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J Korean Med Sci. 2023;38(1):e4.

Rapid FEV1/FVC Decline Is Related With Incidence of Obstructive Lung Disease and Mortality in General Population.

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제1저자 최광용 · 교신저자 이현우

PMID 36593688 PMC9807769 DOI 10.3346/jkms.2023.38.e4 IF 3.2 호흡기내과
소속 (2)
  1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
  2. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. athrunzara86@snu.ac.kr.

Abstract

BACKGROUND Forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) naturally decreases with age; however, an excessive decline may be related with increased morbidity and mortality. This study aimed to evaluate the FEV1/FVC decline rate in the Korean general population and to identify whether rapid FEV1/FVC decline is a risk factor for obstructive lung disease (OLD) and all-cause and respiratory mortality.

METHODS We evaluated individuals aged 40-69 years who underwent baseline and biannual follow-up spirometric assessments for up to 18 years, excluding those with airflow limitations at baseline. Based on the quartiles of the annual FEV1/FVC decline rate, the most negative FEV1/FVC change (1st quartile of annual FEV1/FVC decline rate) was classified as rapid FEV1/FVC decline. We investigated the risk of progression to OLD and all-cause and respiratory mortality in individuals with rapid FEV1/FVC decline.

RESULTS The annual FEV1/FVC decline rate in the eligible 7,768 patients was 0.32 percentage point/year. The incidence rate of OLD was significantly higher in patients with rapid FEV1/FVC decline than in those with non-rapid FEV1/FVC decline (adjusted incidence rate, 2.119; 95% confidence interval [CI], 1.932-2.324). Rapid FEV1/FVC decline was an independent risk factor for all-cause mortality (adjusted hazard [HR], 1.374; 95% CI, 1.105-1.709) and respiratory mortality (adjusted HR, 1.353; 95% CI, 1.089-1.680).

CONCLUSION The annual FEV1/FVC decline rate was 0.32%p in the general population in Korea. The incidence rate of OLD and the hazards of all-cause and respiratory mortality were increased in rapid FEV1/FVC decliners.

© 2023 The Korean Academy of Medical Sciences.

Keywords

Cohort StudiesForced Expiratory VolumeForced Vital CapacityMortalityRespiratory Function TestsRisk Factors

Figures

Fig. 1
Fig. 1 Cumulative incidence of OLD according to quartiles of FEV1/FVC decline rate measured at two-year intervals. Cumulative incidence of OLD for 18 years was 35.03% in 1st quartile group, 16.67% in 2nd quartile group, 6.59% in 3rd quartile group, and 1.39% in 4th quartile group. There was a linear trend of cumulative incidence of OLD according to quartiles of FEV1/FVC decline rate (P = 0.034). FEV1 = forced expiratory volume in 1 second, FVC = forced vital capacity, OLD = obstructive lung disease.
Fig. 2
Fig. 2 Kaplan−Meier survival curve for all-cause and respiratory mortality. Survival probability was compared between non-rapid FEV1/FVC decliner and rapid FEV1/FVC decliner in terms of (A) all-cause mortality and (B) respiratory mortality. FEV1 = forced expiratory volume in 1 second, FVC = forced vital capacity.

그림 출처: PubMed Central 공개 논문 (PMC9807769)

Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

그 밖의 정보
출판 형태
Journal Article
저널
Journal of Korean medical science · eISSN 1598-6357
전자 출판
2023-01-02
MeSH
Humans · Incidence · Lung* · Vital Capacity · Lung Diseases, Obstructive* · Forced Expiratory Volume · Spirometry
참고문헌
49편