One of the largest studies to investigate whether Preserved Ratio Impaired Spirometry (PRISm), an understudied low lung function state, is an early predictor of co-morbidities has found it is strongly associated with an increased risk of death. The analysis, led by University of Bristol researchers and published in The Lancet Respiratory Medicine, evaluated results of lung spirometry tests in over 350,000 UK adults and followed them up over 12 years.
Previous research has suggested that a particular pattern of low-scoring lung capacity tests known as a PRISm, calculated from forced expiration into a spirometer, is a precursor of chronic obstructive pulmonary disease (COPD). However, these findings are based on relatively small selective cohorts with short follow-up. Researchers from Bristol Medical School aimed to determine the prevalence, risk factors, clinical implications, and mortality of low-scoring PRISm in a large adult general population.
Using data from 351,874 UK Biobank participants, comprising 189247 women and 162627 men, the team found 38639 (11 per cent) of 351874 participants were identified as having PRISm and this was strongly associated with obesity, smoking and patient reported doctor-diagnosed asthma. PRISm was strongly associated with symptoms and comorbidity including increased risk of breathlessness and cardiovascular disease.
Longitudinal analysis showed that 241 (12·3 per cent) of 1973 participants who had PRISm at baseline transitioned to airflow obstruction consistent with COPD. The team found that PRISm was associated with increased all-cause mortality.
Dr James Dodd, Consultant Senior Lecturer in Respiratory Medicine at Bristol Medical School: (THS) and North Bristol NHS Trust, said: “Our results found that PRISm was associated with breathlessness, multimorbidity, and increased risk of death, which does not seem to be explained by smoking, obesity, or existing lung disease.”
, the study’s first author from Bristol Medical School, added: “Our analysis is an example of the power of large population cohorts like UK Biobank in allowing us to more accurately describe the epidemiology and implications of abnormal lung function by accounting for sample size and selection bias.”
Dr Dodd continued: “Although for many patients PRISm is transient, it is important to understand which individuals are at risk of progressive lung function abnormalities. Further research into the genetic, structural and functional pathophysiology of PRISm is warranted.”
The study was funded by the National Institute for Health Research (NIHR) and the Medical Research Council (MRC).
‘Prevalence, risk factors, and clinical implications of preserved ratio impaired spirometry: a UK Biobank cohort analysis’ by Daniel H Higbee, Raquel Granell, George Davey Smith, James W Dodd in The Lancet Respiratory Medicine.
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About UK Biobank
UK Biobank is a large-scale biomedical database and research resource containing genetic, lifestyle and health information from half a million UK participants. UK Biobank’s database, which includes blood samples, heart and brain scans and genetic data of the 500,000 volunteer participants, is globally accessible to approved researchers who are undertaking health-related research that’s in the public interest.
UK Biobank recruited 500,000 people aged between 40-69 years in 2006-2010 from across the UK. With their consent, they provided detailed information about their lifestyle, physical measures and had blood, urine and saliva samples collected and stored for future analysis.
UK Biobank’s research resource is a major contributor in the advancement of modern medicine and treatment, enabling better understanding of the prevention, diagnosis and treatment of a wide range of serious and life-threatening illnesses – including cancer, heart diseases and stroke. Since the UK Biobank resource was opened for research use in April 2012, over 23,000 researchers from +90 countries have been approved to use it and more than 2,000 peer-reviewed papers that used the resource have now been published.
UK Biobank is generously supported by its founding funders the Wellcome Trust and UK Medical Research Council, as well as the British Heart Foundation, Cancer Research UK, Department of Health, Northwest Regional Development Agency and Scottish Government. The organisation has over 150 dedicated members of staff, based in multiple locations across the UK. Find out more here: http://www.ukbiobank.ac.uk
The Lancet Respiratory Medicine
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Prevalence, risk factors, and clinical implications of preserved ratio impaired spirometry: a UK Biobank cohort analysis’
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