Pulmonary Subtypes Exhibit Differential Global Initiative for Chronic Obstructive Lung Disease Spirometry Stage Progression: The COPDGene® Study.

摘要: Rationale We classified individuals into pulmonary disease subtypes based on 2 underlying pathophysiologic axes (airway-predominant and emphysema-predominant) their increased mortality risk. Our next objective was to determine whether some subcomponents of these are additionally associated with unique patterns Global initiative for chronic Obstructive Lung Disease (GOLD) spirometry stage progression. Methods After accounting intra-individual measurement variability in measures between baseline (Phase 1) the 5-year follow up 2) COPD Genetic Epidemiology (COPDGene®) study, 4615 had complete data that would characterize progression over 5 years (2033 non-Hispanic whites; 827 African Americans; 48% female). Individuals could express risk one or both primary subtype thus they were further 6 groups: high-risk airway-predominant only (APD-only), moderate-risk (MR-APD-only), emphysema-predominant (EPD-only), combined airway- (combined APD-EPD), MR-APD-EPD), no subtype. Outcomes dichotomized GOLD from Phase 1 2. Logistic regression outcomes adjusted age, sex, race, change smoking status. Results The MR-APD-only group conversion 0 preserved ratio-impaired (PRISm) status (odds ratio [OR] 11.3, 95% confidence interval [CI] 5.7-22.1) 2-4 (OR 6.0, CI 2.0-18.0). EPD-only 2.4, 1.2-4.6), 2.6, 1.0-6.9). Conversion PRISm (31%-38%) occurred APD-only groups. Conclusion Differential occurs groups expressing independently combination. Airway-predominant highly important determining early