Different Risks of Mortality and Longitudinal Transition Trajectories in New Potential Subtypes of the Preserved Ratio Impaired Spirometry: Evidence From the English Longitudinal Study of Aging

Background: Preserved ratio impaired spirometry (PRISm), characterized by the decreased forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) with a preserved FEV1/FVC ratio, is highly prevalent and heterogeneous. We aimed to identify the subtypes of PRISm and examine their differen...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Di He, Yilan Sun, Musong Gao, Qiong Wu, Zongxue Cheng, Jun Li, Yong Zhou, Kejing Ying, Yimin Zhu
Formato: article
Lenguaje:EN
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://doaj.org/article/79566ddeb68d47bfb12b62395e02c3f8
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:79566ddeb68d47bfb12b62395e02c3f8
record_format dspace
spelling oai:doaj.org-article:79566ddeb68d47bfb12b62395e02c3f82021-11-11T06:31:25ZDifferent Risks of Mortality and Longitudinal Transition Trajectories in New Potential Subtypes of the Preserved Ratio Impaired Spirometry: Evidence From the English Longitudinal Study of Aging2296-858X10.3389/fmed.2021.755855https://doaj.org/article/79566ddeb68d47bfb12b62395e02c3f82021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.755855/fullhttps://doaj.org/toc/2296-858XBackground: Preserved ratio impaired spirometry (PRISm), characterized by the decreased forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) with a preserved FEV1/FVC ratio, is highly prevalent and heterogeneous. We aimed to identify the subtypes of PRISm and examine their differences in clinical characteristics, long-term mortality risks, and longitudinal transition trajectories.Methods: A total of 6,616 eligible subjects were included from the English longitudinal study of aging. Two subtypes of the PRISm were identified as mild PRISm (either of FEV1 and FVC <80% predicted value, FEV1/FVC ≥0.7) and severe PRISm (both FEV1 and FVC <80% predicted values, FEV1/FVC ≥0.7). Normal spirometry was defined as both FEV1 and FVC ≥80% predicted values and FEV1/FVC ≥0.7. Hazard ratios (HRs) and 95% CIs were calculated by the multiple Cox regression models. Longitudinal transition trajectories were described with repeated spirometry data.Results: At baseline, severe PRISm had increased respiratory symptoms, including higher percentages of phlegm, wheezing, dyspnea, chronic bronchitis, and emphysema than mild PRISm. After an average of 7.7 years of follow-up, severe PRISm significantly increased the risks of all-cause mortality (HR=1.91, 95%CI = 1.58–2.31), respiratory mortality (HR = 6.02, 95%CI = 2.83–12.84), and CVD mortality (HR = 2.11, 95%CI = 1.42–3.13) compared with the normal spirometry, but no significantly increased risks were found for mild PRISm. In the two longitudinal transitions, mild PRISm tended to transition toward normal spirometry (40.2 and 54.7%), but severe PRISm tended to maintain the status (42.4 and 30.4%) or transition toward Global Initiative for Chronic Obstructive Lung Disease (GOLD)2–4 (28.3 and 33.9%).Conclusion: Two subtypes of PRISm were identified. Severe PRISm had increased respiratory symptoms, higher mortality risks, and a higher probability of progressing to GOLD2–4 than mild PRISm. These findings provided new evidence for the stratified management of PRISm.Di HeDi HeYilan SunMusong GaoQiong WuQiong WuZongxue ChengZongxue ChengJun LiJun LiYong ZhouKejing YingYimin ZhuYimin ZhuFrontiers Media S.A.articlepreserved ratio impaired spirometrylung functionheterogeneitysubtypesmortalitylongitudinal transitionMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution DOAJ
collection DOAJ
language EN
topic preserved ratio impaired spirometry
lung function
heterogeneity
subtypes
mortality
longitudinal transition
Medicine (General)
R5-920
spellingShingle preserved ratio impaired spirometry
lung function
heterogeneity
subtypes
mortality
longitudinal transition
Medicine (General)
R5-920
Di He
Di He
Yilan Sun
Musong Gao
Qiong Wu
Qiong Wu
Zongxue Cheng
Zongxue Cheng
Jun Li
Jun Li
Yong Zhou
Kejing Ying
Yimin Zhu
Yimin Zhu
Different Risks of Mortality and Longitudinal Transition Trajectories in New Potential Subtypes of the Preserved Ratio Impaired Spirometry: Evidence From the English Longitudinal Study of Aging
description Background: Preserved ratio impaired spirometry (PRISm), characterized by the decreased forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) with a preserved FEV1/FVC ratio, is highly prevalent and heterogeneous. We aimed to identify the subtypes of PRISm and examine their differences in clinical characteristics, long-term mortality risks, and longitudinal transition trajectories.Methods: A total of 6,616 eligible subjects were included from the English longitudinal study of aging. Two subtypes of the PRISm were identified as mild PRISm (either of FEV1 and FVC <80% predicted value, FEV1/FVC ≥0.7) and severe PRISm (both FEV1 and FVC <80% predicted values, FEV1/FVC ≥0.7). Normal spirometry was defined as both FEV1 and FVC ≥80% predicted values and FEV1/FVC ≥0.7. Hazard ratios (HRs) and 95% CIs were calculated by the multiple Cox regression models. Longitudinal transition trajectories were described with repeated spirometry data.Results: At baseline, severe PRISm had increased respiratory symptoms, including higher percentages of phlegm, wheezing, dyspnea, chronic bronchitis, and emphysema than mild PRISm. After an average of 7.7 years of follow-up, severe PRISm significantly increased the risks of all-cause mortality (HR=1.91, 95%CI = 1.58–2.31), respiratory mortality (HR = 6.02, 95%CI = 2.83–12.84), and CVD mortality (HR = 2.11, 95%CI = 1.42–3.13) compared with the normal spirometry, but no significantly increased risks were found for mild PRISm. In the two longitudinal transitions, mild PRISm tended to transition toward normal spirometry (40.2 and 54.7%), but severe PRISm tended to maintain the status (42.4 and 30.4%) or transition toward Global Initiative for Chronic Obstructive Lung Disease (GOLD)2–4 (28.3 and 33.9%).Conclusion: Two subtypes of PRISm were identified. Severe PRISm had increased respiratory symptoms, higher mortality risks, and a higher probability of progressing to GOLD2–4 than mild PRISm. These findings provided new evidence for the stratified management of PRISm.
