Search

Background: Sleep's impact on the human immune system and inflammatory responses makes it a potential risk factor for lung function impairment. However, the relationship between sleep duration and lung function impairment in middle-aged and young adults has been rarely investigated. Methods: A total of 9,284 aged 20–64 years were categorized into four groups according to sleep duration (≤ 6 h, 7 h, 8 h, and ≥ 9 h), with 7 h as the reference, by using the U.S. NHANES data, 2007–2012. Forced expiratory volume in the 1 s (FEV1), forced vital capacity (FVC), FEV1 to FVC (FEV1/FVC) ratio, peak expiratory flow (PEF), and forced expiratory flow at 25–75% (FEF25 − 75%) were measured by spirometry. Restrictive impairment was defined as baseline FVC < 80% predicted and obstructive impairment as FEV1/FVC < 0.70. Generalized linear regression and logistic regression were performed to estimate the associations between sleep duration and lung function. Results: Compared with 7 h of sleep duration, shorter and longer sleep duration were associated with decreases in FEV1 (≤ 6 h: β=-0.010, 95% CI=-0.014 to -0.006; 8 h: β=-0.005, 95% CI=-0.009 to -0.001), FVC (≤ 6 h: β=-0.018, 95% CI=-0.014 to -0.007; 8 h: β=-0.005, 95% CI=-0.009 to -0.002), and PEF (≤ 6 h: β=-0.006, 95% CI=-0.010 to -0.002; 8 h: β=-0.007, 95% CI=-0.011 to -0.002; ≥ 9 h: β=-0.012, 95% CI=-0.020 to -0.004). Similarly, shorter (≤ 6 h: OR = 1.346, 95% CI = 1.065 to 1.700) and longer (≥ 9 h: OR = 1.827, 95% CI = 1.236 to 2.700) sleep duration were associated with increased risks of restrictive impairment. Moreover, the aforementioned associations were more pronounced among male participants. Conclusions: Compared with 7 h of sleep duration, shorter and longer sleep duration were associated with impaired lung function among adults aged 20–64 years, and these associations were stronger among males. [ABSTRACT FROM AUTHOR]

Abstract Background Leptospirosis, a spirochaete infection, can lead to Leptospirosis Pulmonary Haemorrhage Syndrome (LPHS), which requires intensive care admission and has a high mortality. Although data on short-term outcomes are available, the long-term respiratory sequelae of LPHS survivors are not known. We aimed to identify the post-discharge pulmonary functions and functional limitations in survivors of LPHS. Methods We conducted a prospective cohort study from January to December 2022 at the Medical Intensive Care Unit (ICU) of the National Hospital of Sri Lanka to assess the sequential changes in the spirometry parameters in patients who survived LPHS. The Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1 s (FEV1) were measured on the day of discharge from the ICU (D0), 7th day after discharge (D7) and 28th day after discharge (D28). The predicted lung volume was calculated using the gender, age and height as per standard protocol. Physical and functional role limitations were assessed on D28 using the modified Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36). Results Twenty-one patients with a mean age of 44 years (SD 16.07) were enrolled for the study. The majority were male patients (n = 19, 90.5%). Leptospirosis was serologically confirmed in all individuals. Seventeen (81%) patients had reduced FEV1 and FVC on D0, indicating a restrictive lung abnormality. FVC and FEV1 improved during the first 7 days (p

Yu Yang,1,2 Shuqi Wang,1,3 Boying Jia,1,3 Shuchun Chen1,3 1Department of Internal Medicine, Hebei Medical University, Shijiazhuang, People’s Republic of China; 2Department of Pharmacy, The Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China; 3Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of ChinaCorrespondence: Shuchun Chen, Department of Endocrinology, Hebei General Hospital, 348 heping West Road, Shijiazhuang, Hebei, 050051, People’s Republic of China, Tel/Fax +86 311 85988406, Email chenshuc2014@163.comPurpose: To investigate the relationship between the triglyceride-glucose (TyG) index and pulmonary function metrics among the general population undergoing health examinations.Materials and Methods: The enrollment totaled 696 participants. Fasting triglycerides and glucose levels were used to calculate the TyG index. Participants were divided into two categories according to their median TyG: one with high TyG and the other with low TyG. A portable spirometer was used to assess lung function. Fundamental clinical features and lung function indicators were compared between the two groups, and the relationship between the TyG index and lung function parameters was explored.Results: Compared with the low TyG group, the high TyG group exhibited significantly reduced levels of FEV1/FVC, FVC% pred, FEV1% pred, FEV3% pred, FEV3/FVC, FEF75, FEF75% pred, FEF25-75% pred, and MVV% pred, suggesting poor pulmonary function. The TyG index was significantly inversely correlated with multiple pulmonary function metrics, including FVC% pred, FEV1% pred, FEV3% pred, FEV1/FVC, FEV3/FVC, FEF75, FEF75% pred and FEF25-75% pred, which persisted even after accounting for confounding variables.Conclusion: In summary, the present study establishes a correlation between the TyG index and some lung function indicators, offering a new indicator of metabolic abnormalities related to lung functionality.Keywords: triglyceride-glucose index, lung function, insulin resistance, FEV1, FVC

Background: It is known that the consumption of single phytochemicals improves respiratory function in chronic obstructive pulmonary disease (COPD) patients. Since phytochemicals have a synergistic effect on health, a more comprehensive analysis is needed. The aim of this study was to estimate the intake of phytochemicals using the dietary phytochemical index (DPI) and assess their association with respiratory function, inspiratory muscle strength and function, and peripheral muscle strength. Methods: This study was conducted at the Special Hospital for Pulmonary Diseases in Zagreb (September 2023 to May 2024). The DPI was assessed using three 24 h recalls from 71 COPD patients (66.5 ± 8.4 years; 53.5% men). Anthropometric measurements, respiratory function, inspiratory muscle function and strength, and peripheral muscle strength were assessed during pulmonary rehabilitation following standard protocols. Results: Patients were divided into DPI tertiles with mean values of 7.3 ± 3.0, 16.0 ± 3.0, and 32.2 ± 8.8, respectively. After controlling for confounding factors, a significant association was found between DPI tertiles and FEV1 (p-trend < 0.001), FVC (p-trend = 0.002), FEV1/FVC (p-trend < 0.001), MIP (p-trend = 0.012), and MSUE (p-trend = 0.002). In addition, an inverse association was found between DPI tertiles and diaphragm thickness during inhalation (p-trend = 0.012) and exhalation (p-trend = 0.013). Conclusions: This study suggests that a higher intake of phytochemicals could be beneficial in dietary interventions for COPD therapy. Future prospective studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: The telomere has long been regarded as a dependable biomarker for cellular senescence. The lung function can reflect the function and status of the lungs. As individuals age beyond adulthood, there is a gradual decline in lung function. However, the existence of a associated between leukocyte telomere length (LTL) and lung function remains uncertain. Methods: A two-sample Mendelian randomization (MR) analysis was used. The Single-nucleotide polymorphisms (SNPs) of LTL from the genome-wide association (GWAS) study were used as exposure instruments variable, and the lung function indicator including Forced expiratory volume in 1-s (FEV1), FEV1 Best measure, FEV1 predicted and Forced vital capacity (FVC) from the Neale Lab and MRC-IEU were used as outcomes. The associated between the exposures and outcomes was assessed using inverse-variance weighted (IVW), MR-Egger, and weighted median methods. Sensitivity analysis was conducted using Cochran's Q-test, MR-Egger intercept test, MR-PRESSO, leave-one-out analysis, and Steriger test. Results: Using the IVW method, a significant association was identified between genetically determined telomere length extension and enhanced lung function in FEV1, with ukb-a-336 (P = 0.127, OR = 1.028,95CI% = 1.003–1.042) and ukb-b-19657 (P = 7.26E-05, OR = 1.051,95CI% = 1.025–1.077),in FEV1 predicted, ukb-a-234 (P = 0.013, OR = 1.029,95CI% = 1.003–1.042), ukb-b-8428 (P = 0.001, OR = 1.032,95CI% = 1.012–1.052), in FEV1 best measure, ukb-a-231 (P = 7.24E-05, OR = 1.050,95CI% = 1.025–1.075), ukb-b-11141 (P = 1.40E-09, OR = 1.067,95CI% = 1.045–1.090).The sensitivity analysis did not reveal heterogeneity or horizontal pleiotropy.Meanwhile, the Steriger test results also indicate that the directionality between exposure and outcome is correct. Therefore, the results indicated robustness. Conclusion: There is a correlation between longer LTL and better lung function in the European dataset. [ABSTRACT FROM AUTHOR]

