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A comprehensive analysis of association of medical history with airflow limitation: a cross-sectional study

Authors Nishida Y, Takahashi Y, Tezuka K, Yamazaki K, Yada Y, Nakayama T, Asai S

Received 27 March 2017

Accepted for publication 30 May 2017

Published 8 August 2017 Volume 2017:12 Pages 2363—2371


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Charles Downs

Peer reviewer comments 2

Editor who approved publication: Dr Richard Russell

Yayoi Nishida,1 Yasuo Takahashi,1 Kotoe Tezuka,1 Keiko Yamazaki,1 Yoichi Yada,2 Tomohiro Nakayama,3,4 Satoshi Asai2

1Division of Genomic Epidemiology and Clinical Trials, Clinical Trials Research Center, 2Division of Pharmacology, Department of Biomedical Sciences, 3Division of Companion Diagnostics, 4Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan

Background: Multiple comorbidity is common and increases the complexity of the presentation of patients with COPD. This study was a comprehensive analysis of the relationship between a medical history of 22 disease categories and the presence of airflow limitation (AL) without any history of asthma or bronchiectasis, compatible with COPD.
Methods: A total of 11,898 Japanese patients aged ≥40 years, who underwent spirometry tests, comprising patients with AL (n=2,309) or without AL (n=9,589), were evaluated. Generalized estimating equations were used to assess the relationship between the presence of AL and each disease. The model was adjusted for age, sex, body mass index (BMI) and pack-years of smoking.
Results: In multivariate analysis, female sex (odds ratio [OR]: 0.59; 95% confidence interval [CI]: 0.52–0.67), age (OR for 10-year age increase: 1.99; CI: 1.90–2.09), BMI (OR for 1 kg/m2 increase: 0.96; CI: 0.95–0.98) and smoking history (<15 vs 15–24, 25–49 and ≥50 pack-years; OR: 1.78, 2.6 and 3.69, respectively; CI: 1.46–2.17, 2.24–3.0 and 3.15–4.33, respectively) were significantly associated with the presence of AL. In addition, a history of tuberculosis (OR: 1.72; CI: 1.39–2.11), primary lung cancer (OR: 1.50; CI: 1.28–1.77), myocardial infarction (OR: 1.22; CI: 1.01–1.48), heart failure (OR: 1.53; CI: 1.29–1.81), arrhythmia (OR: 1.19; CI: 1.03–1.38) or heart valve disorder (OR: 1.33; CI: 1.14–1.56) was significantly associated with the presence of AL, after adjustment.
Conclusion: This study suggests that a history of heart disease leading to abnormal cardiac function may be associated with AL and that the presence of certain types of heart disease provides a rationale to assess lung status and look for respiratory impairment, including COPD.

Keywords: airflow limitation, COPD, chronic heart disease, arrhythmia, heart valve disorder

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