Background Obesity is the most common metabolic disease in the world. However, the relationship between obesity and lung function is not fully understood. Although several longitudinal studies have shown that increase...Background Obesity is the most common metabolic disease in the world. However, the relationship between obesity and lung function is not fully understood. Although several longitudinal studies have shown that increases in body weight can lead to reductions in pulmonary function, whether this is the case with the Japanese population and whether high body mass index （BMI） status alone represents an appropriate predictor of obstructive lung dysfunction remains unclear.The purpose of present study was to estimate the effect of BMI on lung function measured by spirometry of Japanese patients in general clinics. We measured BMI and performed spirometry on screening patients who had consulted general clinics.Methods Subjects comprised 1231 patients ≥40 years of age （mean age （65.0±12.0） years, 525 men, 706 women） who had consulted clinics in Nagasaki Prefecture, Japan, for non-respiratory disease. BMI was calculated and lung function was measured by spirometry.Results BMI was found to be positively correlated with forced expiratory volume in 1 second （FEV1）/forced vital capacity （FVC） in men and with maximum mid-expiratory flow （MMF） in all subjects. Following adjustment for relevant factors, a significant positive correlation between BMI and FEV1/FVC was identified for all subjects. Comparison between subjects with normal BMI （18.5-25.0） and higher BMI （25.1-30.0） also demonstrated that FEV1/FVC and percentage of predicted maximum mid-expiratory flow （%MMF） were significantly higher in the latter subjects.Conclusions In a population without marked respiratory disease, higher BMI subjects showed less obstructive pulmonary dysfunction compared to normal BMI subjects. High BMI status alone may be inappropriate as a predictor of obstructive lung dysfunction, particularly in populations with a low prevalence of obesity.展开更多
BACKGROUND Eosinophil counts are a promising guide to systemic steroid administration for chronic obstructive pulmonary disease(COPD).AIM To study the role of peripheral eosinophilia in hospitalized patients with acut...BACKGROUND Eosinophil counts are a promising guide to systemic steroid administration for chronic obstructive pulmonary disease(COPD).AIM To study the role of peripheral eosinophilia in hospitalized patients with acute exacerbation of COPD(AECOPD).METHODS From January 2014 to May 2017,patients with AECOPD hospitalized in Taipei Tzu Chi Hospital were retrospectively stratified into two groups according to their peripheral eosinophil count:The EOS group(eosinophil count≥2%)and the non-EOS group(eosinophil count<2%).Demographics,comorbidities,laboratory data,steroid use,length of hospital stay,and COPD-related readmissions were compared between the groups.RESULTS A total of 625 patients were recruited,with 176 patients(28.2%)in the EOS group.The EOS group showed a lower prevalence of infection,lower cumulative doses of prednisolone equivalents,shorter length of hospital stay,and higher number of COPD-related readmissions than the non-EOS group.There were significantly linear correlations between eosinophil percentage and number of readmissions and between eosinophil percentage and length of hospital stay P<0.001,and a lower percent-predicted value of forced expiratory volume in one second(FEV1)were associated with shorter time to first COPD-related readmission[adjusted hazard ratio(adj.HR)=1.488,P<0.001;adj.HR=0.985,P<0.001,respectively].CONCLUSION The study findings suggest that the EOS group had the features of a shorter length of hospital stay,and lower doses of systemic steroids,but more frequent readmissions.The EOS group and lower percent-predicted FEV1 values were risk factors for shorter time to first COPD-related readmission.展开更多
Exercise-Induced bronchoconstriction (EIB) is related to increased ventilation (VE) during exercise and describes the transient airway narrowing following exercise. A reliable diagnosis is essential for optimal treatm...Exercise-Induced bronchoconstriction (EIB) is related to increased ventilation (VE) during exercise and describes the transient airway narrowing following exercise. A reliable diagnosis is essential for optimal treatment. The impact of a repeated exercise challenge test (ECT) in a clinical setting is not well established and conducting a repeated ECT with the possibility to adjust the exercise intensity on an individual basis may give more information. The aim of the study was to evaluate the test-retest reliability of an ECT for EIB and its association with exercise intensity. Methods: After examination by a pulmonologist, 20 referred subjects with symptoms strong indications of Exercise-Induced bronchoconstriction performed two consecutive exercise challenge tests on a treadmill. The exercise intensity of the repeated test was adjusted. Forced expiratory volume in 1 second (FEV1) was measured before and 1, 3, 6, 10, and 15 minutes after exercise. EIB was defined as a reduction of ≥ 10% in FEV1. Ventilation and heart rate were measured during exercise. Results: Five subjects tested positive in both tests, and ten subjects tested negative in both tests. Three subjects tested positive in the first test only, while two subjects tested positive in the second test only. The exercise intensity was not significantly different between the two tests for any of the subjects. Conclusion: There were 25% divergences in the diagnostic results of two consecutive exercise challenge tests. The difference in the test results was not explained by a difference in the exercise intensity.展开更多