The association between newborn DNA methylation (DNAm) and asthma acquisition (AA) during adolescence has been suggested. Lung function (LF) has been shown to be associated with asthma risk and its severity. However, the role of LF in the associations between DNAm and AA is unclear, and it is also unknown whether the association between DNAm and AA is consistent with that between DNAm and LF. We address this question through assessing newborn epigenetic features of preadolescence LF and of AA during adolescence, along with their biological pathways and processes. Our study's primary medical significance lies in advancing the understanding of asthma's early life origins. By investigating epigenetic markers in newborns and their association with lung function in preadolescence, we aim to uncover potential early biomarkers of asthma risk. This could facilitate earlier detection and intervention strategies. Additionally, exploring biological pathways linking early lung function to later asthma development can offer insights into the disease's pathogenesis, potentially leading to novel therapeutic targets. Methods: The study was based on the Isle of Wight Birth cohort (IOWBC). Female subjects with DNAm data at birth and with no asthma at age 10 years were included (n = 249). The R package ttScreening was applied to identify CpGs potentially associated with AA from 10 to 18 years and with LF at age 10 (FEV1, FVC, and FEV1/FVC), respectively. Agreement in identified CpGs between AA and LF was examined, along with their biological pathways and processes via the R function gometh. We tested the findings in an independent cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC), to examine overall replicability. Results: In IOWBC, 292 CpGs were detected with DNAm associated with AA and 1517 unique CpGs for LF (514 for FEV1, 436 for FVC, 408 for FEV1/FVC), with one overlapping CpG, cg23642632 (NCKAP1) between AA and LF. Among the IOWBC-identified CpGs, we further tested in ALSPAC and observed the highest agreement between the two cohorts in FVC with respect to the direction of association and statistical significance. Epigenetic enrichment analyses indicated non-specific connections in the biological pathways and processes between AA and LF. Conclusions: The present study suggests that FEV1, FVC, and FEV1/FVC (as objective measures of LF) and AA (incidence of asthma) are likely to have their own specific epigenetic features and biological pathways at birth. More replications are desirable to fully understand the complexity between DNAm, lung function, and asthma acquisition. [ABSTRACT FROM AUTHOR]

BackgroundThe telomere has long been regarded as a dependable biomarker for cellular senescence. The lung function can reflect the function and status of the lungs. As individuals age beyond adulthood, there is a gradual decline in lung function. However, the existence of a associated between leukocyte telomere length (LTL) and lung function remains uncertain.MethodsA two-sample Mendelian randomization (MR) analysis was used. The Single-nucleotide polymorphisms (SNPs) of LTL from the genome-wide association (GWAS) study were used as exposure instruments variable, and the lung function indicator including Forced expiratory volume in 1-s (FEV1), FEV1 Best measure, FEV1 predicted and Forced vital capacity (FVC) from the Neale Lab and MRC-IEU were used as outcomes. The associated between the exposures and outcomes was assessed using inverse-variance weighted (IVW), MR-Egger, and weighted median methods. Sensitivity analysis was conducted using Cochran’s Q-test, MR-Egger intercept test, MR-PRESSO, leave-one-out analysis, and Steriger test.ResultsUsing the IVW method, a significant association was identified between genetically determined telomere length extension and enhanced lung function in FEV1, with ukb-a-336 (P = 0.127, OR = 1.028,95CI% = 1.003–1.042) and ukb-b-19657 (P = 7.26E-05, OR = 1.051,95CI% = 1.025–1.077),in FEV1 predicted, ukb-a-234 (P = 0.013, OR = 1.029,95CI% = 1.003–1.042), ukb-b-8428 (P = 0.001, OR = 1.032,95CI% = 1.012–1.052), in FEV1 best measure, ukb-a-231 (P = 7.24E-05, OR = 1.050,95CI% = 1.025–1.075), ukb-b-11141 (P = 1.40E-09, OR = 1.067,95CI% = 1.045–1.090).The sensitivity analysis did not reveal heterogeneity or horizontal pleiotropy.Meanwhile, the Steriger test results also indicate that the directionality between exposure and outcome is correct. Therefore, the results indicated robustness.ConclusionThere is a correlation between longer LTL and better lung function in the European dataset.

Abdullah Alzayed Department of Pediatrics, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, 13317, Saudi ArabiaCorrespondence: Abdullah Alzayed, Department of Pediatrics, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, 13317, Saudia Arabia, Email aaalzayed@imamu.edu.saObjective: This study aims to evaluate the association between socioeconomic conditions and the lung function of children below 18 years old.Design: Systematic review.Methods: PRISMA guidelines were followed to browse relevant studies from 2013 to 2023. Data from the included studies were extracted after the Newcastle–Ottawa risk of bias tool was applied.Main Outcome: Forced expiratory volume in the first second (FEV1) liters.Results: 20 papers with 89,619 participants were included. Logistic regression model for FEV1 based on multiple SES indices, suggested a positive association between lower respiratory function and a lower SES, with an interquartile odds ratio (OR) of 1.67 (95% CI 1.03– 1.34).Conclusion: Children from a lower socioeconomic status (SES) do exhibit lower lung function and addressing the causes of this can contribute to developing preventive public health strategies.Limitations: Lack of appropriate reference values and varied indicators of socioeconomic status in the studies contributed to significant statistical differences.Prospero Registration Number: CRD 42020197658.Keywords: socioeconomic status, SES, lung function, children, FEV1, FVC

Traffic-Related Air Pollution (TRAP) exposure has been connected to significant health impacts among children. A cross-sectional comparative study was conducted among school children in Malaysia to determine the relationship between their exposure to TRAP and respiratory health effects. Air monitoring was conducted in schools and residences, while the children's routines were investigated using a diary of daily activities. Respondents' background and respiratory symptoms were obtained from a validated questionnaire, while a spirometry test was performed to determine their lung function status. The distances between schools and residences from the had contributed to the higher concentration of air pollutants in this study, which had associations with the children's respiratory symptoms and lung function status. PM2.5 was the main predictor influencing the respondents' respiratory symptoms and lung function abnormalities. In conclusion, exposure of school children to a high TRAP level might increase their risk of getting respiratory symptoms and lung function reduction. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus is a chronic disease with microvascular and macrovascular complications. The pulmonary complications of diabetes mellitus have been poorly characterized. Pulmonary function tests (PFTs) are noninvasive tests that show how well the lungs are working. Objectives: The aim of this study is to compare pulmonary PFTs in type 2 diabetic and non diabetic patients undergoing elective major abdominal surgeries under general anesthesia. Materials & Methods: A total of 100 patients (50 diabetic & 50 non diabetic), undergoing elective major abdominal surgeries under general anesthesia were enrolled for the study. Pulmonary function tests were performed 60 minutes before and after the end of surgery. The PFTs recorded were FEV1, FVC, FEV1/FVC, FEF 25%, and Peak expiratory flow rate (PEFR). Results: Majority of the subjects (34% diabetic and 42% non diabetic) was 51-55 years age group, the mean age among diabetics was 52.9 ± 4.8 and non diabetic group were 51.3 ± 4.8 years. The male were slightly higher than female in both the groups. The mean age, gender and BMI of both the groups was not statistically different and both the groups were comparable at baseline. The pulmonary function test (FEV1, FVC, FEF 25%, and PEFR) were significantly reduced in diabetic subjects compared with non diabetic subject, except FEV1/FVC. Conclusion: The mean scores of FVC, FEV1, PEFR, and FEF 25% were significantly reduced among type 2 diabetic patients as compared to non-diabetic subjects, except FEV1/FVC ratio [ABSTRACT FROM AUTHOR]

