» Articles » PMID: 32759170

Chronic Airflow Limitation and Its Relation to Respiratory Symptoms Among Ever-smokers and Never-smokers: a Cross-sectional Study

Abstract

Background: The diagnosis of chronic obstructive pulmonary disease is based on the presence of persistent respiratory symptoms and chronic airflow limitation (CAL). CAL is based on the ratio of forced expiratory volume in 1 s to forced vital capacity (FEV:FVC) after bronchodilation, and FEV:FVC less than the fifth percentile is often used as a cut-off for CAL. The aim was to investigate if increasing percentiles of FEV:FVC were associated with (cough with phlegm, dyspnoea or wheezing) in a general population sample of never-smokers and ever-smokers.

Methods: In a cross-sectional study comprising 15 128 adults (50-64 years), 7120 never-smokers and 8008 ever-smokers completed a respiratory questionnaire and performed FEV and FVC after bronchodilation. We calculated their -scores for FEV:FVC and defined the fifth percentile using the Global Lung Function Initiative (GLI) reference value, GLI and increasing percentiles up to GLI. We analysed the associations between different strata of percentiles and prevalence of using multivariable logistic regression for estimation of OR.

Results: Among all subjects, regardless of smoking habits, the odds of were elevated up to the GLI strata. Among never-smokers, the odds of were elevated at GLI (OR 3.57, 95% CI 2.43 to 5.23) and at GLI (OR 2.57, 95% CI 1.69 to 3.91), but not at higher percentiles. Among ever-smokers, the odds of were elevated from GLI (OR 4.64, 95% CI 3.79 to 5.68) up to GLI (OR 1.33, 95% CI 1.00 to 1.75).

Conclusions: The association between percentages of FEV:FVC and respiratory symptoms differed depending on smoking history. Our results support a higher percentile cut-off for FEV:FVC for never-smokers and, in particular, for ever-smokers.

Citing Articles

Chronic Airflow Limitation, Lower Respiratory Symptoms, COPD and Chronic Rhinosinusitis in a Middle-Aged Population: The Swedish CArdioPulmonary bioImage Study (SCAPIS). A Link Between the Lower and Upper Airways.

Andersson A, Bergqvist J, Schioler L, Bossios A, Farnebo L, Holmlund T Int J Chron Obstruct Pulmon Dis. 2025; 20:273-286.

PMID: 39959845 PMC: 11829582. DOI: 10.2147/COPD.S493219.


Applying the Rome Proposal on Exacerbations of Chronic Obstructive Pulmonary Disease: Does Comorbid Chronic Heart Failure Matter?.

Jacobson P, Lind L, Persson H Int J Chron Obstruct Pulmon Dis. 2023; 18:2055-2064.

PMID: 37744733 PMC: 10517701. DOI: 10.2147/COPD.S425592.


The ratio FEV /FVC and its association to respiratory symptoms-A Swedish general population study.

Toren K, Schioler L, Lindberg A, Andersson A, Behndig A, Bergstrom G Clin Physiol Funct Imaging. 2020; 41(2):181-191.

PMID: 33284499 PMC: 7898324. DOI: 10.1111/cpf.12684.

References
1.
Vaz Fragoso C, Concato J, McAvay G, Van Ness P, Rochester C, Yaggi H . Defining chronic obstructive pulmonary disease in older persons. Respir Med. 2009; 103(10):1468-76. PMC: 2739264. DOI: 10.1016/j.rmed.2009.04.019. View

2.
Tan W, Bourbeau J, Hernandez P, Chapman K, Cowie R, Fitzgerald J . Exacerbation-like respiratory symptoms in individuals without chronic obstructive pulmonary disease: results from a population-based study. Thorax. 2014; 69(8):709-17. PMC: 4112491. DOI: 10.1136/thoraxjnl-2013-205048. View

3.
Bestall J, Paul E, Garrod R, Garnham R, Jones P, Wedzicha J . Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999; 54(7):581-6. PMC: 1745516. DOI: 10.1136/thx.54.7.581. View

4.
Parshall M, Schwartzstein R, Adams L, Banzett R, Manning H, Bourbeau J . An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012; 185(4):435-52. PMC: 5448624. DOI: 10.1164/rccm.201111-2042ST. View

5.
Pellegrino R, Viegi G, Brusasco V, Crapo R, Burgos F, Casaburi R . Interpretative strategies for lung function tests. Eur Respir J. 2005; 26(5):948-68. DOI: 10.1183/09031936.05.00035205. View