The association of spirometric small airways obstruction with respiratory symptoms, cardiometabolic diseases, and quality of life: results from the Burden of Obstructive Lung Disease (BOLD) study

Ben Knox-Brown, Jaymini Patel, James Potts, Rana Ahmed, Althea Aquart-Stewart, Cristina Barbara, A. Sonia Buist, Hamid Hacene Cherkaski, Meriam Denguezli, Mohammed Elbiaze, Gregory E. Erhabor, Frits M.E. Franssen, Mohammed Al Ghobain, Thorarinn Gislason, Christer Janson, Ali Kocabaş, David Mannino, Guy Marks, Kevin Mortimer, Asaad Ahmed NafeesDaniel Obaseki, Stefanni Nonna M. Paraguas, Li Cher Loh, Abdul Rashid, Sundeep Salvi, Terence Seemungal, Michael Studnicka, Wan C. Tan, Emiel F.M. Wouters, Hazim Abozid, Alexander Mueller, Peter Burney, Andre F.S. Amaral

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background: Spirometric small airways obstruction (SAO) is common in the general population. Whether spirometric SAO is associated with respiratory symptoms, cardiometabolic diseases, and quality of life (QoL) is unknown. Methods: Using data from the Burden of Obstructive Lung Disease study (N = 21,594), we defined spirometric SAO as the mean forced expiratory flow rate between 25 and 75% of the FVC (FEF25-75) less than the lower limit of normal (LLN) or the forced expiratory volume in 3 s to FVC ratio (FEV3/FVC) less than the LLN. We analysed data on respiratory symptoms, cardiometabolic diseases, and QoL collected using standardised questionnaires. We assessed the associations with spirometric SAO using multivariable regression models, and pooled site estimates using random effects meta-analysis. We conducted identical analyses for isolated spirometric SAO (i.e. with FEV1/FVC ≥ LLN). Results: Almost a fifth of the participants had spirometric SAO (19% for FEF25-75; 17% for FEV3/FVC). Using FEF25-75, spirometric SAO was associated with dyspnoea (OR = 2.16, 95% CI 1.77–2.70), chronic cough (OR = 2.56, 95% CI 2.08–3.15), chronic phlegm (OR = 2.29, 95% CI 1.77–4.05), wheeze (OR = 2.87, 95% CI 2.50–3.40) and cardiovascular disease (OR = 1.30, 95% CI 1.11–1.52), but not hypertension or diabetes. Spirometric SAO was associated with worse physical and mental QoL. These associations were similar for FEV3/FVC. Isolated spirometric SAO (10% for FEF25-75; 6% for FEV3/FVC), was also associated with respiratory symptoms and cardiovascular disease. Conclusion: Spirometric SAO is associated with respiratory symptoms, cardiovascular disease, and QoL. Consideration should be given to the measurement of FEF25-75 and FEV3/FVC, in addition to traditional spirometry parameters.

Original languageEnglish
Article number137
JournalRespiratory Research
Volume24
Issue number1
DOIs
Publication statusPublished - Dec 2023

Keywords

  • Cardiovascular disease
  • Quality of life
  • Small airways obstruction
  • Spirometry
  • Symptoms

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