Background: Asthma, being a commonest chronic disease in children, is leading to disability as well as school absence. Present study was aimed to Study of clinical profile of asthma and other comorbidities among school going children. Material and Methods: Present study was prospective, observational study, conducted in school going children in urban Bangalore, age group between 6 to 15 years. On the basis of the history, students with suspected asthma were subjected to PEFR & spirometry. Results: During present study, total 8 schools were selected randomly, among 1000 subjects were enrolled into the study. Based on questionnaire 85 of subjects were suspected of asthma. 563 subjects were male and the prevalence of asthma in males is 38(6.75%) and 437 subjects were female and the prevalence of asthma in the female is 47 (10.76%). The P-Value is 0.02 statistically significant, indicating that females were more risk than males. The p-value was statistically significant for exposure to cigarette smoke at home, exposure to household smoke & pets at home; indicating that those were significant high risk factor to develop asthma. Among 1000 subjects, 85 subjects were suspected asthma, for them Pulmonary function was performed. Among 85 asthma suspected subjects, 5 (5.88%) subjects have PEFR less than 60 followed by 12 (14.11%) subjects have PEFR between 60-70, 25 (29.41%) subjects have PEFR between 70-80 and 43 (50.58%) subjects have PEFR more than 80. Conclusion: In the present study, the overall prevalence of bronchial asthma among children of the school-going age group was found to be 8.5%. The risk factors were exposure to cigarette smoke at home, exposure to household smoke, and pets at home are significantly high-risk factors to develop asthma. [ABSTRACT FROM AUTHOR]

Introduction: Abnormal lung function in people with multiple sclerosis (PwMS) could be considered as the result of muscle weakness or MS-specific structural central nervous system (CNS) abnormalities as a precipitant factor for the worsening of motor impairment or cognitive symptoms. Methods: This is a cross-sectional observational study in PwMS. Forced spirometry was conducted, and normative metrics of forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and the relation FEV1/FVC were calculated. Qualitative and quantitative brain magnetic resonance imaging (MRI) examinations were carried out. Results: A total of 371 PwMS were included in the study. Of those, 196 (53%) had RRMS, 92 (25%) SPMS, and 83 (22%) PPMS. Low FVC and FEV1 was present in 16 (8%), 16 (19%), and 23 (25%) of the patients in the RRMS, PPMS, and SPMS, respectively. PwMS with T2-FLAIR lesions involving the corpus callosum (CC) had a significantly higher frequency of abnormally low FVC and FEV1 (OR 3.62; 95% CI 1.33–9.83; p = 0.012) than patients without lesions in that region. This association remained significant in the RRMS group (OR 10.1; 95% CI 1.3–67.8; p 0.031) when the model excluded PPMS and SPMS. According to our study, for every increase of 1 z score of FVC, we observed an increase of 0.25 cm3 of hippocampal volume (β 0.25; 95% CI 0.03–0.47; p 0.023) and 0.43 cm3 of left hippocampus volume (β 0.43; 95% CI 0.16–0.71; p 0.002). Conclusions: We observed an incremental prevalence of abnormally low pulmonary function tests that parallels a sequence from more early relapsing courses to long-standing progressive courses (RRMS to PPMS or SPMS). [ABSTRACT FROM AUTHOR]

Objective: To study the spirometry parameters of children six months after severe acute coronavirus 2 (SARS-CoV-2) infection. Methods: This single center descriptive study enrolled children aged 7–18 years after 6 months of SARS-CoV-2 infection. A detailed interval history and clinical examination was recorded. Spirometry was performed and best of the three attempts was taken into consideration to measure forced vital capacity (FVC) and forced expiratory volume 1 second (FEV1). Results: A convenience sample of 40 (21 boys) children was enrolled, median (IQR) age 13 (10.75, 17) years. Twelve (30%) children had abnormal spirometry with low FVC (<80%); 10/12 (83.3%) had FEV1<80%. Children who were underweight had higher odds of having abnormal spirometry [OR (95% CI) 5.13 (1.19, 22.11); P=0.028]. There was no significant association of abnormal spirometry with age, sex, severity of initial infection and oxygen requirement during the initial infection (P>0.05). Conclusion: Abnormal spirometry results were observed in one-third children post-SARS-CoV-2 infection at six months follow-up. [ABSTRACT FROM AUTHOR]

Summary: Background: We aimed to assess whether exposure to risk factors in early life from conception to puberty continue to contribute to lung function decline later in life by using a pooled cohort comprising approx. 11,000 adults followed for more than 20 years and with up to three lung function measurements. Methods: Participants (20–68 years) in the ECRHS and NFBC1966 cohort studies followed in the periods 1991–2013 and 1997–2013, respectively, were included. Mean annual decline in maximum forced expired volume in 1 s (FEV1) and forced vital capacity (FVC) were main outcomes. Associations between early life risk factors and change in lung function were estimated using mixed effects linear models adjusted for sex, age, FEV1, FVC and height at baseline, accounting for personal smoking. Findings: Decline in lung function was accelerated in participants with mothers that smoked during pregnancy (FEV1 2.3 ml/year; 95% CI: 0.7, 3.8) (FVC 2.2 ml/year; 0.2, 4.2), with asthmatic mothers (FEV1 2.6 ml/year; 0.9, 4.4) (FEV1/FVC 0.04 per year; 0.04, 0.7) and asthmatic fathers (FVC 2.7 ml/year; 0.5, 5.0), and in women with early menarche (FVC 2.4 ml/year; 0.4, 4.4). Personal smoking of 10 pack-years contributed to a decline of 2.1 ml/year for FEV1 (1.8, 2.4) and 1.7 ml/year for FVC (1.3, 2.1). Severe respiratory infections in early childhood were associated with accelerated decline among ever-smokers. No effect-modification by personal smoking, asthma symptoms, sex or cohort was found. Interpretation: Mothers’ smoking during pregnancy, parental asthma and early menarche may contribute to a decline of FEV1 and FVC later in life comparable to smoking 10 pack-years. Funding: European Union's Horizon 2020; Research Council of Norway; Academy of Finland; University Hospital Oulu; European Regional Development Fund; Spanish Ministry of Science and Innovation; Generalitat de Catalunya.

Physical inactivity is a crucial contributor to the obesity epidemic. Previous studies demonstrated that physical inactivity and obesity have been linked with the impairments of pulmonary and respiratory muscle function. However, the impact of physical activity (PA) on pulmonary and respiratory muscle function in obese young adults remains unclear. The study aimed to compare pulmonary and respiratory muscle function between physically inactive and active obese young adults. Obese young adults (BMI ≥ 25 kg/m² ) aged between 18 - 25 years old were included. They were classified into 2 groups, physically inactive obese (IO, n = 16) and active obese (AO, n = 14) groups according to the metabolic equivalent of task (MET) obtained from the global physical activity questionnaire (GPAQ). Then, pulmonary and respiratory muscle function were measured. The results showed that there were no differences in baseline data between groups. The AO group showed significantly higher forced expiratory volume in 1 second (FEV1) (2.90 ± 0.55 vs 3.40 ± 0.79, p = 0.04), and maximal inspiratory pressure (MIP) (96.25 ± 6.18 vs 124.50 ± 12.28, p = 0.01) than those IO group. There were no differences between the groups in regard to FVC, FEV1/FVC ratio, %FVC, %FEV1, MVV, %MVV and maximum expiratory pressure (MEP) (all p > 0.05). In addition, FEV1 (r = 0.43, p = 0.01) and MIP (r = 0.40, p = 0.03) were positively moderately correlated with MET. Higher in FEV1 and MIP which observed in physically active obese young adults indicate that regular PA appears to be beneficial to pulmonary function and inspiratory muscle strength in obese individuals. [ABSTRACT FROM AUTHOR]

Asthma is a chronic respiratory disease that poses significant individual, social, financial and healthcare burdens. Physicians and researchers have recommended 25-hydroxy vitamin D supplementation, in combination with prescribed medication, as a potential means of reducing asthma severity. This systematic review focuses on the association between 25-hydroxy vitamin D levels and lung function in both children and adults with asthma. We identified published work by searching MEDLINE via PubMed, using regular search terms related to 25-hydroxy vitamin D and asthma. Fourteen studies were screened out of 643 eligible citations from MEDLINE research that involved 65 children and 951 adults. A strong positive association was observed in four studies, whereas five showed a moderate association, and two had no correlation. The majority of studies found a negative correlation between 25-hydroxy vitamin D deficiency and mild, uncontrolled and partly controlled asthma. 25-hydroxy vitamin D 25 OH values were below 20 ng/ml in the majority of studies, and those with uncontrolled severe asthma showed the lowest values. [ABSTRACT FROM AUTHOR]

