Restrictive Spirometric Pattern and Preserved Ratio Impaired Spirometry in a Population Aged 50-64 Years

Area of Science:

• Pulmonary Medicine
• Diagnostic Imaging
• Epidemiology

Background:

• Prevalence and characteristics of restrictive spirometric pattern (RSP) and preserved ratio impaired spirometry (PRISm) in the general population are not well-defined.
• Post-bronchodilator spirometry and computed tomography (CT) of the lungs are crucial for understanding these patterns.

Purpose of the Study:

• To investigate the shared and unique features of RSP and PRISm.
• To determine the prevalence of RSP and PRISm in a general population sample.

Main Methods:

• Utilized data from the Swedish CArdioPulmonary bioImage Study (SCAPIS) with 28,555 participants aged 50-64 years.
• Assessed participants via questionnaires, lung CT, post-bronchodilator spirometry, and coronary artery calcification (CAC) scoring.
• Employed adjusted logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs).

Main Results:

• Prevalence of RSP and PRISm were both 5.1%, with similar rates in never-smokers.
• Shared features included current smoking, dyspnea, chronic bronchitis, rheumatic disease, diabetes, ischemic heart disease, bronchial wall thickening, interstitial lung abnormalities, and bronchiectasis.
• Emphysema was uniquely associated with PRISm (OR, 1.69; 95% CI, 1.36-2.10), while CAC score ≥300 was linked to PRISm.

Conclusions:

• PRISm and RSP share common respiratory, cardiovascular, and metabolic conditions.
• Emphysema is specifically associated with PRISm, not RSP.
• Coronary atherosclerosis may be linked to PRISm, suggesting potential shared pathways.