BACKGROUND The prevalence of depression in patients with chronic obstructive pulmonary disease(COPD)ranges from 10%to 42%,but the diagnosis of depression in patients with COPD is often unrecognized and untreated.Unrec...BACKGROUND The prevalence of depression in patients with chronic obstructive pulmonary disease(COPD)ranges from 10%to 42%,but the diagnosis of depression in patients with COPD is often unrecognized and untreated.Unrecognized depression has major implications for compliance with medical treatment,prolonged lengths of stay,increased frequency of hospital admissions,and increased consultations with primary care physicians.Many studies have attempted to identify risk factors for progression,prognosis and response to therapy in patients with depression.However,few studies have examined the risk factors for depression in patients with COPD,and some results remain controversial.AIM To identify the potential risk factors to define patients with COPD who are at“high risk”of depression.METHODS The clinical data of 293 patients with COPD were reviewed from January 2017 to December 2018.The correlations between demographics,clinical characteristics and depression were analyzed.The risk factors for depression in patients with COPD were identified by multivariate logistic regression analysis.The cutoff value,sensitivity and specificity of the independent correlation factors were calculated with a receiver operating characteristic curve.RESULTS Of the 293 patients included,65(22.18%)individuals were identified to have depression.Significant differences were detected between patients with and without depression in terms of body mass index(BMI),forced expiratory volume in 1 s(FEV1),and COPD assessment test(CAT)score(all P<0.05).Low BMI,low FEV1,and high CAT were independent risk factors for depression in patients with COPD and the cutoff values of BMI,FEV1,and CAT scores were 21.373 kg/m2,0.855 L and 12.5,respectively.CONCLUSION Low BMI,low FEV1,and high CAT score were identified as independent risk factors for depression in patients with COPD.展开更多
Background: Routine lung function testing requires expensive equipment, or requires maximum expiratory effort. The airflow perturbation device (APD) is a light handheld device, allowing for serial measures of respirat...Background: Routine lung function testing requires expensive equipment, or requires maximum expiratory effort. The airflow perturbation device (APD) is a light handheld device, allowing for serial measures of respiratory resistance noninvasively and effortlessly. Methods: In a convenience sample of 398 patients undergoing pulmonary function testing, we compared routine spirometric indices (forced expired volume in 1 second (FEV1), peak expiratory flow (PEF)), and airways resistance (Raw-272 patients), to measures of respiratory resistance measured with the APD including inspiratory (IR), expiratory (ER) and averaged (AR) resistance. Results: Measures of lung function were significantly correlated (p 0.001). On regression analysis, between 7% - 17% of the variance (R2) for FEV1, PEF, and Raw was explained by APD measurements. Approximately 2/3 of the variance in FEV1 was explained by PEF measurements. Conclusions: APD measurements of lung function correlate with conventional measures. Future studies should be directed at exploring the use of the APD device in serial measures of lung function in patients with lung disease.展开更多
文摘Background Obesity is the most common metabolic disease in the world. However, the relationship between obesity and lung function is not fully understood. Although several longitudinal studies have shown that increases in body weight can lead to reductions in pulmonary function, whether this is the case with the Japanese population and whether high body mass index （BMI） status alone represents an appropriate predictor of obstructive lung dysfunction remains unclear.The purpose of present study was to estimate the effect of BMI on lung function measured by spirometry of Japanese patients in general clinics. We measured BMI and performed spirometry on screening patients who had consulted general clinics.Methods Subjects comprised 1231 patients ≥40 years of age （mean age （65.0±12.0） years, 525 men, 706 women） who had consulted clinics in Nagasaki Prefecture, Japan, for non-respiratory disease. BMI was calculated and lung function was measured by spirometry.Results BMI was found to be positively correlated with forced expiratory volume in 1 second （FEV1）/forced vital capacity （FVC） in men and with maximum mid-expiratory flow （MMF） in all subjects. Following adjustment for relevant factors, a significant positive correlation between BMI and FEV1/FVC was identified for all subjects. Comparison between subjects with normal BMI （18.5-25.0） and higher BMI （25.1-30.0） also demonstrated that FEV1/FVC and percentage of predicted maximum mid-expiratory flow （%MMF） were significantly higher in the latter subjects.Conclusions In a population without marked respiratory disease, higher BMI subjects showed less obstructive pulmonary dysfunction compared to normal BMI subjects. High BMI status alone may be inappropriate as a predictor of obstructive lung dysfunction, particularly in populations with a low prevalence of obesity.
基金Supported by Taipei Tzu Chi Hospital,No.TCRD-TPE-108-RT-4 and No.TCRD-TPE-108-4.