BACKGROUND: Diaphragmatic ultrasound is increasingly used to assess patients with Chronic Obstructive Pulmonary Disease (COPD). The present study aims to investigate diaphragmatic dysfunction in COPD patients through a systematic review and meta-analysis. METHODS: In December 2022, The researchers studied four international databases such as Medline/PubMed, ProQuest, ISI/WOS, and Scopus. Joanna Briggs Institute (JBI) checklist was used to review and control the quality of articles. RESULTS: Finally, 6 articles were included in the analysis. Based on the meta-analysis results, forced expiratory volume (FEV1) was significantly lower in COPD patients compared to the control group (Hedges's g= -2.99, 95 % CI -4.78, -1.19; P =0.001). Forced vital capacity (FVC) was significantly lower in COPD patients compared to the control group (Hedges's g= -1.12, 95 % CI -1.91, - 0.33; P =0.005). COPD patients had significantly lower FEV1/FVC than the control group (Hedges's g= -1.57, 95 % CI -2.33, -0.81; P <0.001). CONCLUSION: The present study showed that the diaphragm ultrasound (DUS) method could identify the difference in FEV1, FVC, and FEV1/FVC indices in two groups of COPD patients and healthy people. [ABSTRACT FROM AUTHOR]

The association between newborn DNA methylation (DNAm) and asthma acquisition (AA) during adolescence has been suggested. Lung function (LF) has been shown to be associated with asthma risk and its severity. However, the role of LF in the associations between DNAm and AA is unclear, and it is also unknown whether the association between DNAm and AA is consistent with that between DNAm and LF. We address this question through assessing newborn epigenetic features of preadolescence LF and of AA during adolescence, along with their biological pathways and processes. Our study’s primary medical significance lies in advancing the understanding of asthma’s early life origins. By investigating epigenetic markers in newborns and their association with lung function in preadolescence, we aim to uncover potential early biomarkers of asthma risk. This could facilitate earlier detection and intervention strategies. Additionally, exploring biological pathways linking early lung function to later asthma development can offer insights into the disease’s pathogenesis, potentially leading to novel therapeutic targets. Methods: The study was based on the Isle of Wight Birth cohort (IOWBC). Female subjects with DNAm data at birth and with no asthma at age 10 years were included (n = 249). The R package ttScreening was applied to identify CpGs potentially associated with AA from 10 to 18 years and with LF at age 10 (FEV1, FVC, and FEV1/FVC), respectively. Agreement in identified CpGs between AA and LF was examined, along with their biological pathways and processes via the R function gometh. We tested the findings in an independent cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC), to examine overall replicability. Results: In IOWBC, 292 CpGs were detected with DNAm associated with AA and 1517 unique CpGs for LF (514 for FEV1, 436 for FVC, 408 for FEV1/FVC), with one overlapping CpG, cg23642632 (NCKAP1) between AA and LF. Among the IOWBC-identified CpGs, we further tested in ALSPAC and observed the highest agreement between the two cohorts in FVC with respect to the direction of association and statistical significance. Epigenetic enrichment analyses indicated non-specific connections in the biological pathways and processes between AA and LF. Conclusions: The present study suggests that FEV1, FVC, and FEV1/FVC (as objective measures of LF) and AA (incidence of asthma) are likely to have their own specific epigenetic features and biological pathways at birth. More replications are desirable to fully understand the complexity between DNAm, lung function, and asthma acquisition.

Background: Exposure to household air pollution generated as a result of cooking and heating is a leading contributor to global disease. The effects of cookstove-generated air pollution on adult lung function, however, remain uncertain.Objectives: We investigated acute responses in lung function following controlled exposures to cookstove-generated air pollution.Methods: We recruited 48 healthy adult volunteers to undergo six two-hour treatments: a filtered-air control and emissions from five different stoves with fine particulate matter (PM2.5) targets from 10 to 500 µg/m3. Spirometry was conducted prior to exposure and immediately, and three and 24 h post-exposure. Mixed-effect models were used to estimate differences in post-exposure lung function for stove treatments versus control.Results: Immediately post-exposure, lung function was lower compared to the control for the three highest PM2.5-level stoves. The largest differences were for the fan rocket stove (target 250 µg/m3; forced vital capacity (FVC): -60 mL, 95% confidence interval (95% CI) -135, 15; forced expiratory volume (FEV1): -51 mL, 95% CI -117, 16; mid-expiratory flow (FEF25-75): -116 mL/s, 95% CI -239, 8). At 3 h post-exposure, lung function was lower compared to the control for all stove treatments; effects were of similar magnitude for all stoves. At 24 h post-exposure, results were consistent with a null association for FVC and FEV1; FEF25-75 was lower relative to the control for the gasifier, fan rocket, and three stone fire.Conclusions: Patterns suggesting short-term decreases in lung function follow from exposure to cookstove air pollution even for stove exposures with low PM2.5 levels.

Background: The few studies that have examined associations between greenspace and lung function in adulthood have yielded conflicting results and none have examined whether the rate of lung function decline is affected. Objective: We explored the association between residential greenspace and change in lung function over 20 years in 5559 adults from 22 centers in 11 countries participating in the population-based, international European Community Respiratory Health Survey. Methods: Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were measured by spirometry when participants were approximately 35 (1990–1994), 44 (1999–2003), and 55 (2010–2014) years old. Greenness was assessed as the mean Normalized Difference Vegetation Index (NDVI) in 500 m, 300 m, and 100 m circular buffers around the residential addresses at the time of lung function measurement. Green spaces were defined as the presence of agricultural, natural, or urban green spaces in a circular 300 m buffer. Associations of these greenspace parameters with the rate of lung function change were assessed using adjusted linear mixed effects regression models with random intercepts for subjects nested within centers. Sensitivity analyses considered air pollution exposures. Results: A 0.2-increase (average interquartile range) in NDVI in the 500 m buffer was consistently associated with a faster decline in FVC (−1.25 mL/year [95% confidence interval: −2.18 to −0.33]). These associations were especially pronounced in females and those living in areas with low PM10 levels. We found no consistent associations with FEV1 and the FEV1/FVC ratio. Residing near forests or urban green spaces was associated with a faster decline in FEV1, while agricultural land and forests were related to a greater decline in FVC. Conclusions: More residential greenspace was not associated with better lung function in middle-aged European adults. Instead, we observed slight but consistent declines in lung function parameters. The potentially detrimental association requires verification in future studies.

Background: Oxidative stress results from the amplification mechanism of COPD, which leads to decreased lung function and the quality of life of the sufferers. Vitamin D has a function in reducing oxidative stress levels through several mechanisms, which can be revealed by analyzing several biomarkers to determine the role of vitamin D on lung function and the quality of life of stable COPD patients. Methods: The subjects included GOLD 2 and 3 stable COPD patients who had 25(OH)D levels of < 32 ng/ml and were receiving bronchodilator Indacaterol maleate therapy. The biomarkers examined included Nrf2, HDAC2, MDA, MMP-9, pulmonary function tests 6MWT, and QOL. The patients in the control and treatment groups were administered with vitamin D at a dose of 1,000 and 5,000 IU, respectively, for three months. Results: The administration of vitamin D to the patients in the control and treatment groups can significantly reduce oxidative stress, as evidenced by reduced MDA (p-value < 0.01) and MMP-9 levels (p-value < 0.01). Vitamin D affects exercise tolerance, as evidenced by 6MWT (p-value = 0.01). Vitamin D affects the quality of life, as evidenced by 6MWT (p-value = 0.01). Vitamin D affects Nrf2 levels (p-value = 0.08) and HDAC2 (p-value = 0.01). Conclusion: The pathway analysis through the study of the Nrf2, HDAC2, MMP-9, and MDA levels does not prove that vitamin D can prevent decreased lung function and quality of life in patients with stable COPD. [ABSTRACT FROM AUTHOR]

ObjectiveBronchodilator responsiveness (BDR) is prevalent in COPD, but its clinical implications remain unclear. We explored the significance of BDR, defined by post-bronchodilator change in FEV1 (BDRFEV1) as a measure reflecting the change in flow and in FVC (BDRFVC) reflecting the change in volume.MethodsWe analyzed 2974 participants from a multicenter observational study designed to identify varying COPD phenotypes (SPIROMICS). We evaluated the association of BDR with baseline clinical characteristics, rate of prospective exacerbations and mortality using negative binomial regression and Cox proportional hazards models.ResultsA majority of COPD participants exhibited BDR (52.7%). BDRFEV1 occurred more often in earlier stages of COPD, while BDRFVC occurred more frequently in more advanced disease. When defined by increases in either FEV1 or FVC, BDR was associated with a self-reported history of asthma, but not with blood eosinophil counts. BDRFVC was more prevalent in subjects with greater emphysema and small airway disease on CT. In a univariate analysis, BDRFVC was associated with increased exacerbations and mortality, although no significance was found in a model adjusted for post-bronchodilator FEV1.ConclusionWith advanced airflow obstruction in COPD, BDRFVC is more prevalent in comparison to BDRFEV1 and correlates with the extent of emphysema and degree of small airway disease. Since these associations appear to be related to the impairment of FEV1, BDRFVC itself does not define a distinct phenotype nor can it be more predictive of outcomes, but it can offer additional insights into the pathophysiologic mechanism in advanced COPD.Clinical trials registrationClinicalTrials.gov: NCT01969344T4.

