Evaluation of lung capacity and diffusing capacity in patients with chronic obstructive pulmonary disease_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

DUAN Haoyu ,  LIANG Binmiao

Department of Respiratory and Crical Care Medicine, West China Hlospital, Sichuan University, Chengdu,Sichuan 610040, P. R. China;

Corresponding author：

LIANG Binmiao, Email: liangbinmiao@163.com

Keywords：

Chronic obstructive pulmonary disease; hyperinflation; diffusing capacity for carbon monoxide; the ratio of residual volume to total lung capacity

DOI：

10.7507/1671-6205.202210034

Video：

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Objective To observe the changes in pulmonary function in chronic obstructive pulmonary disease (COPD) patients with different GOLD grades, diffusing capacity for carbon monoxide in percent predicted value (D_LCO%pred), and the relationship between D_LCO%pred and hyperinflation parameter, the ratio of residual volume to total lung capacity (RV/TLC). Methods Their age, sex, body mass index (BMI), and lung function parameters were recorded. Group according to GOLD grade, and compare the lung function among different groups; With D_LCO%pred 60% as the cut-off value, the lung function of each group was compared. Pearson and Spearman correlation determined the relationship between D_LCO%pred and age, RV/TLC, and other factors. Results Four hundred and thirty-one patients were enrolled. With the increase of GOLD grade, the pulmonary function became worse (P<0.05). Compared with D_LCO%pred ≥ 60%, the group with D_LCO%pred<60% had lower BMI (t=–5.642, P<0.001) and worse pulmonary function (P<0.001). The correlation analysis showed that BMI (r=0.352, P<0.001), forced vital capacity in percent predicted value (FVC%pred) (r=0.349, P<0.001), forced expiratory volume in one second in percent predicted value (FEV₁%pred) (r=0.414, P<0.001), the ratio of forced expiratory volume in one second to forced vital capacity (FEV₁/FVC) (r=0.434, P<0.001), peak expiratory flow in percent predicted value (PEF%pred) (r=0.335, P<0.001), maximal mid expiratory flow in percent predicted value (MMEF%pred) (r=0.405, P<0.001), inspiratory capacity in percent predicted value (IC%pred) (r=0.301, P<0.001) were positively correlated with D_LCO%pred; while RV/TLC (r=–0.328, P<0.001), GOLD grade (r=–0.430, P<0.001) were negatively correlated with D_LCO%pred; However, there was no significant correlation between age (r=–0.012, P=0.810), sex (r=0.076, P=0.117) and D_LCO%pred. Conclusions With the increase of GOLD grade, D_LCO%pred decreases, and RV/TLC increases. RV/TLC is negatively correlated with D_LCO%pred. Attaching importance to the evaluation of hyperinflation and diffusing capacity of COPD patients is helpful in evaluating COPD in all aspects, and has particular clinical significance.

Citation： DUAN Haoyu, LIANG Binmiao. Evaluation of lung capacity and diffusing capacity in patients with chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(6): 381-386. doi: 10.7507/1671-6205.202210034 Copy

