Lung Function Levels Research Articles

Association of lung function and blood glucose level: a 10-year study in China

BackgroundAt present, chronic respiratory diseases are a major burden in terms of morbidity and mortality and are of increasing public health concern in China. Meanwhile, the prevalence of diabetes has increased by more than 10 times over the last 40 years. While a few studies have investigated the association between chronic respiratory diseases and diabetes mellitus, the association is not clear. This study aimed to explore this association and provide evidence.MethodsIn this single-center study, we enrolled participants aged ≥ 20 years undergoing at least two regular health check-ups from 2009 to 2019 at MJ Healthcare Center in Beijing. Each health check-up included physical examination, biochemical tests, a pulmonary function test, a questionnaire. A total of 11,107 adults were included, and cross-sectional and longitudinal analyses were performed.ResultsWe found that both prediabetic and diabetic adults had lower lung function than the normal population at baseline, indicating that lung function decline may start from prediabetic status. Quantitatively, with 1-mmol/L increase in fasting plasma glucose level, the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FVC% and FEV1% lowered by 25 ml, 13 ml, 0.71-1.03%, and 0.46-0.72%, respectively. However, no significant difference was found in the rates for the lung function decline among different baseline diabetes statuses.ConclusionPeople with higher blood glucose level had more severe lung function decline, with decline starting from prediabetic status, but no significant difference was noted in the rate of lung function decline based on different baseline diabetic statuses.

Respiratory Function, Physical Capacity, and Metabolic Syndrome Components in Combustible Cigarettes and Heated Tobacco Products Users: A Four-Year Follow-Up Cohort Study

Purpose: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide and is the fourth leading cause of death in Kazakhstan. Cigarette smoking is a prevalent risk factor for COPD. While quitting smoking is the preferred way to reduce COPD risk, literature suggests that heated tobacco products (HTP) might be a better option for people who cannot quit smoking. The aim of this paper was to analyze the long-term effects of shifting to HTP use in long-term smokers compared to continued combustible cigarettes (CC) use.
 Patients and methods: A cohort of 1200 participants (400 HTP and 800 CC) aged 40-59 years with a minimum of 10 pack-year smoking history were recruited and followed for four years. The functional outcomes compared between HTP and CC users included: (1) COPD Assessment Test (CAT); (2) post-bronchodilator lung function; (3) 6-minute walking distance (6MWD) test; and (4) metabolic syndrome components. One way ANOVA was used to compare functional outcomes between visits, while multivariable linear mixed models were used to test associations between health outcomes and smoking type (HTP vs. CC) over time.
 Results: Out of 1200 participants 893 (609 CC users and 284 HTP users) remained in the study by the fourth year of follow up. Comparison between functional outcomes showed that most of them have improved between visits, while lung function and fasting blood glucose levels got worse. Linear mixed models showed HTP use was associated with better functional outcomes over time compared to CC users. Lung function decrease was significantly less in HTP users, while improvements in CAT scores, waist circumference, and systolic blood pressure were significantly better compared to CC users.
 Conclusion: This study demonstrated that HTP users experienced it to a significantly lesser decrease in lung function compared to CC users, while demonstrating better improvements in other functional outcomes. The results of this study suggest that HTP might be a less deleterious alternative compared to CC in people with long history of CC use and who cannot quit smoking.

Asthma-related lung function and physical activity patterns among children living in urban neighborhoods

