Subjects with Discordant Airways Obstruction: Lost between Spirometric Definitions of COPD

Background. Since the FEV1/FVC ratio declines with age, using the fixed ratio of 0.70 leads to overdiagnosis of COPD in older populations and underdiagnosis among young adults. Objective. To evaluate whether discordant obstructive cases (FEV1/FVC < 0.70 but ≥LLN) are a healthy population or have...

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Main Authors: Bernd Lamprecht, Lea Schirnhofer, Bernhard Kaiser, Sonia A. Buist, David M. Mannino, Michael Studnicka
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Pulmonary Medicine
Online Access:http://dx.doi.org/10.1155/2011/780215
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author Bernd Lamprecht
Lea Schirnhofer
Bernhard Kaiser
Sonia A. Buist
David M. Mannino
Michael Studnicka
author_facet Bernd Lamprecht
Lea Schirnhofer
Bernhard Kaiser
Sonia A. Buist
David M. Mannino
Michael Studnicka
author_sort Bernd Lamprecht
collection DOAJ
description Background. Since the FEV1/FVC ratio declines with age, using the fixed ratio of 0.70 leads to overdiagnosis of COPD in older populations and underdiagnosis among young adults. Objective. To evaluate whether discordant obstructive cases (FEV1/FVC < 0.70 but ≥LLN) are a healthy population or have clinical features that would place them at increased risk. Methods. We used post-bronchodilator spirometry data from the population-based Austrian Burden of Obstructive Lung Disease (BOLD) study. Those with post-bronchodilator FEV1/FVC ratio <LLN and <0.70 were defined as concordant obstructive cases. Participants with post-bronchodilator FEV1/FVC ratio ≥LLN but <0.70 were defined as discordant obstructive cases. Results. Discordant obstructive cases were more likely to be older, male and never-smokers. Additionally they had less respiratory symptoms and less severe impairment of FEV1. However, discordant obstructive cases reported significantly more often a diagnosis of heart disease than subjects with normal lung function (27.2% vs 7.3%, P=.015). Conclusion. The clinical profile of discordant obstructive cases includes potentially important comorbid disease.
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series Pulmonary Medicine
spelling doaj-art-1025c2fd9c384ff1ba8f14de88ff2b4c2025-08-20T03:55:44ZengWileyPulmonary Medicine2090-18362090-18442011-01-01201110.1155/2011/780215780215Subjects with Discordant Airways Obstruction: Lost between Spirometric Definitions of COPDBernd Lamprecht0Lea Schirnhofer1Bernhard Kaiser2Sonia A. Buist3David M. Mannino4Michael Studnicka5Department of Pulmonary Medicine, Paracelsus Private Medical University of Salzburg, 5020 Salzburg, AustriaDepartment of Pulmonary Medicine, Paracelsus Private Medical University of Salzburg, 5020 Salzburg, AustriaDepartment of Pulmonary Medicine, Paracelsus Private Medical University of Salzburg, 5020 Salzburg, AustriaDepartment of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, OR 97239, USADepartment of Preventive Medicine and Environmental Health, University of Kentucky, Lexington, KY 40536, USADepartment of Pulmonary Medicine, Paracelsus Private Medical University of Salzburg, 5020 Salzburg, AustriaBackground. Since the FEV1/FVC ratio declines with age, using the fixed ratio of 0.70 leads to overdiagnosis of COPD in older populations and underdiagnosis among young adults. Objective. To evaluate whether discordant obstructive cases (FEV1/FVC < 0.70 but ≥LLN) are a healthy population or have clinical features that would place them at increased risk. Methods. We used post-bronchodilator spirometry data from the population-based Austrian Burden of Obstructive Lung Disease (BOLD) study. Those with post-bronchodilator FEV1/FVC ratio <LLN and <0.70 were defined as concordant obstructive cases. Participants with post-bronchodilator FEV1/FVC ratio ≥LLN but <0.70 were defined as discordant obstructive cases. Results. Discordant obstructive cases were more likely to be older, male and never-smokers. Additionally they had less respiratory symptoms and less severe impairment of FEV1. However, discordant obstructive cases reported significantly more often a diagnosis of heart disease than subjects with normal lung function (27.2% vs 7.3%, P=.015). Conclusion. The clinical profile of discordant obstructive cases includes potentially important comorbid disease.http://dx.doi.org/10.1155/2011/780215
spellingShingle Bernd Lamprecht
Lea Schirnhofer
Bernhard Kaiser
Sonia A. Buist
David M. Mannino
Michael Studnicka
Subjects with Discordant Airways Obstruction: Lost between Spirometric Definitions of COPD
Pulmonary Medicine
title Subjects with Discordant Airways Obstruction: Lost between Spirometric Definitions of COPD
title_full Subjects with Discordant Airways Obstruction: Lost between Spirometric Definitions of COPD
title_fullStr Subjects with Discordant Airways Obstruction: Lost between Spirometric Definitions of COPD
title_full_unstemmed Subjects with Discordant Airways Obstruction: Lost between Spirometric Definitions of COPD
title_short Subjects with Discordant Airways Obstruction: Lost between Spirometric Definitions of COPD
title_sort subjects with discordant airways obstruction lost between spirometric definitions of copd
url http://dx.doi.org/10.1155/2011/780215
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