Natural Course of the Diffusing Capacity of the Lungs for Carbon Monoxide in COPD: Importance of Sex.

Carbon Monoxide / metabolism Female Humans Male Phenotype Pulmonary Diffusing Capacity Pulmonary Disease, Chronic Obstructive / metabolism Respiratory Function Tests Sex Factors Smokers

COPD diffusing capacity of the lungs for carbon monoxide lung function decline sex

Journal

Chest

ISSN: 1931-3543

Titre abrégé: Chest

Pays: United States

ID NLM: 0231335

Informations de publication

Date de publication:
08 2021

Historique:

received: 26 11 2020

revised: 06 03 2021

accepted: 31 03 2021

pubmed: 21 4 2021

medline: 4 1 2022

entrez: 20 4 2021

Statut: ppublish

Résumé

The value of the single-breath diffusing capacity of the lungs for carbon monoxide (Dlco) relates to outcomes for patients with COPD. However, little is known about the natural course of Dlco over time, intersubject variability, and factors that may influence Dlco progression. What is the natural course of Dlco in patients with COPD over time, and which other factors, including sex differences, could influence this progression? We phenotyped 602 smokers (women, 33%), of whom 506 (84%) had COPD and 96 (16%) had no airflow limitation. Lung function, including Dlco, was monitored annually over 5 years. A random coefficients model was used to evaluate Dlco changes over time. The mean (± SE) yearly decline in Dlco % in patients with COPD was 1.34% ± 0.015%/y. This was steeper compared with non-COPD control subjects (0.04% ± 0.032%/y; P = .004). Sixteen percent of the patients with COPD, vs 4.3% of the control subjects, had a statistically significant Dlco % slope annual decline (4.14%/y). At baseline, women with COPD had lower Dlco values (11.37% ± 2.27%; P < .001) in spite of a higher FEV Patients with COPD have an accelerated decline in Dlco compared with smokers without the disease. However, the decline is slow, and a testing interval of 3 to 4 years may be clinically informative. The lower and more rapid decline in Dlco values in women, compared with men, suggests a differential impact of sex in gas exchange function. ClinicalTrials.gov; No.: NCT01122758; URL: www.clinicaltrials.gov.

Sections du résumé

BACKGROUND

RESEARCH QUESTION

What is the natural course of Dlco in patients with COPD over time, and which other factors, including sex differences, could influence this progression?

STUDY DESIGN AND METHODS

We phenotyped 602 smokers (women, 33%), of whom 506 (84%) had COPD and 96 (16%) had no airflow limitation. Lung function, including Dlco, was monitored annually over 5 years. A random coefficients model was used to evaluate Dlco changes over time.

RESULTS

The mean (± SE) yearly decline in Dlco % in patients with COPD was 1.34% ± 0.015%/y. This was steeper compared with non-COPD control subjects (0.04% ± 0.032%/y; P = .004). Sixteen percent of the patients with COPD, vs 4.3% of the control subjects, had a statistically significant Dlco % slope annual decline (4.14%/y). At baseline, women with COPD had lower Dlco values (11.37% ± 2.27%; P < .001) in spite of a higher FEV

INTERPRETATION

Patients with COPD have an accelerated decline in Dlco compared with smokers without the disease. However, the decline is slow, and a testing interval of 3 to 4 years may be clinically informative. The lower and more rapid decline in Dlco values in women, compared with men, suggests a differential impact of sex in gas exchange function.

TRIAL REGISTRY

ClinicalTrials.gov; No.: NCT01122758; URL: www.clinicaltrials.gov.

Identifiants

DOI: 10.1016/j.chest.2021.03.069 PMID: 33878339

pubmed: 33878339

pii: S0012-3692(21)00696-6

doi: 10.1016/j.chest.2021.03.069

pii:

doi:

Substances chimiques

Carbon Monoxide 7U1EE4V452

Banques de données

ClinicalTrials.gov

['NCT01122758']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

481-490

Commentaires et corrections

Type : CommentIn