Objective Black and Latino American children residing in urban environments are at increased risk for comorbid asthma and obesity. Physical activity (PA) is a modifiable behavior known to contribute to the asthma-obesity phenotype. While research has indicated links between optimal asthma status and high PA among children, little is documented about whether this group may display other asthma and PA patterns that warrant clinical attention and tailored interventions. Methods Children with persistent asthma (N = 97) ages 7–9 and their caregivers from urban neighborhoods completed daily measures of asthma status and moderate-to-vigorous physical activity (MVPA) and questionnaires about health and sociodemographic characteristics. Clinical asthma guidelines (e.g. FEV1 ≥ 80%) and sample means were used to categorize children into high or low lung function and MVPA patterns. Individual, family, and contextual differences across lung function and MVPA patterns were investigated. Results Twenty-nine percent of participants displayed optimal lung function and high MVPA. The remainder of the sample exhibited various less optimal patterns (e.g. poorer lung function and high MVPA). Caregivers of children displaying poorer lung function and high MVPA levels were more likely to report asthma related fears than caregivers of children with low MVPA levels regardless of lung function status. Conclusions Asthma and PA interventions can be tailored to better address each child’s unique clinical and behavioral patterns. An enhanced understanding of risk factors for suboptimal patterns of asthma status and PA may aid in multicomponent intervention efforts.

An Increase in Plasma Adipsin Levels Is Associated With Higher Cumulative Dust Exposure and Airway Obstruction in Foundry Workers.

The aim of the study was to assess whether plasma adipokine levels (adipsin, adiponectin, leptin, and resistin) are associated with pulmonary function in foundry workers. We examined 65 dust-exposed foundry workers and 40 nonexposed controls and analyzed their lung function and plasma adipokine levels at baseline and after approximately 7 years of follow-up. A higher increase in plasma adipsin was associated with the development of airway obstruction in exposed subjects during follow-up after adjusting for body mass index changes during the follow-up period. Furthermore, the increase in adipsin levels was positively associated with cumulative dust exposure even after adjusting for smoking and body mass index changes during follow-up ( P = 0.015). The results suggest that plasma adipsin is involved in the pathogenesis of subclinical airway inflammation and the development of chronic obstruction and is induced by occupational dust exposure.

Personal PM2.5 Elemental Components, Decline of Lung Function, and the Role of DNA Methylation on Inflammation-Related Genes in Older Adults: Results and Implications of the BAPE Study.

Epidemiological evidence of the effects of PM2.5 elements on lung function and DNA methylation is limited. We conducted a longitudinal panel study of 76 healthy older adults aged 60-69 years in Jinan, China, from September 2018 to January 2019. We periodically measured individual 72 h PM2.5 and element concentrations, lung function, and DNA methylation levels of eight inflammation-related genes. We used linear mixed-effect models to investigate the effects of exposure to personal PM2.5 elements on the lung function and DNA methylation. Mediation analysis was used to investigate the underlying effect mechanism. Negative changes in the ratio of forced expiratory volume in 1 s to forced vital capacity, ranging from -1.23% [95% confidence interval (CI): -2.11%, -0.35%] to -0.77% (95% CI: -1.49%, -0.04%), were significantly associated with interquartile range (IQR) increases in personal PM2.5 at different lag periods (7-12, 13-24, 25-48, 0-24, 0-48, and 0-72 h). Arsenic (As), nickel, rubidium (Rb), selenium, and vanadium were significantly associated with at least three lung function parameters, and IQR increases in these elements led to 0.12-5.66% reductions in these parameters. PM2.5 elements were significantly associated with DNA methylation levels. DNA methylation mediated 7.28-13.02% of the As- and Rb-related reduced lung function. The findings indicate that exposure to elements in personal PM2.5 contributes to reduced lung function through DNA methylation.

Risk assessment and dose-effect of co-exposure to benzene, toluene, ethylbenzene, xylene, and styrene (BTEXS) on pulmonary function: A cross-sectional study

