Phenotypic characterisation of early COPD: a prospective case-control study
Por:
Cosío BG, Pascual-Guardia S, Borras-Santos A, Peces-Barba G, Santos S, Vigil L, Soler-Cataluña JJ, Martínez-González C, Casanova C, Marcos PJ, Alvarez CJ, López-Campos JL, Gea J, Garcia-Aymerich J, Molina J, Román M, Moises J, Szabo V, Reagan EA, San José Estépar R, Washko G, Agustí A and Faner R
Publicada:
1 oct 2020
Ahead of Print:
5 oct 2020
Categoría:
Pulmonary and respiratory medicine
Resumen:
The phenotypic characteristics of chronic obstructive pulmonary disease (COPD) in individuals younger than 50 years of age (early COPD) are not well defined. This prospective, multi-centre, case-control study sought to describe these characteristics and compare them with those of smokers (>= 10 pack-years) of similar age with normal spirometry (controls).
We studied 92 cases (post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <0.7) and 197 controls. Results were contrasted with participants with similar inclusion criteria recruited into the ECLIPSE and COPDGene cohorts.
Cases had moderate airflow limitation (FEV1 71.3 +/- 20.8%) but were often symptomatic, used healthcare resources frequently, had air trapping (residual volume 150.6 +/- 55.5% ref.), had reduced diffusing capacity (84.2 +/- 20.7% ref.) and had frequent evidence of computed tomography (CT) emphysema (61%). Of note, less than half of cases (46%) had been previously diagnosed with COPD. Interestingly, they also often reported a family history of respiratory diseases and had been hospitalised because of respiratory problems before the age of 5 years more frequently than controls (12% versus 3%, p=0.009). By and large, these observations were reproduced when available in the ECLIPSE and COPDGene cohorts.
These results show that early COPD is associated with substantial health impact and significant structural and functional abnormalities, albeit it is often not diagnosed (hence, treated). The fact that a sizeable proportion of patients with early COPD report a family history of respiratory diseases and/or early-life events (including hospitalisations before the age of 5 years) renders further support to the possibility of early-life origin of COPD.
Filiaciones:
Cosío BG:
Servicio de Neumología, Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Spain
CIBER de Enfermedades Respiratorias, Madrid, Spain
Pascual-Guardia S:
CIBER de Enfermedades Respiratorias, Madrid, Spain
Servei de Pneumologia, Hospital del Mar - IMIM, Barcelona, Spain
Universitat Pompeu Fabra, Barcelona, Spain
Borras-Santos A:
CIBER de Enfermedades Respiratorias, Madrid, Spain
ISGlobal, Barcelona, Spain
Peces-Barba G:
CIBER de Enfermedades Respiratorias, Madrid, Spain
Fundación Jiménez Díaz, Hospital Universitario, Grupo Quirón, Madrid, Spain
Santos S:
CIBER de Enfermedades Respiratorias, Madrid, Spain
Servicio de Neumología, Hospital Universitario de Bellvitge, Barcelona, Spain
IDIBELL, Universidad de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
Vigil L:
CIBER de Enfermedades Respiratorias, Madrid, Spain
Servei de Pneumologia, Hospital Universitari Parc Taulí, Sabadell, Spain
:
CIBER de Enfermedades Respiratorias, Madrid, Spain
Servicio de Neumología, Hospital Arnau de Vilanova-LLiria, Valencia, Spain
Martínez-González C:
Servicio de Neumología, Hospital Universitario Central de Asturias, Oviedo, Spain
Casanova C:
Servicio de Neumología-Unidad de Investigación Hospital Universitario La Candelaria, Universidad de La Laguna, Tenerife, Spain
Marcos PJ:
Dirección de Procesos Asistenciales, Servicio de Neumología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complejo Hospitalario Universitario de A Coruña, Area Sanitaria de A Coruña, Sergas, Universidade da Coruña, A Coruña, Spain
Alvarez CJ:
CIBER de Enfermedades Respiratorias, Madrid, Spain
Servicio Neumología, HU 12 de Octubre, Madrid, Spain
Departamento de Medicina, Facultad Medicina UCM, Madrid, Spain
López-Campos JL:
CIBER de Enfermedades Respiratorias, Madrid, Spain
Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain
Gea J:
CIBER de Enfermedades Respiratorias, Madrid, Spain
Servei de Pneumologia, Hospital del Mar - IMIM, Barcelona, Spain
Universitat Pompeu Fabra, Barcelona, Spain
Garcia-Aymerich J:
Universitat Pompeu Fabra, Barcelona, Spain
ISGlobal, Barcelona, Spain
CIBER de Epidemiologia y Salud Pública, Madrid, Spain
Molina J:
Centro de Salud Francia, DAO, Madrid, Grupo de Respiratorio semFYC, Madrid, Spain
Román M:
Centro de Salud de Son Pisa, Unidad de investigación en enfermedades respiratorias crónicas en atención primaria, IdISBa, Palma de Mallorca, Spain
Moises J:
CIBER de Enfermedades Respiratorias, Madrid, Spain
Institut Respiratori, Hospital Clinic, Barcelona, Spain
Universitat de Barcelona, Barcelona, Spain
Institut d'Investigacio August Pi i Sunyer, Barcelona, Spain
Szabo V:
Institut d'Investigacio August Pi i Sunyer, Barcelona, Spain
Reagan EA:
National Jewish Health, Denver, CO, USA
San José Estépar R:
Applied Chest Imaging Laboratory, Dept of Radiology, Brigham and Women's Hospital, Boston, MA, USA
Washko G:
Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA
Agustí A:
CIBER de Enfermedades Respiratorias, Madrid, Spain
Institut Respiratori, Hospital Clinic, Barcelona, Spain
Universitat de Barcelona, Barcelona, Spain
Institut d'Investigacio August Pi i Sunyer, Barcelona, Spain
Faner R:
CIBER de Enfermedades Respiratorias, Madrid, Spain
Institut d'Investigacio August Pi i Sunyer, Barcelona, Spain
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