文摘BACKGROUND Eosinophil counts are a promising guide to systemic steroid administration for chronic obstructive pulmonary disease(COPD).AIM To study the role of peripheral eosinophilia in hospitalized patients with acute exacerbation of COPD(AECOPD).METHODS From January 2014 to May 2017,patients with AECOPD hospitalized in Taipei Tzu Chi Hospital were retrospectively stratified into two groups according to their peripheral eosinophil count:The EOS group(eosinophil count≥2%)and the non-EOS group(eosinophil count<2%).Demographics,comorbidities,laboratory data,steroid use,length of hospital stay,and COPD-related readmissions were compared between the groups.RESULTS A total of 625 patients were recruited,with 176 patients(28.2%)in the EOS group.The EOS group showed a lower prevalence of infection,lower cumulative doses of prednisolone equivalents,shorter length of hospital stay,and higher number of COPD-related readmissions than the non-EOS group.There were significantly linear correlations between eosinophil percentage and number of readmissions and between eosinophil percentage and length of hospital stay P<0.001,and a lower percent-predicted value of forced expiratory volume in one second(FEV1)were associated with shorter time to first COPD-related readmission[adjusted hazard ratio(adj.HR)=1.488,P<0.001;adj.HR=0.985,P<0.001,respectively].CONCLUSION The study findings suggest that the EOS group had the features of a shorter length of hospital stay,and lower doses of systemic steroids,but more frequent readmissions.The EOS group and lower percent-predicted FEV1 values were risk factors for shorter time to first COPD-related readmission.
文摘Exercise-Induced bronchoconstriction (EIB) is related to increased ventilation (VE) during exercise and describes the transient airway narrowing following exercise. A reliable diagnosis is essential for optimal treatment. The impact of a repeated exercise challenge test (ECT) in a clinical setting is not well established and conducting a repeated ECT with the possibility to adjust the exercise intensity on an individual basis may give more information. The aim of the study was to evaluate the test-retest reliability of an ECT for EIB and its association with exercise intensity. Methods: After examination by a pulmonologist, 20 referred subjects with symptoms strong indications of Exercise-Induced bronchoconstriction performed two consecutive exercise challenge tests on a treadmill. The exercise intensity of the repeated test was adjusted. Forced expiratory volume in 1 second (FEV1) was measured before and 1, 3, 6, 10, and 15 minutes after exercise. EIB was defined as a reduction of ≥ 10% in FEV1. Ventilation and heart rate were measured during exercise. Results: Five subjects tested positive in both tests, and ten subjects tested negative in both tests. Three subjects tested positive in the first test only, while two subjects tested positive in the second test only. The exercise intensity was not significantly different between the two tests for any of the subjects. Conclusion: There were 25% divergences in the diagnostic results of two consecutive exercise challenge tests. The difference in the test results was not explained by a difference in the exercise intensity.
基金Supported by Horizontal Projects of National Key Research and Development Plan Projects,No.1210053010.
文摘BACKGROUND The prevalence of depression in patients with chronic obstructive pulmonary disease(COPD)ranges from 10%to 42%,but the diagnosis of depression in patients with COPD is often unrecognized and untreated.Unrecognized depression has major implications for compliance with medical treatment,prolonged lengths of stay,increased frequency of hospital admissions,and increased consultations with primary care physicians.Many studies have attempted to identify risk factors for progression,prognosis and response to therapy in patients with depression.However,few studies have examined the risk factors for depression in patients with COPD,and some results remain controversial.AIM To identify the potential risk factors to define patients with COPD who are at“high risk”of depression.METHODS The clinical data of 293 patients with COPD were reviewed from January 2017 to December 2018.The correlations between demographics,clinical characteristics and depression were analyzed.The risk factors for depression in patients with COPD were identified by multivariate logistic regression analysis.The cutoff value,sensitivity and specificity of the independent correlation factors were calculated with a receiver operating characteristic curve.RESULTS Of the 293 patients included,65(22.18%)individuals were identified to have depression.Significant differences were detected between patients with and without depression in terms of body mass index(BMI),forced expiratory volume in 1 s(FEV1),and COPD assessment test(CAT)score(all P<0.05).Low BMI,low FEV1,and high CAT were independent risk factors for depression in patients with COPD and the cutoff values of BMI,FEV1,and CAT scores were 21.373 kg/m2,0.855 L and 12.5,respectively.CONCLUSION Low BMI,low FEV1,and high CAT score were identified as independent risk factors for depression in patients with COPD.
文摘Background: Routine lung function testing requires expensive equipment, or requires maximum expiratory effort. The airflow perturbation device (APD) is a light handheld device, allowing for serial measures of respiratory resistance noninvasively and effortlessly. Methods: In a convenience sample of 398 patients undergoing pulmonary function testing, we compared routine spirometric indices (forced expired volume in 1 second (FEV1), peak expiratory flow (PEF)), and airways resistance (Raw-272 patients), to measures of respiratory resistance measured with the APD including inspiratory (IR), expiratory (ER) and averaged (AR) resistance. Results: Measures of lung function were significantly correlated (p 0.001). On regression analysis, between 7% - 17% of the variance (R2) for FEV1, PEF, and Raw was explained by APD measurements. Approximately 2/3 of the variance in FEV1 was explained by PEF measurements. Conclusions: APD measurements of lung function correlate with conventional measures. Future studies should be directed at exploring the use of the APD device in serial measures of lung function in patients with lung disease.