Inhalation is the most frequent route and the lung is the primary damaged organ for human exposure to benzene, toluene, ethylbenzene, xylene, and styrene (BTEXS). However, there is limited information on the risk and dose-effect of the BTEXS mixture on pulmonary function, particularly the overall effect. We conducted a cross-sectional study in a petrochemical plant in southern China. Spirometry and cumulative exposure dose (CED) of BTEXS were used to measure lung function and exposure levels for 635 workers in 2020, respectively. Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were tested and interpreted as percentages to predicted values [FVC or FEV1% predicted], and FEV1 to FVC ratio [FEV1/FVC (%)]. We found the reduction in FVC% predicted and the risk of lung ventilation dysfunction (LVD) and its two subtypes (mixed and restrictive ventilation dysfunction, MVD, and MVD) were significantly associated with BTEXS individuals. In addition, pulmonary function damage associated with BTEXS was modified by the smoking status and age. Generalized weighted quantile sum (gWQS) regressions were used to estimate the overall dose-effect on lung function damage induced by the BTEXS mixture. Our results show wqs, an index of weighted quartiles for BTEXS, was potentially associated with the reduction in FVC and FEV1% predicted with the coefficients [95% confidence intervals (CI)] between −1.136 (−2.202, −0.070) and −1.230 (−2.265, −0.195). Odds ratios (ORs) and 95% CIs for the wqs index of LVD, MVD, and RVD were 1.362 (1.129, 1.594), 1.323 (1.084, 1.562), and 1.394 (1.096, 1.692), respectively. Furthermore, xylene, benzene, and toluene in the BTEXS mixture potentially contribute to the development of lung function impairment. Our novel findings demonstrated the dose-response relationships between pulmonary function impairment and the BTEXS mixture and disclosed the potential key pollutants in the BTEXS mixture.

Gestational phthalate exposure and lung function during childhood: A prospective population-based study

The potential effect of gestational exposure to phthalates on the lung function levels during childhood is unclear. Therefore, we examined this association at different ages (from 4 to 11 years) and over the whole childhood. Specifically, we measured 9 phthalate metabolites (MEP, MiBP, MnBP, MCMHP, MBzP, MEHHP, MEOHP, MECPP, MEHP) in the urine of 641 gestating women from the INMA study (Spain) and the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC in their offspring at ages 4, 7, 9 and 11. We used linear regression and mixed linear regression with a random intercept for subject to assess the association between phthalates and lung function at each study visit and for the overall childhood, respectively. We also assessed the phthalate metabolites mixture effect on lung function using a Weighted Quantile Sum (WQS) regression. We observed that the phthalate metabolites gestational levels were consistently associated with lower FVC and FEV1 at all ages, both when assessed individually and jointly as a mixture, although most associations were not statistically significant. Of note, a 10% increase in MiBP was related to lower FVC (−0.02 (−0.04, 0)) and FEV1 z-scores (−0.02 (−0.04, −0.01) at age 4. Similar significant reductions in FVC were observed at ages 4 and 7 associated with an increase in MEP and MnBP, respectively, and for FEV1 at age 4 associated with an increase in MBzP. WQS regression consistently identified MBzP as an important contributor to the phthalate mixture effect. We can conclude that the gestational exposure to phthalates was associated with children's lower FVC and FEV1, especially in early childhood, and in a statistically significant manner for MEP, MiBP, MBzP and MnBP. Given the ubiquity of phthalate exposure and its established endocrine disrupting effects in children, our findings support current regulations that limit phthalate exposure.

Impact of society and national guidelines on patient selection for lung cancer surgery in the United Kingdom.

We sought to evaluate the impact of different national clinical guidelines (with consistent and conflicting recommendations) on clinician's practice in the UK. In this cohort study, we analysed data from National Lung Cancer Audit comprising all patients diagnosed with lung cancer between 2008 and 2013 within England and Wales for consistent (British Thoracic Society and National Institute of Clinical Excellence) recommendations for lower/more permissive lung function but opposing stage (N2) selection parameters for surgery. From 2008 to 2013, data from 167192 patients with primary lung cancers were included. The proportion of patients undergoing surgery for lung cancer increased from 9.5% to 20.5% in 2013 (P < 0.001) as the number of general thoracic surgeons in the UK increased from 40 to 81 in the corresponding timeframe. Mean forced expiratory volume in 1 s of surgical patients increased from 76% (22) to 81% (22) in 2013 (P < 0.001). Of the patients undergoing surgery, the proportion of patients with N2 disease across the 6-year interval was broadly consistent between 8% and 11% without any evidence of trend (P = 0.125). Within 3 years of new clinical guideline recommendations, we did not observe any overall change suggesting greater selection for surgery on lower levels of lung function. When presented with conflicting recommendation, no observable change in selection was noted on surgery for N2 disease. The observed increase in surgical resection rates is more likely due to greater access to surgery (by increasing number of surgeons) rather than any impact of guideline recommendations.