Background: Giant bullae (GB) are space occupying lesions associated with chronic respiratory symptoms. The aim of this study is to evaluate outcome of intra-cavitary tube drainage procedures (ITDP) in terms of clinical and radiological benefits. Methods: A prospective study was conducted in The Department of Thoracic Surgery, Jinnah Postgraduate Medical Center, Karachi, from February 2021 to April 2022 after ethical approval. Patients above 12 years, with poor reserve and GB underwent clinical, radiological and laboratory assessment before and after ITDPs to document various studied parameters. Results: A total of 48 patients were included; thirty-two (66.7%) were males. Mean age was 46.7±12.14 years. Most common aetiology was COPD (28; 58.3%). GB were =10 cm in size in 36 (75%) with right upper lobe involvement in 20 (41.7%). Preoperative dyspnoea score of IV was seen in 41 (85.4%) and chest pain in 42(87.5%) patients. In 34(70.8%) patients, Monaldi procedure and in 14 (29.2%) Brompton technique was used. Dyspnoea score improved from grade IV to II (24/41; p=0.004) along with reduction in pain and cough (p=0.012; p=0.002), respectively. Improvement post operatively in oxygen saturation, forced vital capacity, forced expiratory volume in 1 sec (6.08±1.36%, 0.73±0.516 L and 0.57±0.07 L, respectively, p<0.001) was seen. Partial pressure of oxygen (PaO2) and carbon dioxide improved by 40.6±4.82 (p=0.009) and 13.22±3.62mmHg (p=0.7). Improvement of PaO2 was associated with reduction in the size of bullae (9.33±5.13cm; p=0.006). Radiographical resolution was seen in 41 (87.5%) majorly within 2 months (21; 51.2%). Duration of hospital stay was 4.20±0.92 days with no mortality. Complications were seen in 25 (52.1%) patients. Conclusion: Intra-cavitary tube drainage procedures allow both clinical and physiological improvement in patients with GB. They allow resolution of bullae in patients with poor reserves and help in expansion of underlying compressed lung, improving both the clinical symptoms and radiological picture. [ABSTRACT FROM AUTHOR]

A cohort of 113 participants satisfying the criteria for metabolic syndrome was used in this study to examine the link between metabolic syndrome and pulmonary function as measured by spirometry. The US National Cholesterol Education Programme Adult Treatment Panel III criteria for metabolic syndrome were used to select participants for a cross-sectional study. We gathered and analyzed information on each subject's demographics, metabolic parameters and lung function tests (FEV1, FVC, and FEV1/FVC ratio). The correlations between the elements of the metabolic syndrome, gender, and pulmonary function indicators were evaluated using statistical analysis. There was a wide age range in the study sample, with the 40 to 59 year old age bracket being the most common. Males had a higher prevalence of metabolic syndrome, according to the gender distribution. Males had greater systolic, diastolic, triglyceride, and fasting blood glucose levels than females, as well as lower levels of high-density lipoprotein cholesterol, among other symptoms of the metabolic syndrome. A sizable number of the individuals had abnormal pulmonary function, with a mixed obstructive and restrictive pattern being the most common. The number of metabolic syndrome components and pulmonary impairment were found to be significantly correlated. The strong link between metabolic syndrome and pulmonary dysfunction is shown in this study, underscoring the significance of early detection and therapy of metabolic syndrome, especially in people with impaired pulmonary function. To enhance the metabolic and pulmonary health of this population, comprehensive lifestyle treatments should be taken into consideration. [ABSTRACT FROM AUTHOR]

Bulent Enis Sekerel,1 Hilal Unsal,1 Umit Murat Sahiner,1 Ozge Uysal Soyer,1 Ebru Damadoglu,2 Gul Karakaya,2 Ali Fuat Kalyoncu2 1Division Pediatric Allergy and Asthma, Hacettepe University Faculty of Medicine, Ankara, Turkey; 2Division of Allergy and Immunology, Department of Chest Diseases, Hacettepe University Faculty of Medicine, Ankara, TurkeyCorrespondence: Bulent Enis Sekerel, Tel +90 312 305 17 00, Fax +90 312 305 50 00, Email bsekerel@hacettepe.edu.trBackground: Spirometers are critical devices that reveal the respiratory dynamics caused by respiratory problems and their severity and facilitate their diagnosis and follow-up. Hand-held spirometers have emerged relatively recently and offer several advantages over conventional desktop systems. There remains, however, a need for reassurance of high-quality spirometry testing with next-generation portable spirometers that connect over Bluetooth® to smart device applications. In this study, we examine the accuracy and repeatability of lung function measurements of a novel hand-held ultrasonic spirometer, the Spirohome Clinic and compare its clinical performance to a reference device, the EasyOne Air.Methods: Benchtop validation of the spirometers was conducted using a lung simulator device according to ATS/ERS guidelines and the ISO 26782 standard waveforms. Subsequently, 48 volunteers (pediatric patients between 6 and 11 years of age and adolescent patients between 12 and 18 years of age) performed spirometry with both the Spirohome Clinic and the EasyOne Air spirometer during their clinic visits. Spirometric data including repeated FEV1, FVC, FEV6, FEF25-75, and PEF measurements were collected.Results: Both the Spirohome Clinic and the EasyOne Air successfully passed requirements for accuracy stated in relevant guidelines and standards for spirometry. The only statistically significant (p< 0.05) difference was for FVC measurement accuracy. Clinical comparisons revealed strong correlation between spirometers in the measurement of key pulmonary function parameters including FEV1 and FVC with a Pearson’s correlation coefficient of 0.99. Bland–Altman plots showed good agreement between mean differences of FEV1 and FVC with the majority measurements remaining between the limits of 95% agreement for both the entire patient cohort and also in age and gender subsets.Conclusion: The present study demonstrated that the Spirohome Clinic spirometer conforms to ATS/ERS performance requirements and validates the clinical comparability of its measurement accuracy and repeatability to the EasyOne Air. These findings support the indicated use of the Spirohome Clinic for high-quality lung function testing in clinical settings.Keywords: handheld spirometer, ultrasonic spirometer, portable spirometer, spirometry, pediatric, respiratory disease, FEV1, FVC

Objective:China has established a goal of reducing adult smoking prevalence from 27.7% to 20% by 2030. Understanding the possible ongoing impairment in lung function in smokers, is critically important to encourage the populations to change their smoking behavior.MethodsA total of 14,273 males joined the health examination at Huadong Sanatorium from Jan 2012 to Dec 2019 were included. In cross-sectional analysis, we used multiple linear regression to evaluate the association between baseline lung function and smoking status. Then, 3,558 males who received ≥2 spirometry exams were analyzed in longitudinal study. Annual lung function decline was compared using mixed linear models adjusted for confounders.ResultsIn cross-sectional analysis, compared with never-smokers, decreases of −133.56 mL (95% CI: −167.27, −99.85) and −51.44 mL (−69.62, −33.26) in FEV1, −1.48% (−1.94, −1.02) and −1.29% (−1.53, −1.04) in FEV1/FVC were observed in former and current smokers. In longitudinal analysis, significant declines were observed in FEV1 [5.04 (2.30, 7.78) mL] and FEV1/FVC [0.09 (0.05, 0.13) %] in current smokers but not observed in former smokers after adjustment. Participants with long duration of smoking cessation had decelerate lung function than short duration. The annual decline rate of current smokers with high smoking intensity (≥30 cigarettes per day) was 13.80 and 14.17 times greater than that of never-smokers in FEV1 and FVC. Thus, early smoking cessation can slow down lung function decline trend for current smokers.ConclusionsThe harms of current smoking on lung function emphasize the necessity of smoking cessation, especially for those with comorbidities.

