Abstract
Progressive decline in lung function is the hallmark of chronic obstructive pulmonary disease (COPD). We aimed to assess the rate of decline in forced expiratory volume in 1 second (FEV1) in patients from a community cohort database in Korea. 5,865 subjects aged 40–69 years from the Ansung-Ansan cohort database I–III (2001–2006) were included in this study. We assessed the annual rate of decline in FEV1 over time in relation to smoking status, patient sex, and presence or absence of pre-bronchodilator airflow limitation using a generalized additive mixed model. The mean follow-up duration was 3.8 years. The annual mean decline in FEV1 in the entire cohort was significantly more rapid for men than women (31.3 mL vs 27.0 mL, P = 0.003). Among men without pre-bronchodilator airflow limitation, annual mean declines in FEV1 were 31.5, 35.5, and 40.1 mL for never smokers, former smokers (P = 0.09 vs. never smokers), and current smokers (P < 0.001 vs. never smokers), respectively; and 23.4, 19.7, and 33.9 mL, respectively, for men with pre-bronchodilator airflow limitation. Thus, among Korean males, smoking accelerates lung function decline over time whereas smoking cessation slows the rate of FEV1 decline regardless of pre-bronchodilator airflow limitation. This underscores the importance of smoking cessation in Koreans.
Highlights
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and increased medical expenses worldwide[1,2]
The present study aimed to evaluate the rate of decline in forced expiratory volume in 1 second (FEV1) in patients selected from a community cohort database in Korea
The annual decline in lung function was estimated for a population-based cohort in Korea
Summary
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and increased medical expenses worldwide[1,2]. Fletcher and Peto reported that exposure to tobacco smoke accelerates the age-related decline in lung function as assessed by the forced expiratory volume in 1 second (FEV1), leading to clinical disease[4]. Cigarette smoking is the most important risk factor for acceleration of lung function decline[15]. The birth weight and FEV1 in adulthood were positively associated, and factors in early life seem to be as important as heavy smoking for the prediction of lung function in adult life[22]. A recent study by Lange et al analysed three different longitudinal cohorts and reported that approximately 50% of patients developed COPD because of an accelerated decline in FEV1 over time, while the other 50% developed COPD because of abnormal lung development and growth[23]. The present study aimed to evaluate the rate of decline in FEV1 in patients selected from a community cohort database in Korea
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