Effect of High-Quality Nursing Care on Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure: An Observational Cohort Study.

Background To investigate the efficacy of high-quality nursing care on patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with respiratory failure. Methods A total of 84 AECOPD patients were included in this study. Lung function indexes, nursing satisfaction, and arterial blood gas index were collected to assess the efficacy of high-quality nursing care on patients with acute chronic obstructive pulmonary disease complicated with respiratory failure. Results The level of lung function after treatment had a statistical difference between the two groups (P < 0.05). On other hand, the nursing satisfaction is improved in the observation group. The PaCO2 and PaO2 level was improved after treatment; there was statistical significance (P < 0.05). Conclusion High-quality nursing intervention has good therapeutic effect on acute exacerbation of COPD complicated with respiratory failure.

P187 Nutritional status and its relation with lung function and vitamin D3 level in cystic fibrosis patients

P187 Nutritional status and its relation with lung function and vitamin D3 level in cystic fibrosis patients

IL-36 is Closely Related to Neutrophilic Inflammation in Chronic Obstructive Pulmonary Disease.

BackgroundInterleukin (IL)-36α, IL-36β, and IL-36γ belong to the IL-36 family and play an important role in the pathogenesis of many diseases. Chronic obstructive pulmonary disease (COPD) may be correlated with IL-36; however, the specific role of IL-36 in COPD is unclear. In this study, we aimed to clarify whether IL-36 could be an indicator for determining COPD severity and the specific nature of the pro-inflammatory effects of IL-36 in COPD.MethodsA total of 70 patients with COPD and 20 control subjects were included in this study. We collected peripheral blood samples from both the groups, analyzed the blood cell fractions by routine blood examination, and measured the serum levels of IL-36α, IL-36β, and IL-36γ by performing polymerase chain reaction and enzyme-linked immunosorbent assay. In addition, the correlation between the number of neutrophils and eosinophils and the level of IL-36 was also analyzed.ResultsWe found that level of IL-36 in patients with COPD was positively correlated with the number of neutrophils but not with eosinophils, whereas the correlation was not found in the control group. Moreover, the level of IL-36 was negatively correlated with the level of lung function of patients with COPD, and the levels of IL-36α, IL-36β, and IL-36γ increased with advancing disease severity.ConclusionIn COPD, the pro-inflammatory effect of IL-36 is closely related to neutrophils, and hence, IL-36 might be considered a novel biomarker for determining COPD severity.

Association between greenspace and lung function in Italian children-adolescents.

Few studies have examined the impact of urban greenspace exposure on lung function in children-adolescents, and the available evidence is still inconsistent. The aim of the current study was to verify the hypothesis that the effects of greenspace exposure vary with differing levels of lung function of children-adolescents. Between November 2005 and May 2006, 2150 children-adolescents (age-range: 10-15 years) living in the city of Palermo were enrolled in a cross-sectional survey. Parents were interviewed through a modified version of the Italian Studies on Respiratory Disorders in Children and the Environment (SIDRIA) questionnaire. All children-adolescents performed spirometry and were tested for allergic sensitization. Exposures to greenspace and grey space at the home addresses were measured using the CORINE land-cover classes. Parametric quantile regression models were applied for assessing the association between greenspace exposure and spirometry parameters, accounting for possible confounders and effect modifiers. A p-value lower than 0.05 was considered statistically significant. From the 1st to the 21st percentile, children-adolescents living within greenspace had higher FEV1 than those living within grey space. In particular, the estimated effects were: 1st (β=0.238L, p=0.01), 5th (β=0.140L, p=0.01), 10th (β=0.097L, p=0.015), and 15th (β=0.073L, p=0.025). Similarly, from the 1st to the 29th percentile, children-adolescents living within greenspace had higher FVC than those living within grey space. In particular, the estimated effects were: 1st (β=0.367L, p=0.0003), 5th (β=0.215L, p=0.0003), 10th (β=0.150L, p=0.0004), and 15th (β=0.112L, p=0.001). No significant associations were found for FEV1/FVC, FEF25-75 and FEF25-75/FVC. Quantile regression techniques may provide new insights into the evaluation of the association between greenspace exposure and lung function in children-adolescents, showing substantially heterogeneous effects from lower to higher quantiles of spirometry parameters. These results may help implementing policies for planning sustainable housing and surrounding greenspaces.