1.	Wang C, Xu JY, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet, 2018, 391(10131): 1706-1717.
2.	Berg K, Wright JL. The pathology of chronic obstructive pulmonary disease: progress in the 20th and 21st centuries. Arch Pathol Lab Med, 2016, 140(12): 1423-1428.
3.	Brandsma CA, Van den Berge M, Hackett TL, et al. Recent advances in chronic obstructive pulmonary disease pathogenesis: from disease mechanisms to precision medicine. J Pathol, 2020, 250(5): 624-635.
4.	Gagnon P, Guenette JA, Langer D, et al. Pathogenesis of hyperinflation in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 2014, 9(1): 187-201.
5.	Ni YM, Yu YC, Dai RR, et al. Diffusing capacity in chronic obstructive pulmonary disease assessment: a meta-analysis. Chron Respir Dis, 2021, 18: 1-11.
6.	D'Ascanio M, Viccaro F, Calabrò N, et al. Assessing static lung hyperinflation by whole-body plethysmography, helium dilution, and impulse oscillometry system (IOS) in patients with COPD. Int J Chron Obstruct Pulmon Dis, 2020, 15: 2583-2589.
7.	Waatevik M, Frisk B, Real FG, et al. CT-defined emphysema in COPD patients and risk for change in desaturation status in 6-min walk test. Respir Med, 2021, 187: 106542.
8.	Nambu A, Zach J, Schroeder J, et al. Relationships between diffusing capacity for carbon monoxide (D_LCO), and quantitative computed tomography measurements and visual assessment for chronic obstructive pulmonary disease. Eur J Radiol, 2015, 84(5): 980-985.
9.	Balasubramanian A, MacIntyre NR, Henderson RJ, et al. Diffusing capacity of carbon monoxide in assessment of COPD. Chest, 2019, 156(6): 1111-1119.
10.	Elbehairy AF, O'Donnell CD, Abd Elhameed A, et al. Low resting diffusion capacity, dyspnea, and exercise intolerance in chronic obstructive pulmonary disease. J Appl Physiol, 2019, 127(4): 1107-1116.
11.	Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease 2022 report [EB/OL]. [2022-10-31]. Available at: https://goldcopd.org/2022-gold-reports-2/.
12.	Stanojevic S, Kaminsky DA, Miller MR, et al. ERS/ATS technical standard on interpretive strategies for routine lung function tests. Eur Respir J, 2022, 60(1): 2101499.
13.	Jian WH, Gao Y, Hao CL, et al. Reference values for spirometry in Chinese aged 4-80 years. J Thorac Dis, 2017, 9(11): 4538-4549.
14.	Chen CL, Jian WH, Gao Y, et al. Early COPD patients with lung hyperinflation associated with poorer lung function but better bronchodilator responsiveness. Int J Chron Obstruct Pulmon Dis, 2016, 11(1): 2519-2526.
15.	Park J, Lee CH, Lee YJ, et al. Longitudinal changes in lung hyperinflation in COPD. Int J Chron Obstruct Pulmon Dis, 2017, 12: 501-508.
16.	de-Torres JP, O'Donnell DE, Marín JM, et al. Clinical and prognostic impact of low diffusing capacity for carbon monoxide values in patients with Global Initiative for Obstructive Lung Disease ⅠCOPD. Chest, 2021, 160(3): 872-878.
17.	Kang J, Oh YM, Lee JH, et al. Distinctive patterns of pulmonary function change according to baseline lung volume and diffusing capacity. Int J Tuberc Lung Dis, 2020, 24(6): 597-605.
18.	Marini JJ. Dynamic hyperinflation and auto-positive end-expiratory pressure: Lessons learned over 30 years. Am J Respir Crit Care Med, 2011, 184(7): 756-762.
19.	Rodríguez-Roisin R, Drakulovic M, Rodríguez DA, et al. Ventilation-perfusion imbalance and chronic obstructive pulmonary disease staging severity. J Appl Physiol, 2009, 106(6): 1902-1908.
20.	王晓晟, 李敏, 康筱玲, 等. 慢性阻塞性肺疾病患者肺功能分组的临床特征和治疗反应比较. 中华结核和呼吸杂志, 2015, 38(12): 901-906.
21.	Casanova C, Marin JM, Martinez-Gonzalez C, et al. Differential effect of modified medical research council dyspnea, COPD assessment test, and clinical COPD questionnaire for symptoms evaluation within the new GOLD staging and mortality in COPD. Chest, 2015, 148(1): 159-168.

