom 8.8% (2225/25,159) had reduced FEV3/FEV6. Participants with reduced FEV3/FEV6 exhibited increased risks of congestive heart failure, asthma, chronic bronchitis, emphysema, respiratory symptoms, and all-cause mortality risk (adjusted hazard ratio=1.23, 95% confidence interval: 1.13–1.34, P<0.001). The findings remained consistent across subgroups. A nonlinear U-shaped association was observed between FEV3/FEV6 and all-cause mortality, with the turning point at 1.04.
CONCLUSION: Participants with reduced FEV3/FEV6 had worse respiratory health outcomes, suggesting that FEV3/FEV6 can be used as a prognostic spirometry indicator.