Impact of timing of nintedanib initiation among patients newly diagnosed with idiopathic pulmonary fibrosis

Aims While nintedanib treatment has been shown to slow the progression of idiopathic pulmonary fibrosis (IPF) in patients across varying levels of lung function, the effect of treatment timing on outcomes has not been examined. We assessed hospitalization risk and medical costs among patients with IPF based on the timing of nintedanib initiation after IPF diagnosis. Materials and methods This retrospective administrative claims study included data from 04/01/2014–09/30/2019 for patients aged ≥40 years who initiated nintedanib within 1 year of IPF diagnosis. Patients were assigned to study cohorts based on the time from IPF diagnosis to nintedanib initiation. All-cause hospitalization and all-cause medical costs were modeled using marginal structural models including inverse probability weights to adjust for both baseline and time-varying characteristics. Results Of 11,195 patients diagnosed with IPF during the identification period, 449 met the study selection criteria (mean age 72.3 years, 68% male, mean follow-up time 13.3 months). Adjusted hospitalization risk and medical costs both varied significantly by the timing of nintedanib initiation (p < .001 and p = .020, respectively). Adjusted weighted hospitalization risk was higher among untreated vs. treated patients in months 2–3, months 4–6, and months 7–12 after diagnosis (hazard ratio [95% CI] 1.97 [1.09–3.56], p = .026; 2.62 [1.22–5.63], p = .014; and 5.57 [2.31–13.45], p < .001, respectively). Medical costs were 69% higher for patients initiating treatment in months 2–3 vs. month 1 (cost ratio [95% CI] 1.69 [1.20–2.38], p = .003). Limitations Disease severity could not be assessed because clinical data were unavailable; however, proxies such as oxygen use were included to adjust for between-cohort differences in disease severity. Conclusions Patients who initiate nintedanib promptly after IPF diagnosis may have reduced hospitalization risk and medical costs compared with those who start treatment later. Additional studies are warranted to improve understanding of the impact of prompt antifibrotic therapy on patient outcomes.

Lung function in young adulthood: differences between males and females with asthma.

BackgroundThere are phenotypic differences in asthma in males and females. Differences in lung function between the sexes at the peak lung function level in young adulthood are so far not directly addressed. The aim of the present study was to assess lung function in early adulthood in males and females depending on asthma onset and remission.MethodsParticipants were included from the population-based birth cohort BAMSE and classified as having: never asthma, childhood asthma in remission, adolescent onset asthma or persistent asthma. Pre- and post-bronchodilator lung function (in Z-score) and lung clearance index (LCI) were measured at age 24 years. Lung function was compared stratified for sex between the never asthma and asthma groups univariately and in multiple linear regression analyses adjusted for maternal and paternal asthma, maternal smoking during pregnancy, secondary smoking, daily smoking, early respiratory syncytial virus infection, traffic pollution, childhood allergic sensitisation, and body mass index at age 24 years.ResultsAll asthma phenotypes were associated with a lower forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) post-bronchodilation at 24 years. This was most pronounced in males with persistent asthma compared to males with never asthma (regression coefficient: −0.503; 95% CI: −0.708– −0.298). Childhood asthma (in remission or persistent) was associated with a lower FEV1. After adjustment, the associations remained significant for males. For females, the significant associations with lower FEV1 and FEV1/FVC remained only for subjects with asthma in remission. Persistent asthma was associated with higher LCI in females.ConclusionsIn females, in contrast to males, the association between asthma and lower lung function was attenuated after adjustment for known risk factors.

