Study: Low Lung Function Early in Life Raises COPD Risk

Low levels of lung function during the beginning of adulthood could lead to an increased risk of chronic obstructive pulmonary disease (COPD) manifestation later in life, according to a recent study.

“Chronic obstructive pulmonary disease is thought to result from an accelerated decline in forced expiratory volume in 1 second (FEV₁) over time,” explained the studies authors.
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“Yet it is possible that a normal decline in FEV₁ could also lead to COPD in persons whose maximally attained FEV₁ is less than population norms,” they said.

For the study, researchers evaluated participants from 3 different cohorts based on lung function at the beginning of cohort and the absence or presence of COPD during the previous study visit. The mean age of participants was 40 years.

Out of 657 participants with a FEV₁ of <80% of the predicted value before age 40 years, 25% (174) of patients had COPD after 22 years. In contrast, only 7% (158) of participants had COPD after 22 years of observation (P<0.001) among 2207 patients with an 80% baseline FEV₁ before 40 years of age.

“Approximately half the 332 persons with COPD at the end of the observation period had had a normal FEV1 before 40 years of age and had a rapid decline in FEV1 thereafter, with a mean (±SD) decline of 53±21 ml per year. The remaining half had had a low FEV1 in early adulthood and a subsequent mean decline in FEV1 of 27±18 ml per year (P<0.001), despite similar smoking exposure,” they wrote.

“Our study suggests that low FEV1 in early adulthood is important in the genesis of COPD and that accelerated decline in FEV1 is not an obligate feature of COPD,” they concluded.

-Michelle Canales Butcher

Reference:
Lange P, Celli B, Agusti A, et al. Lung-function trajectories leading to chronic obstructive pulmonary disease. N Engl J Med. 2015 July [epub ahead of print] doi:10.1056/NEJMoa1411532.