1. Wang C, Xu JY, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet, 2018, 391(10131): 1706-1717.
2. Berg K, Wright JL. The pathology of chronic obstructive pulmonary disease: progress in the 20th and 21st centuries. Arch Pathol Lab Med, 2016, 140(12): 1423-1428.
3. Brandsma CA, Van den Berge M, Hackett TL, et al. Recent advances in chronic obstructive pulmonary disease pathogenesis: from disease mechanisms to precision medicine. J Pathol, 2020, 250(5): 624-635.
4. Gagnon P, Guenette JA, Langer D, et al. Pathogenesis of hyperinflation in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 2014, 9(1): 187-201.
5. Ni YM, Yu YC, Dai RR, et al. Diffusing capacity in chronic obstructive pulmonary disease assessment: a meta-analysis. Chron Respir Dis, 2021, 18: 1-11.
6. D'Ascanio M, Viccaro F, Calabrò N, et al. Assessing static lung hyperinflation by whole-body plethysmography, helium dilution, and impulse oscillometry system (IOS) in patients with COPD. Int J Chron Obstruct Pulmon Dis, 2020, 15: 2583-2589.
7. Waatevik M, Frisk B, Real FG, et al. CT-defined emphysema in COPD patients and risk for change in desaturation status in 6-min walk test. Respir Med, 2021, 187: 106542.
8. Nambu A, Zach J, Schroeder J, et al. Relationships between diffusing capacity for carbon monoxide (D_LCO), and quantitative computed tomography measurements and visual assessment for chronic obstructive pulmonary disease. Eur J Radiol, 2015, 84(5): 980-985.
9. Balasubramanian A, MacIntyre NR, Henderson RJ, et al. Diffusing capacity of carbon monoxide in assessment of COPD. Chest, 2019, 156(6): 1111-1119.
10. Elbehairy AF, O'Donnell CD, Abd Elhameed A, et al. Low resting diffusion capacity, dyspnea, and exercise intolerance in chronic obstructive pulmonary disease. J Appl Physiol, 2019, 127(4): 1107-1116.
11. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease 2022 report [EB/OL]. [2022-10-31]. Available at: https://goldcopd.org/2022-gold-reports-2/.
12. Stanojevic S, Kaminsky DA, Miller MR, et al. ERS/ATS technical standard on interpretive strategies for routine lung function tests. Eur Respir J, 2022, 60(1): 2101499.
13. Jian WH, Gao Y, Hao CL, et al. Reference values for spirometry in Chinese aged 4-80 years. J Thorac Dis, 2017, 9(11): 4538-4549.
14. Chen CL, Jian WH, Gao Y, et al. Early COPD patients with lung hyperinflation associated with poorer lung function but better bronchodilator responsiveness. Int J Chron Obstruct Pulmon Dis, 2016, 11(1): 2519-2526.
15. Park J, Lee CH, Lee YJ, et al. Longitudinal changes in lung hyperinflation in COPD. Int J Chron Obstruct Pulmon Dis, 2017, 12: 501-508.
16. de-Torres JP, O'Donnell DE, Marín JM, et al. Clinical and prognostic impact of low diffusing capacity for carbon monoxide values in patients with Global Initiative for Obstructive Lung Disease ⅠCOPD. Chest, 2021, 160(3): 872-878.
17. Kang J, Oh YM, Lee JH, et al. Distinctive patterns of pulmonary function change according to baseline lung volume and diffusing capacity. Int J Tuberc Lung Dis, 2020, 24(6): 597-605.
18. Marini JJ. Dynamic hyperinflation and auto-positive end-expiratory pressure: Lessons learned over 30 years. Am J Respir Crit Care Med, 2011, 184(7): 756-762.
19. Rodríguez-Roisin R, Drakulovic M, Rodríguez DA, et al. Ventilation-perfusion imbalance and chronic obstructive pulmonary disease staging severity. J Appl Physiol, 2009, 106(6): 1902-1908.
20. 王晓晟, 李敏, 康筱玲, 等. 慢性阻塞性肺疾病患者肺功能分组的临床特征和治疗反应比较. 中华结核和呼吸杂志, 2015, 38(12): 901-906.
21. Casanova C, Marin JM, Martinez-Gonzalez C, et al. Differential effect of modified medical research council dyspnea, COPD assessment test, and clinical COPD questionnaire for symptoms evaluation within the new GOLD staging and mortality in COPD. Chest, 2015, 148(1): 159-168.

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