Electroacupuncture attenuates pulmonary vascular remodeling in a rat model of chronic obstructive pulmonary disease via the VEGF/PI3K/Akt pathway.

Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. Pulmonary vascular remodeling is the main pathological feature of COPD. Vascular endothelial growth factor (VEGF), the key regulator of angiogenesis, mediates activation of the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) pathway, which regulates the proliferation and migration of vascular endothelial cells and plays important roles in pulmonary angiogenesis and remodeling in COPD. Here, the efficacy of electroacupuncture (EA) with respect to regulation of microvascular remodeling induced by VEGF/PI3K/Akt was evaluated in a rat model of COPD. Rats were randomly assigned to blank, COPD model, EA and sham acupuncture (SA) groups. Rats in the EA group received EA at GV14, BL13 and BL23 three times per week, while those in the SA group, as a control, received shallow and minimal electrostimulation at sites 5-10 mm away from the traditional acupuncture point locations. After 2, 4 and 8 weeks of treatment, the optimal treatment duration was determined according to the results of lung function, lung pathology and inflammatory factor levels. Then, microvessel density, protein levels and mRNA expression of selected VEGF/PI3K/Akt pathway intermediates were determined by immunofluorescence, immunohistochemistry and Western blot analysis, and mRNA qRT-PCR, respectively. EA improved lung function and lung tissue histopathology, with the best effect after 8 weeks of treatment, as noted by reduced density of lung microvessels and expression of angiogenesis-related factors (VEGF and endothelin (ET)-1). EA-treated COPD rats exhibited reduced VEGF, VEGF receptor 2 (VEGFR2), ET-1 mRNA and VEGF, VEGFR2, phosphorylated (p)-VEGFR2, PI3K, Akt, p-Akt, mammalian target of rapamycin (mTOR), and p-mTOR at the protein level in comparison with untreated and SA-treated COPD model rats. EA had beneficial effects on COPD in this animal model including reduced pulmonary vascular remodeling via mechanisms possibly related to the VEGF/PI3K/Akt pathway.

Lung function and air pollution exposure in adults with asthma in Beijing: a 2-year longitudinal panel study.

The effect of air pollution on the lung function of adults with asthma remains unclear to date. This study followed 112 patients with asthma at 3-month intervals for 2 years. The pollutant exposure of the participants was estimated using the inverse distance weight method. The participants were divided into three groups according to their lung function level at every visit. A linear mixed-effect model was applied to predict the change in lung function with each unit change in pollution concentration. Exposure to carbon monoxide (CO) and particles less than 2.5 micrometers in diameter (PM2.5) was negatively associated with large airway function in participants. In the severe group, exposure to chronic sulfur dioxide (SO2) was negatively associated with post-bronchodilator forced expiratory flow at 50%, between 25% and 75% of vital capacity % predicted (change of 95% CI per unit: -0.34 (-0.55, -0.12), -0.24 (-0.44, -0.03), respectively). In the mild group, the effect of SO2 on the small airways was similar to that in the severe group, and it was negatively associated with large airway function. Exposure to CO and PM2.5 was negatively associated with the large airway function of adults with asthma. The negative effects of SO2 were more evident and widely observed in adults with severe and mild asthma than in adults with moderate asthma. Patients with asthma react differently to air pollutants as evidenced by their lung function levels.

Alcohol intake, beverage type, and lung function: a multicohort study of Chinese adults.

