Tuberc Respir Dis.  2010 Sep;69(3):177-183.

Longitudinal Evaluation of Lung Function Associated with Emphysema in Healthy Smokers

• Sim YS
• Ham E
• Choi KY
• Lee SY
• Kim SC
• Kim YK
• Park SH

Abstract

BACKGROUND
Smoking reduces pulmonary function and induces various lung diseases. Recently, the rate of emphysema detection has increased due to lung cancer screening with low-dose chest computed tomography (CT). The purpose of this study was to evaluate changes in lung function associated with emphysema in healthy smokers.
METHODS
One hundred and ninety one healthy smokers, who had undergone a low-dose chest CT (LDCT) scan as part of lung cancer screening and had revisited the health center after a median 23.9 months' time, were recruited into this study. The severity of emphysema was calculated by the direct observation of a radiologist and a pulmonologist indipendently. Longitudinal changes in lung function according to emphysema based on LDCT and type of smoker was analyzed.
RESULTS
Of the participants in this study, 25% of healthy smokers had emphysema, which was mild in severity, in older patients (p=0.003) and in heavy smokers (p<0.001). FEV1/FVC and FEF25-75% were decreased in current smokers with emphysema (p=0.001 and p=0.009, respectively) and without emphysema (p=0.001 and p=0.042). Although lung function was not decreased in ex-smokers without emphysema, FEV1/FVC and FEF25-75% were decreased in ex-smoker with emphysema (p=0.020 and p=0.010).
CONCLUSION
Upon examination with LDCT, the prevalence of emphysema was higher in healthy smokers was than in non-smokers. Lung function was diminished in smokers with emphysema, in spite of former smoker.

Keyword

Emphysema; Tomography, X-Ray Computed; Smoking; Spirometry

MeSH Terms

Emphysema
Humans
Lung
Lung Diseases
Lung Neoplasms
Mass Screening
Prevalence
Smoke
Smoking
Spirometry
Thorax
Tomography, X-Ray Computed
Smoke

Figure

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  Figure 1 Change of lung function according to presence of emphysema in (A) smoker (n=191), (B) current smoker (n=131), and (C) ex-smoker (n=60) at initial and follow up visit. The middle line of bar shows median value with interquartile range (upper and lower lines). The data are presented as % predicted value of FVC, FEV1, FEF25-75%, and FEV1/FVC. PE: pulmonary emphysema group; NPE: no pulmonary emphysema group; FEV1: forced expiratory volume in 1 second; FVC: forced vital capacity; FEF25-75%: forced expiratory flow between 25 and 75% of vital capacity. *p<0.05.

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