BackgroundThe association between systemic iron status and lung function was conflicting in observational studies. We aim to explore the potential causal relationships between iron status and the levels of lung function using the two-sample Mendelian randomization (MR) design.MethodsGenetic instruments associated with iron status biomarkers were retrieved from the Genetics of Iron Status (GIS) consortium (N = 48,972). Summary statistics of these genetic instruments with lung function were extracted from a meta-analysis of UK Biobank and SpiroMeta consortium (N = 400,102). The main analyses were performed using the inverse-variance weighted method, and complemented by multiple sensitivity analyses.ResultsBased on conservative genetic instruments, MR analyses showed that genetically predicted higher iron (beta: 0.036 per 1 SD increase, 95% confidence interval (CI): 0.016 to 0.056, P = 3.51 × 10−4), log10-transformed ferritin (beta: 0.081, 95% CI: 0.047 to 0.116, P = 4.11 × 10−6), and transferrin saturation (beta: 0.027, 95% CI: 0.015 to 0.038, P = 1.09 × 10−5) were associated with increased forced expiratory volume in 1 s (FEV1), whereas higher transferrin was associated with decreased FEV1 (beta: −0.036, 95% CI: −0.064 to −0.008, P = 0.01). A significant positive association between iron status and forced vital capacity (FVC) was also observed. However, there is no causal association between iron status and FEV1-to-FVC ratio (P = 0.10). Similar results were obtained from the liberal instruments analyses and multiple sensitivity analyses.ConclusionOur study provided strong evidence to support that higher iron status is causally associated with higher levels of FEV1 and FVC, but has no impact on airway obstruction, confirming iron status as an important target for lung function management.

Background: Given the potential risk of unhealthy weight management, the monitoring of body composition in athletes is advised. However, limited data reveal how body composition measurements can benefit athlete health and, in particular, respiratory function. The aim of this study is to evaluate the impact of body composition on pulmonary function in a population of adult athletes. Methods: Data from 435 competitive adult athletes regarding body compositions parameters and spirometry are retrospectively analyzed. Results: Our study population consists of 335 males and 100 female athletes. Muscle mass and fat-free mass are significantly and positively associated with forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) in the male and female population, while waist-to-height ratio is negatively associated with FEV1, FVC, and FEV1/FVC in the male population. In multivariable analysis, muscle mass and fat-free mass show significant association with FEV1 and FVC in both males and females (p < 0.05), and waist-to-height ratio is significantly and inversely associated with FEV1 and FVC in males (p < 0.05). Conclusions: Fat-free mass and muscle mass are positively and independently associated with FEV1 and FVC in athletes of both genders, and waist-to-height ratio is inversely associated with FEV1 and FVC only among male athletes. These findings suggest that body composition in athletes may be helpful in monitoring respiratory function. [ABSTRACT FROM AUTHOR]

Yao-Kuang Wu,1,2 Wen-Lin Su,1,2 Mei-Chen Yang,1,2 Sin-Yi Chen,1 Chih-Wei Wu,1 Chou-Chin Lan1,2 1Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; 2School of Medicine, Tzu-Chi University, Hualien, TaiwanCorrespondence: Chou-Chin LanDivision of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 289, Jianguo Road, Xindian District, New Taipei City, TaiwanTel +886-2-66289779 ext 5709Fax +886-2-66289009Email bluescopy@yahoo.com.twBackground: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease with exacerbations causing hospitalizations, morbidity, and mortality. COPD exacerbation causes a substantial health impact, and its subtypes might differ in prognosis and treatment response.Methods: This study evaluated the factors of COPD exacerbations and explored the probabilities of frequent severe COPD exacerbations. Categorical and continuous variables between groups were compared. The hazard ratio (HR) and the probability of no hospital readmission were also estimated.Results: A total of 617 COPD patients were enrolled and comprised the frequent exacerbator (N = 226) and the non-frequent exacerbator (N = 391) groups. The frequent exacerbator group significantly displayed a higher eosinophil count (EC; p=0.004), a higher percentage of the frequent severe acute exacerbation history before the index hospitalization (IH; p < 0.001), a lower FEV1 value (p=0.001), and a higher triple combination inhaler prior and following the IH (p < 0.001 and p=0.002) than the non-frequent exacerbator one. Increasing age (aOR of 1.02), higher EC (aOR of 1.09), and lower FEV1 value (aOR of 0.72) were significantly associated with an increased hospital readmission risk. The readmission rate and risk were higher in patients with a history of frequent severe acute exacerbation (aHR of 3.38) than those without severe acute exacerbation. Cases treated with the triple combination inhaler before the IH had a higher readmission rate and risk than non-users.Conclusion: Patients with EC ≥ 2%, FEV1 < 50%, or frequent severe acute exacerbation history before the IH have a higher risk of being diagnosed with a frequent exacerbator phenotype. Besides, higher age, triple combination inhaler before the IH, and smoking might be independently correlated with the frequent readmission risk within 1-year post-exacerbation. A better comprehension of the COPD exacerbation mechanism may further identify the best course of preventative strategy and lead to novel interventions.Keywords: chronic obstructive pulmonary disease, COPD, forced expiratory volume in one second, FEV1, forced vital capacity, FVC, index hospitalization, eosinophil count

Background: The current cross-sectional study analyses patients' plasma iron measurements and spirometry to determine the relationship between serum iron, percent transferrin saturation, serum ferritin, total iron-binding capacity (TIBC), and forced expiratory flow (FEF 25–75%), forced expiratory volume 1(FEV1)/Forced vital capacity (FVC), FVC, and FEV1. Methods: Spirometry measurements were assessed by comparing reference values based on age, height, sex, and race. Descriptive analysis of data included percentages, means, and standard deviations. Multivariate analyses were done using the Pearson correlation test and the multiple linear regression method. Results: According to the findings, the average age of those who participated in the study was 59.63 ± 10.32 years old. Serum iron concentrations were shown to be extremely significant and positively correlated with the percent anticipated values of FVC, FEV1/FVC FEV1, and FEF (25–75%). The total iron-binding capacity was extremely significant and linked strongly with the percent expected values of FVC, FEV1, FEF (25–75%), and FEV1/FVC. The percent transferrin saturation was extremely significant and linked positively with the percent anticipated values of FVC, FEV1, FEF (25–75%), and FEV1/FVC. Conclusion: Plasma iron levels were independently linked with both FEV1 and FEF (25–75%) percent predicted in the current investigation. Consequently, the blood iron concentration in COPD patients can be utilized as a biomarker for assessing disease severity because it is relatively simple and inexpensive.

Introduction: Air pollution is a major determinant of several lung diseases. With air pollution being a cause of concern in Delhi, present study aimed to assess proportion of individuals with impairment of lung function and factors associated with it. Methodology: A community-based cross-sectional study was conducted among adult population of Delhi. Data were collected by interview of subjects, with spirometry done on all subjects using portable spirometer. Statistical Analysis: Categorical variables were presented as percentages and compared using chi‐square test. Logistic regression analysis was done for independent predictors of lung function impairment. Significance was considered at P ≤ 0.05. Results: Total 3019 individuals were screened and 34.35% had lung function impairment, majority having restrictive disorder. Univariate analysis showed impairment was slightly higher in women, though not significant. Significantly more proportion of subjects with impairment were in higher age group, with lower levels of education, in working population and in those living in Delhi for longer duration. Students had lower risk of impairment when compared to those doing office job. Most of the findings were substantiated by multivariate analysis. Conclusion: Though spirometry is not an ideal screening test, this study does reflect that more than one-third of study subjects had impaired lung function, with those in higher age group having higher odds for lung function impairment, probably indicating the cumulative effect of air pollution. Measures for curbing air pollution are hence need of the hour and other broader determinants of health should be addressed through evidence-informed public policies and actions across all sectors.

