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Sim, Ham, Choi, Lee, Kim, Kim, and Park: Longitudinal Evaluation of Lung Function Associated with Emphysema in Healthy Smokers
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2010; 69(3): 177-183.

Published online: 30 September 2010

DOI: https://doi.org/10.4046/trd.2010.69.3.177

Longitudinal Evaluation of Lung Function Associated with Emphysema in Healthy Smokers

Yun Su Sim, M.D.1, Eunjae Ham, M.D.1, Kyu Yong Choi, M.D.1, Suk Young Lee, M.D.2, Seok Chan Kim, M.D.2, Young Kyoon Kim, M.D.2, Sung Hak Park, M.D.2

1Department of Health Promotion Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

2Department of Respiratory and Critical Care Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

Address for correspondence: Young Kyoon Kim, M.D. Department of Respiratory and Critical Care Medicine, Seoul St. Mary's Hospital, 505, Banpo-dong, Seocho-gu, Seoul 137-701, Korea. Phone: 82-2-2258-2756, Fax: 82-2-2258-1856, youngkim@catholic.ac.kr

Received 13 May 2010       Accepted 26 August 2010

Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

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.

Keywords: Emphysema, Tomography, X-Ray Computed, Smoking, Spirometry

Figures and Tables

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.
trd-69-177-g001
Table 1
Emphysema severity scale
trd-69-177-i001
Table 2
Comparison of baseline characteristics and pulmonary function test in smoker and non-smoker
trd-69-177-i002

The data are presented as number (%) or the median (interquartile range).

hs-CRP: high sensitive C-reactive protein; WBC: white blood cell; CEA: carcinoembryonic antigen; FEV1: forced expiratory volume in 1 second; FVC: forced vital capacity; FEF25-75%: forced expiratory flow between 25 and 75% of vital capacity; NS: not significant.

Table 3
Emphysema severity score of 51 persons with emphysema in low dose chest CT
trd-69-177-i003

The data are presented as the median (interquartile range).

Table 4
Comparison of baseline characteristics in smoker according to presence of emphysema
trd-69-177-i004

The data are presented as number (%) or the median (interquartile range).

hs-CRP: high sensitive C-reactive protein; WBC: white blood cell; CEA: carcinoembryonic antigen; NS: not significant.

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