ABS45: Emphysema is equally often present in smokers with preCOPD as in smokers without COPD

Abstract

Background:COPD is one of the major leading causes of morbidity and mortality worldwide and cigarette smoking is the major risk factor for the development of COPD. The earlier we can detect signs of incipient COPD, the earlier and with greater impact we can advise smokers to cease smoking. In a previous study, smokers 45–55 years old, were invited to perform spirometry. 57 smokers with normal lung function and pre-COPD were identified. Pre-COPD was defined as smokers having FEV% predicted 89–93 for males and 90–93 for females or FEF50 =60% predicted.Aim:To compare the occurrence of emphysematous lesions in smokers who had normal lung function and pre-COPD with smokers without pre-COPD by spirometry.Setting:Primary health care centre Brinken, Motala and University hospital in Linköping, Sweden.Method:The study group consisted of 59 smokers with a mean age of 55 years, of which 30 were smokers with normal lung function and pre-COPD and 29 were matched controls, who had normal lung function and no pre-COPD. The subjects performed new spirometry and High Resolution Computed Tomography (HRCT) 3–4 years after selection.Results:The cumulative incidence of COPD in all 59 subjects was 8,5% (5/59) and all were recruited smokers defined as having pre-COPD, 16,7%, (5/30). The presence of emphysema on HRCT was 43% (n = 13) in the group of smokers defined as having pre-COPD and 44% (n = 13) in the control group. Smokers with emphysema, identified on HRCT, had significantly lower BMI (p < 0.001).Conclusion:Emphysema at HRCT, is present before the lung function has deteriorated according to spirometric definitions of COPD. Smokers with emphysema had significantly lower BMI. Low body weight might be a consequence of incipient COPD not detectible by spirometry, primarily as a result of the systemic inflammation present in COPD or simply be a risk factor for developing COPD. Conflict of interest and funding None declared.