We aimed to investigate whether alcohol intake contributes to lung function levels and which beverage type may have an effect. We investigated 3742 participants from the Wuhai-Zhuhai Cohort and 12,526 participants from the Dongfeng-Tongji Cohort, and they were followed up for 3 and 5 years, respectively. Information on the type and daily amount of alcohol intake was collected through face-to-face interviews. Lung function was measured by trained physicians using electronic spirometers. Compared with nondrinkers, moderate alcohol intake was significantly associated with a 70.03 and 74.92 mL increase in FEV1 and FVC, respectively (P < 0.05), after adjusting for covariates. With regard to beverage type, red wine was associated with a 105.31 and 98.91 mL increase in FEV1 and FVC, respectively (P < 0.05). Moderate alcohol intake was also associated with a 53.37 and 66.17 mL increase in FEV1 and FVC for liquor, respectively, and a 106.90 and 103.62 mL increase for red wine (all Ps < 0.05). In the longitudinal analyses, moderate alcohol intake and red wine were associated with a 67.77 and 103.77 mL increase in FVC, respectively (P < 0.05). Moderate alcohol intake is associated with increased lung function, especially for red wine. Further studies are needed to investigate the potential mechanism.

Effect of Ambroxol Hydrochloride Combined with Rehabilitation Training Instruction on Lung Function and Endurance Level in Patients with Chronic Obstructive Pulmonary Disease

Effect of Ambroxol Hydrochloride Combined with Rehabilitation Training Instruction on Lung Function and Endurance Level in Patients with Chronic Obstructive Pulmonary Disease

Gene expression of oxidative stress markers and lung function: A CARDIA lung study.

BackgroundCirculating markers of oxidative stress have been associated with lower lung function. Our objective was to study the association of gene expression levels of oxidative stress pathway genes (ALOX12, ALOX15, ARG2, GSTT1, LPO, MPO, NDUFB3, PLA2G7, and SOD3) and lung function forced expiratory volume in one second (FEV1), forced vital capacity (FVC) in Coronary Artery Risk Development in Young Adults study.MethodsLung function was measured using spirometry and the Nanostring platform was used to estimate gene expression levels. Linear regression models were used to study association of lung function measured at year 30, 10‐year decline in lung function and gene expression after adjustment for center, smoking, and BMI, measured at year 25.ResultsThe 10‐year decline of FEV1 was faster in highest NDUFB3 quartile compared to the lowest (difference = −2.09%; p = 0.001) after adjustment for multiple comparisons. The 10‐year decline in FEV1 and FVC was nominally slower in highest versus lowest quartile of PLA2G7 (difference = 1.14%; p = 0.02, and difference = 1.06%; p = 0.005, respectively). The other genes in the study were not associated with FEV1 or FVC.ConclusionHigher gene expression levels in oxidative stress pathway genes are associated with faster 10‐year FEV1 decline.

Factors associated with physical activity among COPD patients with mild or moderate airflow obstruction.

Physical inactivity is already present among patients with chronic obstructive pulmonary disease (COPD) of mild or moderate airflow obstruction. Most previous studies that reported on determinants of physical activity in COPD included patients with severe COPD. Therefore, the aim of this study was to explore which patient characteristics were related with physical activity in COPD patients with mild or moderate airflow obstruction. Cross-sectional analyses were performed on patients selected from the population-based Netherlands Epidemiology of Obesity study. Patients were included if they had a physician-diagnosed COPD GOLD 0-2 or had newly diagnosed COPD GOLD 1-2. Physical activity was evaluated using the Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH) questionnaire and reported in hours per week of metabolic equivalents (MET-h/week). Associations between sociodemographic, lifestyle, clinical and functional characteristics were examined using regression analysis. 323 patients were included in research (77 with physician-diagnosed and 246 with newly diagnosed COPD). We found that physical activity was positively associated with pulmonary function: FEV1 (regression coefficient 0.40 (95% CI 0.09,0.71)) and FVC (regression coefficient 0.34 (95% CI 0.06,0.61)). Physical activity was associated with anxiety (regression coefficient =0.9 (95% CI 0.3,1.6)) only for physician-diagnosed patients.Lung function and anxiety level determine level of physical activity among COPD patients with mild or moderate airflow obstruction. Thus, integrating it into the physical activity plans could help to increase physical activity level of the patients.