format article
author Di He
Di He
Yilan Sun
Musong Gao
Qiong Wu
Qiong Wu
Zongxue Cheng
Zongxue Cheng
Jun Li
Jun Li
Yong Zhou
Kejing Ying
Yimin Zhu
Yimin Zhu
author_facet Di He
Di He
Yilan Sun
Musong Gao
Qiong Wu
Qiong Wu
Zongxue Cheng
Zongxue Cheng
Jun Li
Jun Li
Yong Zhou
Kejing Ying
Yimin Zhu
Yimin Zhu
author_sort Di He
title Different Risks of Mortality and Longitudinal Transition Trajectories in New Potential Subtypes of the Preserved Ratio Impaired Spirometry: Evidence From the English Longitudinal Study of Aging
title_short Different Risks of Mortality and Longitudinal Transition Trajectories in New Potential Subtypes of the Preserved Ratio Impaired Spirometry: Evidence From the English Longitudinal Study of Aging
title_full Different Risks of Mortality and Longitudinal Transition Trajectories in New Potential Subtypes of the Preserved Ratio Impaired Spirometry: Evidence From the English Longitudinal Study of Aging
title_fullStr Different Risks of Mortality and Longitudinal Transition Trajectories in New Potential Subtypes of the Preserved Ratio Impaired Spirometry: Evidence From the English Longitudinal Study of Aging
title_full_unstemmed Different Risks of Mortality and Longitudinal Transition Trajectories in New Potential Subtypes of the Preserved Ratio Impaired Spirometry: Evidence From the English Longitudinal Study of Aging
title_sort different risks of mortality and longitudinal transition trajectories in new potential subtypes of the preserved ratio impaired spirometry: evidence from the english longitudinal study of aging
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/79566ddeb68d47bfb12b62395e02c3f8
work_keys_str_mv AT dihe differentrisksofmortalityandlongitudinaltransitiontrajectoriesinnewpotentialsubtypesofthepreservedratioimpairedspirometryevidencefromtheenglishlongitudinalstudyofaging
AT dihe differentrisksofmortalityandlongitudinaltransitiontrajectoriesinnewpotentialsubtypesofthepreservedratioimpairedspirometryevidencefromtheenglishlongitudinalstudyofaging
AT yilansun differentrisksofmortalityandlongitudinaltransitiontrajectoriesinnewpotentialsubtypesofthepreservedratioimpairedspirometryevidencefromtheenglishlongitudinalstudyofaging
AT musonggao differentrisksofmortalityandlongitudinaltransitiontrajectoriesinnewpotentialsubtypesofthepreservedratioimpairedspirometryevidencefromtheenglishlongitudinalstudyofaging
AT qiongwu differentrisksofmortalityandlongitudinaltransitiontrajectoriesinnewpotentialsubtypesofthepreservedratioimpairedspirometryevidencefromtheenglishlongitudinalstudyofaging
AT qiongwu differentrisksofmortalityandlongitudinaltransitiontrajectoriesinnewpotentialsubtypesofthepreservedratioimpairedspirometryevidencefromtheenglishlongitudinalstudyofaging
AT zongxuecheng differentrisksofmortalityandlongitudinaltransitiontrajectoriesinnewpotentialsubtypesofthepreservedratioimpairedspirometryevidencefromtheenglishlongitudinalstudyofaging
AT zongxuecheng differentrisksofmortalityandlongitudinaltransitiontrajectoriesinnewpotentialsubtypesofthepreservedratioimpairedspirometryevidencefromtheenglishlongitudinalstudyofaging
AT junli differentrisksofmortalityandlongitudinaltransitiontrajectoriesinnewpotentialsubtypesofthepreservedratioimpairedspirometryevidencefromtheenglishlongitudinalstudyofaging
AT junli differentrisksofmortalityandlongitudinaltransitiontrajectoriesinnewpotentialsubtypesofthepreservedratioimpairedspirometryevidencefromtheenglishlongitudinalstudyofaging
AT yongzhou differentrisksofmortalityandlongitudinaltransitiontrajectoriesinnewpotentialsubtypesofthepreservedratioimpairedspirometryevidencefromtheenglishlongitudinalstudyofaging
AT kejingying differentrisksofmortalityandlongitudinaltransitiontrajectoriesinnewpotentialsubtypesofthepreservedratioimpairedspirometryevidencefromtheenglishlongitudinalstudyofaging
AT yiminzhu differentrisksofmortalityandlongitudinaltransitiontrajectoriesinnewpotentialsubtypesofthepreservedratioimpairedspirometryevidencefromtheenglishlongitudinalstudyofaging
AT yiminzhu differentrisksofmortalityandlongitudinaltransitiontrajectoriesinnewpotentialsubtypesofthepreservedratioimpairedspirometryevidencefromtheenglishlongitudinalstudyofaging
_version_ 1718439504259317760