Clinical characteristics of and risk factors for small airway dysfunction detected by impulse oscillometry. (December 2021)

• Record Type: Journal Article
• Authors: Peng, Jieqi; Wu, Fan; Tian, Heshen; Yang, Huajing; Zheng, Youlan; Deng, Zhishan; Wang, Zihui; Xiao, Shan; Wen, Xiang; Huang, Peiyu; Lu, Lifei; Dai, Cuiqiong; Zhao, Ningning; Huang, Suyin; Ran, Pixin; Zhou, Yumin
• Is Part Of: Respiratory medicine. Volume 190(2022)
• Publication Date: 2021-12
• Subjects: FEF25 forced expiratory flow 25% -- FEF50 forced expiratory flow 50% -- FEF75 forced expiratory flow 75% -- Ax reactance area; Impulse oscillometry -- Small airway dysfunction -- Risk factor; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2021.106681
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Background: Small airway dysfunction (SAD) is an early lesion of chronic respiratory disease that is best detected using impulse oscillometry (IOS). Few studies have investigated risk factors for IOS-defined SAD (IOS-SAD) in a large population. We aimed to explore the clinical features of and risk factors for IOS-SAD in a community-based population. Methods: We divided subjects into IOS-SAD and non-SAD groups based on a cutoff of >0.07 kPa/L/s in the difference between the resistance at 5 Hz versus the resistance at 20 Hz (R5–R20). All participants underwent spirometry, IOS, and completed a questionnaire; some participants underwent computed tomography (CT). We analyzed the risk factors for SAD based on binary logistic regression. Results: The total cohort comprised 1327 subjects. The prevalence of IOS-SAD was 32.9% (437/1327). Compared with the non-SAD group, the IOS-SAD group was older (64.0 ± 7.8 vs. 59.6 ± 7.8 years, p < 0.001), included less never-smokers (30.2% vs. 35.8%, p < 0.001), had greater airway resistance and worse lung function, indicated by a larger R5–R20 (0.15 ± 0.08 vs. 0.03 ± 0.02 kPa/L/s, p < 0.001) and smaller forced expiratory volume in 1 s to forced vital capacity after bronchodilation (60.2 ± 14.4% vs. 72.6 ± 10.0%, p < 0.001); on CT, the IOS-SAD group had higher prevalences of emphysema and gas trapping. Risk factors for SAD were older age, high BMI, smoking, childhood cough, and asthma. Conclusion: Subjects with IOS-SAD had increased airway resistance and visible CT changes. Individuals with smoking exposure, advanced age, high BMI, childhood cough, and asthma were more prone to SAD. Clinical trial registration: ChiCTR1900024643. Highlights: This cross-sectional study investigated impulse oscillometry (IOS)-defined small airway dysfunction (SAD) in a large community-based population. Individuals with IOS-SAD had poor lung function, high airway resistance, and more emphysema and gas trapping than those without IOS-SAD. Risk factors for IOS-SAD were older age, high BMI, smoking history, passive smoking, low education, childhood cough, and asthma.