The AUDIT Alcohol Consumption Questions (AUDIT-C) An Effective Brief Screening Test for Problem Drinking

Impulse oscillometry: interpretation and practical applications.

Early chronic obstructive pulmonary disease: Definition, assessment, and prevention

Measuring lung function is an important component in the decision making process for patients with obstructive airways disease (OAD). Not only does it help in arriving at a specific diagnosis, but it also helps in evaluating severity so that appropriate pharmacotherapy can be instituted, it helps determine prognosis and it helps evaluate response to therapy. Spirometry is currently the most commonly performed lung function test in clinical practice and is considered to be the gold standard diagnostic test for asthma and COPD. However, spirometry is not an easy test to perform because the forceful expiratory and inspiratory manoeuvres require good patient co-operation. Children aged <5 years, elderly people and those with physical and cognitive limitations cannot perform spirometry easily.

https://breathe.ersjournals.com/content/breathe/11/1/57.full.pdf

Measuring lung function using sound waves: role of the forced oscillation technique and impulse oscillometry system.

Chronic obstructive pulmonary disease and cardiovascular disease

Impulse oscillometry may be of value in detecting early manifestations of COPD.

Associations between lung function and alcohol consumption – Assessed by both a questionnaire and a blood marker

Background Matrix metalloproteinases (MMP´s) are known biomarkers of atherosclerosis. MMP´s are also involved in the pathophysiological processes underlying chronic obstructive pulmonary disease (COPD). Cigarette smoking plays an important role in both disease states and is also known to affect the concentration and activity of MMP´s systemically. Unfortunately, the epidemiological data concerning the value of MMP´s as biomarkers of COPD and atherosclerosis with special regards to smoking habits are limited. Methods 450 middle-aged subjects with records of smoking habits and tobacco consumption were examined with comprehensive spirometry, carotid ultrasound examination and biomarker analysis of MMP-1, -3, -7, -10 and -12. Due to missing data 33 subjects were excluded. Results The remaining 417 participants were divided into 4 different groups. Group I (n = 157, no plaque and no COPD), group II (n = 136, plaque but no COPD), group III (n = 43, COPD but no plaque) and group IV (n = 81, plaque and COPD). Serum levels of MMP-1,-7,-10-12 were significantly influenced by smoking, and MMP-1, -3, -7 and-12 were elevated in subjects with COPD and carotid plaque. This remained statistically significant for MMP-1 and-12 after adjusting for traditional risk factors. Conclusion COPD and concomitant plaque in the carotid artery were associated with elevated levels of MMP-1 and -MMP-12 even when adjusting for risk factors. Further studies are needed to elucidate if these two MMP´s could be useful as biomarkers in a clinical setting. Smoking was associated with increased serum levels of MMP´s (except for MMP-3) and should be taken into account when interpreting serum MMP results. (Less)

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Matrix Metalloproteinases in COPD and atherosclerosis with emphasis on the effects of smoking.

Background: Previous studies on associations between reduced lung function and cardiovascular disease (CVD) have mainly been based on forced expiratory volume in 1-s (FEV(1) ) and vital capacity (VC). This study examined potential associations between five different lung function variables and plaques in the internal carotid artery (ICA). Methods: Subjects (n = 450) from a previous population-based respiratory questionnaire survey [current smokers without lower respiratory symptoms, subjects with a self-reported diagnosis of chronic obstructive pulmonary disease (COPD) and never-smokers without lower respiratory symptoms] were examined using spirometry, body plethysmography and measurements of diffusing capacity for CO (D(L,CO) ). Plaques in the ICA were assessed by ultrasonography. Results: Two hundred and twenty subjects were current smokers, 139 ex-smokers and 89 never-smokers. COPD was diagnosed in 130 subjects (GOLD criteria). Plaques in the ICA were present in 231 subjects (52%). General linear analysis with adjustment for established risk factors for atherosclerosis, including C-reactive protein, showed that D(L,CO) was lower [77·4% versus 83·7% of predicted normal (PN), P = 0·014] and residual volume (RV) was higher (110·3% versus 104·8% of PN, P = 0·020) in subjects with than without plaques in the ICA. This analysis did not show any statistically significant association between plaques and FEV(1) or VC. Conclusion: The occurrence of plaques in the ICA was associated with low D(L,CO) and high RV, but not significantly with FEV(1) or COPD status. The results suggest that the relationships between reduced lung function, COPD and CVD are complex and not only linked to bronchial obstruction and low-grade systemic inflammation. (Less)

Atherosclerotic plaques in the internal carotid artery and associations with lung function assessed by different methods

There is no generally accepted agreement on the spirometric definition of chronic obstructive pulmonary disease (COPD). A fixed ratio FEV1/VC <0.7 (FR) or a use of the age-related lower limit of normal for FEV1/VC (LLN) are the most common definitions. We analysed respiratory symptoms and extensive lung function in groups of subjects fulfilling none, either or both of the spirometric criteria for COPD.

The study population comprised 450 subjects from a random population sample, who answered a questionnaire on respiratory symptom, underwent spirometry, body plethysmography, measurements of pulmonary reactance (AX) and diffusing capacity for CO (DL,CO).

Results:

View this table:

Symptoms and lung function





For symptoms, there was a significant (p<0.05) difference between groups.

For FEV1, RV/TLC and DL,CO there was a significant difference between FR+LLN+ and FR+ and between FR+ and normal ever-smokers.

Conlusion: Subjects with FEV1/VC LLN.

https://erj.ersjournals.com/content/erj/42/Suppl_57/P944.full.pdf

Sophia Frantz

Papers

Impulse oscillometry may be of value in detecting early manifestations of COPD.

Associations between lung function and alcohol consumption – Assessed by both a questionnaire and a blood marker

Matrix Metalloproteinases in COPD and atherosclerosis with emphasis on the effects of smoking.

Atherosclerotic plaques in the internal carotid artery and associations with lung function assessed by different methods

Fixed ratio or lower limit of normal for the FEV1/VC ratio: Relation to symptoms and extended lung function tests