Background: Aerobic physical activity is one of the non-pharmacology management approaches of asthma. The Asthma Foundation of Indonesia (Yayasan Asma Indonesia, YAI) has designed an aerobic physical activity for people with asthma, known as Asthma Exercise. Asthma exercise is expected to increase the overall functional capacity of the lungs. One way to measure lung function is by measuring the score of forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). The objective of the study was to explore the difference in FEV1 and FVC between bronchial asthma patients with and without asthma exercise. Methods: This study involved asthma patients from the Bandung Asthma Association (Perhimpunan Asma Bandung, PAB) who did asthma exercise (n=28), and as control patients from the Pulmonology Clinic in Dr. Hasan Sadikin General Hospital were selected who did not do asthma exercise. The research data used were primary data from the spirogram examination. Asthma patients were selected based on inclusion and exclusion criteria. This research used unpaired numerical comparative analytical hypothetical tests with a cross-sectional design. Results: The study showed the mean of FEV1 and FVC in the group with asthma exercise (1.6107±0.3780L and 2.0396±0.3465L) was higher than the group without asthma exercise (1.3750±0.4702L and 1.7164±0.4632L). Statistical difference test using independent t-test indicated a score of p=0.044 for FEV1 and p=0.005 for FVC between the two groups. Conclusions: There are significant differences in FEV1 and FVC between bronchial asthma patients with and without asthma exercise. Furthermore, asthma exercise is recommended for asthma patients to improve their lung function.

Purpose: This study aimed to evaluate the associations between dyslipidemia and pulmonary function parameters assessed by spirometry and the forced oscillation technique in asthmatic children. Methods: Asthmatic children (5–18 years old) had fasting serum lipid profiles including low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) concentrations, and C-reactive protein (CRP) measured. Pulmonary function tests were assessed by spirometry and the forced oscillation technique (FOT). Results: One hundred forty-one asthmatic children were enrolled with a mean (SD) age of 11.82 (3.38) years. Eighty-eight (62.4%) children were boys, 64 (45.4%) had dyslipidemia, and 20 (14.2%) were obese. Among the children with dyslipidemia, a high LDL-C concentration (65.6%) was the most common form of dyslipidemia, followed by high TC (57.8%), high TG (35.9%), and low HDL-C concentrations (15.6%). Multivariable analysis showed significant associations between HDL-C concentrations and respiratory resistance at 5 Hz (R5) and respiratory resistance at 20 Hz (R20), and TC concentrations were modestly associated with reactance at 5 Hz (X5), the frequency of resonance (Fres), and the area of reactance (ALX). Asthmatic children who had high LDL-C concentrations had a significantly higher expiratory phase R5, whole breath R20, and expiratory phase R20 than those in children with normal LDL-C concentrations. Conclusion: This study suggests an association of blood cholesterol, especially HDL-C and LDL-C, and respiratory resistance measured by the FOT, irrespective of the obesity status. An intervention for improving LDL-C and HDL-C concentrations may be beneficial on lung function parameters in asthmatic children. Clinical Trial Registration: TCTR20200305005; date of registration: 03-04-2020 (retrospectively registered). [ABSTRACT FROM AUTHOR]

Rationale: Current spirometry quality grading for individuals 7 years and older include within-test repeatability thresholds up to 250 ml, which may be inappropriately wide for children. Objectives:1) To develop, internally validate, and implement a quality grading algorithm for forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) for school-aged children and 2) to compare the algorithm with the one proposed by the American Thoracic Society (ATS). Methods: We conducted a review of existing algorithms and obtained expert input. A pediatric quality grading algorithm was drafted and modified in an iterative process until consensus was achieved, with the main difference from current criteria being tighter volume repeatability for the pediatric quality grading. Four pulmonary function technicians evaluated the interrater agreement of the algorithm in a blinded fashion on an unselected consecutive sample of 87 prebronchodilator spirometry tests, and the grades were compared with those from the ATS algorithm in the same sample of spirometry tests. The algorithm was then implemented into the workflow of the pulmonary function laboratory. Results: For FEV1 and FVC, the interrater agreement values for the pediatric algorithm were 92% and 83%, respectively. When the ATS algorithm was used, 75.9% (n = 66) and 63.2% (n = 55) of subjects achieved a grade of A for FEV1 and FVC; when the pediatric algorithm was used, 69.0% (n = 60) and 58.6% (n = 51) met grade A criteria. There was a more uniform distribution of tests for the pediatric algorithm across grades B through F for FEV1 and FVC, and no grade C tests were observed for the ATS grading algorithm. A total of 2,464 tests graded prospectively by using the pediatric algorithm showed a median (interquartile range) FEV1 and FVC repeatability within 29 ml (13-57 ml) and 34 ml (15-66 ml), respectively. Most subjects received a grade of A for FEV1 (81.1%) and FVC (71.6%), performing a repeatable spirometry test to within 100 ml. Conclusions: A quality grading algorithm that uses smaller ranges of expired volumes to define repeatability is feasible and may be more appropriate in a pediatric pulmonary function laboratory. [ABSTRACT FROM AUTHOR]

Background: The first wave of the COVID-19 pandemic initiated officially in October 2020. Since then several observations have been made regarding the disease and its symptoms. Patients and Methods: We included eighty seven in our observational study. Our main aim was to investigate their long term respiratory follow-up in correlation with their initial radiological and laboratory findings and values. The nose swab PCR test for COVID-19 was used for diagnosis. Patients were monitored at 3 and 6 months after their hospital reception whereas basic parameters of health condition (smoking, PO2, SPO2, WBC, CXR, CRP, intercurrent findings, days of nursing, colchicine administration) in joint with gender and age were recorded. Results: Males seem more susceptible to the viral disease than females in a ratio 1,8:1. The parameters FEV1 and FVC (as % relative changes) were not affected, apart from the DLCO to which CRP (in loge+1 transformation) and SPO2 showed a statistically significant effect. Conclusion: None of these patients were intubated, or admitted to the intensive care unit. The respiratory function is affected by the virus and the effect is reversed within the first three months. Males are more affected and the radiological and laboratory findings are associated with the respiratory functions. [ABSTRACT FROM AUTHOR]

Igor Z Barjaktarevic,1 Russell G Buhr,1,2 Xiaoyan Wang,3 Scott Hu,1 David Couper,4 Wayne Anderson,4 Richard E Kanner,5 Robert Paine III,5 Surya P Bhatt,6 Nirav R Bhakta,7 Mehrdad Arjomandi,7 Robert J Kaner,8 Cheryl S Pirozzi,5 Jeffrey L Curtis,9,10 Wanda K O’Neal,4 Prescott G Woodruff,7 MeiLan K Han,9 Fernando J Martinez,8 Nadia Hansel,11 James Michael Wells,6 Victor E Ortega,12 Eric A Hoffman,13 Claire M Doerschuk,4 Victor Kim,14 Mark T Dransfield,6 M Bradley Drummond,4 Russell Bowler,15 Gerard Criner,14 Stephanie A Christenson,7 Bonnie Ronish,5 Stephen P Peters,12 Jerry A Krishnan,16 Donald P Tashkin,1 Christopher B Cooper1 On behalf of the NHLBI SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS)1Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA; 2Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA; 3Department of General Internal Medicine and Health Services Research, University of California, Los Angeles, Los Angeles, CA, USA; 4Department of Medicine, University of North Carolina, Chapel Hill, NC, USA; 5Department of Medicine, University of Utah, Salt Lake City, UT, USA; 6Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; 7Department of Medicine, University of California, San Francisco, San Francisco, CA, USA; 8Department of Medicine, Weill Cornell Weill Cornell Medical Center, New York, NY, USA; 9Department of Medicine, University of Michigan, Ann Arbor, MI, USA; 10Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA; 11Department of Medicine, John Hopkins University, Baltimore, MD, USA; 12Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA; 13Department of Medicine, University of Iowa, Iowa City, IA, USA; 14Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA; 15Department of Medicine, National Jewish Health Systems, Denver, CO, USA; 16Department of Medicine, University of Illinois at Chicago, Chicago, IL, USACorrespondence: Christopher B CooperDepartments of Medicine and Physiology, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, 37-131 CHS, Los Angeles, CA 90095, USAEmail ccooper@mednet.ucla.eduObjective: Bronchodilator responsiveness (BDR) is prevalent in COPD, but its clinical implications remain unclear. We explored the significance of BDR, defined by post-bronchodilator change in FEV1 (BDRFEV1) as a measure reflecting the change in flow and in FVC (BDRFVC) reflecting the change in volume.Methods: We analyzed 2974 participants from a multicenter observational study designed to identify varying COPD phenotypes (SPIROMICS). We evaluated the association of BDR with baseline clinical characteristics, rate of prospective exacerbations and mortality using negative binomial regression and Cox proportional hazards models.Results: A majority of COPD participants exhibited BDR (52.7%). BDRFEV1 occurred more often in earlier stages of COPD, while BDRFVC occurred more frequently in more advanced disease. When defined by increases in either FEV1 or FVC, BDR was associated with a self-reported history of asthma, but not with blood eosinophil counts. BDRFVC was more prevalent in subjects with greater emphysema and small airway disease on CT. In a univariate analysis, BDRFVC was associated with increased exacerbations and mortality, although no significance was found in a model adjusted for post-bronchodilator FEV1.Conclusion: With advanced airflow obstruction in COPD, BDRFVC is more prevalent in comparison to BDRFEV1 and correlates with the extent of emphysema and degree of small airway disease. Since these associations appear to be related to the impairment of FEV1, BDRFVC itself does not define a distinct phenotype nor can it be more predictive of outcomes, but it can offer additional insights into the pathophysiologic mechanism in advanced COPD.Clinical trials registration: ClinicalTrials.gov: NCT01969344T4.Keywords: bronchodilator responsiveness, inspiratory capacity, FVC, FEV1, SPIROMICS

Polusi udara merupakan salah satu permasalahan yang sering terjadi di perkotaan. Paparan polusi terus menerus dapat menurunkan fungsi paru khususnya pada nilai FEV1, FVC, dan FEVR. Penelitian ini bertujuan mengetahui perbedaan rerata nilai FEV1, FEVR, dan FVC pada laki-laki antara pekerja kantoran dan pekerja yang terpapar polusi. Penelitian ini menggunakan design penelitian observasional analitik dengan pendekatan cross sectional. Penelitian ini dilakukan di Satlantas Kota Surakarta, Kantor BAA dan BAU UMS dan Laboratorium Fisiologi Fakultas Kedokteran UMS. Sampel penelitian yang digunakan adalah laki-laki pekerja kantoran dan pekerja yang terpapar polusi yaitu Supeltas. Besar sampel masing-masing kelompok adalah 30 orang . Teknik pengambilan sampel yang digunakan dalam penelitian ini adalah metode purposive sampling. Perbedaan rerata nilai FEV1, FVC, dan FEVR pada laki-laki antara pekerja kantoran dan pekerja yang terpapar polusi dianalisis dengan uji t tidak berpasangan dan MannWhitney. Hasil penelitian menunjukkan bahwa rerata nilai FEV1 pada pekerja kantoran lebih tinggi daripada pekerja yang terpapar polusi, dengan nilai significancy 0.000. Rerata nilai FVC pada pekerja kantoran lebih tinggi daripada pekerja yang terpapar polusi, dengan nilai significancy 0.000. Rerata nilai FEVR pada pekerja kantoran lebih tinggi daripada pekerja yang terpapar polusi, dengan nilai significancy 0.004. Dapat disimpulkan bahwa terdapat perbedaan rerata nilai FEV1, FVC, dan FEVR yang bermakna pada laki-laki antara pekerja kantoran dan pekerja yang terpapar polusi (p

Background: Respiratory illnesses caused by occupational exposure have the most negative effects on the workers' health status in workplaces. In occupations with a high likelihood of labor-induced pulmonary diseases, a periodic spirometry test is usually used to monitor occupational lung function and prevent occupational respiratory diseases. Monitoring workers exposed to occupational pulmonary diseases is widely done using forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) for early diagnosis of obstructive pulmonary and lung diseases. We assessed the usefulness of longitudinal data of periodic spirometry tests in a sulfate production industry. Materials and Methods: In this longitudinal study, 212 individuals working in a sulfate production industry near Tehran were examined. Demographic data and information, such as FEV1, FVC, FEV1%, FVC%, and FEV1 / FVC ratio were obtained from 2009 to 2013. Data were analyzed using the SPSS software version 21. The one-way analysis of variance (ANOVA) and repeated measures ANOVA for data analysis. Results: The results showed that the variation of the spirometry parameters over 5 years was significant. The factors studied not only decreased in some years but also increased in comparison with the previous year. Also, the average FEV1 and FVC and also FEV1 / FVC significantly was different at different time points [F(2.864, 590.029)= 27.269, P < .0001], [F(2.910, 599.546)= 38.239, P < .0001], and [F(3.257, 671.019)= 13.351, P < .0001]. Conclusion: The best spirometry tests, not only acceptable tests, are important in longitudinal spirometry evaluations. There is no systematic supervision on spirometry tests in Iran and the results of this study reflect a serious need for such supervision. [ABSTRACT FROM AUTHOR]

In this narrative review, we summarize the literature and provide updates on recent studies of air pollution exposures and child lung function and lung function growth. We include exposures to outdoor air pollutants that are monitored and regulated through air quality standards, and air pollutants that are not routinely monitored or directly regulated, including wildfires, indoor biomass and coal burning, gas and wood stove use, and volatile organic compounds. Included is a more systematic review of the recent literature on long-term air pollution and child lung function because this is an indicator of future adult respiratory health and exposure assessment tools have improved dramatically in recent years. We present "summary observations" and "knowledge gaps." We end by discussing what is known about what can be done at the individual/household, local/regional, and national levels to overcome structural impediments, reduce air pollution exposures, and improve child lung function. We found a large literature on adverse air pollution effects on children's lung function level and growth; however, many questions remain. Important areas needing further research include whether early-life effects are fixed or reversible; and what are windows of increased susceptibility, long-term effects of repeated wildfire events, and effects of air quality interventions. [ABSTRACT FROM AUTHOR]

BackgroundRecent meta-analyses of genome-wide association studies in general populations of European descent have identified 28 loci for lung function.ObjectiveWe sought to identify novel lung function loci specifically for asthma and to confirm lung function loci identified in general populations.MethodsGenome-wide association studies of lung function (percent predicted FEV1 [ppFEV1], percent predicted forced vital capacity, and FEV1/forced vital capacity ratio) were performed in 4 white populations of European descent (n = 1544), followed by meta-analyses.ResultsSeven of 28 previously identified lung function loci (HHIP, FAM13A, THSD4, GSTCD, NOTCH4-AGER, RARB, and ZNF323) identified in general populations were confirmed at single nucleotide polymorphism (SNP) levels (P < .05). Four of 32 loci (IL12A, IL12RB1, STAT4, and IRF2) associated with ppFEV1 (P < 10(-4)) belong to the TH1 or IL-12 cytokine family pathway. By using a linear additive model, these 4 TH1 pathway SNPs cumulatively explained 2.9% to 7.8% of the variance in ppFEV1 values in 4 populations (P = 3 × 10(-11)). Genetic scores of these 4 SNPs were associated with ppFEV1 values (P = 2 × 10(-7)) and the American Thoracic Society severe asthma classification (P = .005) in the Severe Asthma Research Program population. TH2 pathway genes (IL13, TSLP, IL33, and IL1RL1) conferring asthma susceptibility were not associated with lung function.ConclusionGenes involved in airway structure/remodeling are associated with lung function in both general populations and asthmatic subjects. TH1 pathway genes involved in anti-virus/bacterial infection and inflammation modify lung function in asthmatic subjects. Genes associated with lung function that might affect asthma severity are distinct from those genes associated with asthma susceptibility.

Background: The lungs go through 4 distinct histological phases of development and in late fetal development respiratory motions and amniotic fluid are thought to have a role in lung maturation. 1,2 Development of this system is not completed until the last weeks of fetal development, just before birth. Therefore premature babies have difficulties associated with insufficient surfactant (end month 6 alveolar cells type 2 appear and begin to secrete surfactant) 3-6 . Considerable structural changes in the chest wall may change infant and childhood predisposition to respiratory failure, lung injury, and ventilation-associated lung injury. Yoga respiration consists of very slow, deep breaths with sustained breath hold after each inspiration and expiration. Thus, previous studies considered Yoga as a method of breathing and chest expansion exercises. Objectives: To assess the effect of yogasana on lung volume, function and breath holding capacity on children. Materials and Methods: Experimental study was conducted 2 groups were formed .Group A was designated for yoga asanas (Uttita Kumarsana, Ardha Matsyandrasana, Parvatasana, Yoga Mudra, Dhanurasana and Bhujangasana) Group B was asked to continue regular playing activities for 30 Min 3 times a week for 12 sessions. Result Analysis: Chest expansion, FVC,FEV1,FEV25-75% and breath holding capacity has shown increased in both group whereas more in children performing yogaasanas. Conclusion: The study concludes that looking at increasing burden of studies & expectation it is necessary to keep children ready to combat with physical mental fitness Yoga session should be incorporated as routine from school itself. [ABSTRACT FROM AUTHOR]