RESUMEN
BACKGROUND: To date, there is very limited longitudinal data on COPD and incidence estimates in Japan. The aim of this study was to investigate the 12-year cumulative incidence of airflow obstruction (COPD) in Japanese males. METHODS: This study included 913 male subjects, aged 30-76 years, who underwent lung function tests at a medical check-up in 1994 (baseline), 1999, and 2006. The study group consisted of 263 persistent never smokers, 296 early quitters, 117 late quitters, and 237 persistent smokers without airflow obstruction at baseline. The 12-year cumulative incidence of airflow obstruction was estimated. The spirometric criteria for diagnosis of airflow obstruction were forced expiratory volume in 1 second (FEV(1))/forced vital capacity (FVC) of <0.7 and 5th percentile lower limit of normal (FEV(1)/FVCAsunto(s)
Enfermedad Pulmonar Obstructiva Crónica/epidemiología
, Adulto
, Anciano
, Pueblo Asiatico
, Volumen Espiratorio Forzado
, Humanos
, Incidencia
, Japón/epidemiología
, Estudios Longitudinales
, Masculino
, Persona de Mediana Edad
, Oportunidad Relativa
, Enfermedad Pulmonar Obstructiva Crónica/diagnóstico
, Enfermedad Pulmonar Obstructiva Crónica/fisiopatología
, Fumar/efectos adversos
, Espirometría
, Capacidad Vital
RESUMEN
BACKGROUND: The aim of this cross-sectional study was to investigate the association between airflow obstruction and the metabolic syndrome (MS) or its components in Japanese men. METHODS: The study included 7,189 male subjects, aged 45-88 years, who underwent spirometric lung function tests at a medical check-up. The spirometric criteria for diagnosis of airflow obstruction were forced expiratory volume in 1 second (FEV(1))/forced vital capacity (FVC) <70%. The severity of airflow obstruction was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline. RESULTS: The prevalence of airflow obstruction was 9.0% and the frequency of MS was 25.6%. In logistic regression models adjusting for age, body mass index, smoking, and alcohol, the risk of MS was higher in subjects with airflow obstruction of GOLD stage II-IV compared to those with normal lung function [odds radio (OR), 1.33; 95% confidence interval (95% CI), 1.01-1.76)]. Of the MS components, waist circumference (OR, 1.76; 95% CI, 1.24-2.50) and blood pressure (OR, 1.37; 95% CI, 1.08-1.74) were associated with airflow obstruction of GOLD stage II-IV, after controlling for potential confounders. CONCLUSION: Airflow obstruction of GOLD stage II-IV might be associated with MS, waist circumference and blood pressure components in Japanese men.
Asunto(s)
Síndrome Metabólico/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Anciano , Anciano de 80 o más Años , Pueblo Asiatico , Glucemia/metabolismo , Presión Sanguínea , Estudios Transversales , Volumen Espiratorio Forzado , Humanos , Japón/epidemiología , Lípidos/sangre , Masculino , Síndrome Metabólico/epidemiología , Síndrome Metabólico/patología , Síndrome Metabólico/fisiopatología , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/patología , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Factores de Riesgo , Capacidad Vital , Circunferencia de la CinturaRESUMEN
BACKGROUND AND OBJECTIVE: Recent studies suggest that CRP levels are related to airflow obstruction. However, limited data exist on the relevance of CRP levels in individuals with or without emphysema. The aim of this study was to assess the relationship between the extent of emphysema, COPD severity and serum CRP levels. METHODS: Lung function tests and high-sensitivity CRP were examined in 651 males with stable disease who underwent CT screening for lung cancer. CRP levels were examined cross-sectionally in individuals with various degrees of emphysema and in those without emphysema. RESULTS: Emphysema was detected in 179 (34.7%) of 516 current smokers. Airflow obstruction was observed in 47 (28.8%) of 163 smokers with mild emphysema, in eight (57.1%) of 14 smokers with moderate emphysema, and in two of two individuals with severe emphysema. CRP levels were not higher in individuals with mild or moderate emphysema compared with individuals without emphysema. Among 98 individuals with airflow obstruction (19.0% of the 516 current smokers), there was a modest correlation between CRP levels and FEV(1)%. CONCLUSIONS: The severity of COPD varied in individuals with similar degrees of emphysema. CRP levels were not significantly higher in individuals with mild or moderate emphysema compared with individuals without emphysema but CRP levels were modestly correlated with FEV(1)% among individuals with airflow obstruction.
Asunto(s)
Proteína C-Reactiva/metabolismo , Enfermedad Pulmonar Obstructiva Crónica/sangre , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico por imagen , Enfisema Pulmonar/sangre , Enfisema Pulmonar/diagnóstico por imagen , Fumar/sangre , Adulto , Anciano , Estudios de Casos y Controles , Estudios de Cohortes , Volumen Espiratorio Forzado , Humanos , Japón , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Enfisema Pulmonar/fisiopatología , Índice de Severidad de la Enfermedad , Fumar/patología , Fumar/fisiopatología , Espirometría , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Undiagnosed diabetes mellitus (DM) and impaired glucose tolerance (IGT) have important health consequences. METHODS AND RESULTS: To examine the prevalence of undiagnosed glucose intolerance, oral glucose tolerance tests were administered to 1,142 consecutively enrolled middle-aged subjects (age range 40-55 years; 914 men, mean 50.7 years; 228 women, mean 49.4 years) who worked in a company and underwent a health check in 2006. No subject had a history of glucose intolerance. Fasting glucose levels increased with age in both men and women, with the levels being higher in men than women at every age. Glucose intolerance was more common in men compared with women (fasting glucose 100.1 +/-19.7 vs 92.9 +/-9.6, P<0.01; 1-h 170.7 +/-52.1 vs 139.7 +/-11.6, P<0.01; 2-h 136.0 +/-50.1 vs 119.8 +/-31.5 mg/dl, P<0.01). The prevalence of IGT and DM was also higher in men than in women (IGT: 24.1 vs 16.7, P<0.01; diabetes 10.7 vs 1.4%, P<0.01). CONCLUSIONS: Fasting glucose levels increased with age in both men and women, with levels being higher in men than in women at every age. The prevalences of undiagnosed IGT and type 2 DM were also higher in men than in women.
Asunto(s)
Envejecimiento/sangre , Intolerancia a la Glucosa/sangre , Intolerancia a la Glucosa/epidemiología , Salud Laboral , Caracteres Sexuales , Adulto , Glucemia/metabolismo , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/epidemiología , Ayuno/sangre , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , PrevalenciaRESUMEN
The prevalence and mortality of chronic obstructive pulmonary disease (COPD) is expected to increase in the future throughout the world. Little data is available on the prevalence of airflow limitation in Japan, especially on medical check-up. The purpose of this study was to assess the prevalence of airflow limitation in Japanese subjects during medical check-ups. The study subjects were 13,534 Japanese subjects (8,583 males and 4,951 females) aged 40-69 years who underwent medical check-ups at the Japanese Red Cross Kumamoto Health Care Center. Pulmonary function data were analyzed according to smoking habits in each age group. The spirometric criteria for diagnosis of airflow limitation were forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) < 70%. The severity of COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. People with a medical diagnosis of asthma or individuals who had other pulmonary diseases were excluded from a diagnosis of COPD. The prevalence of airflow limitation was 7.0% in all subjects, 9.1% in males and 3.3% in females. Using the GOLD system, the prevalence of mild, moderate, severe and very severe airflow limitation was 7.06, 1.92, 0.10 and 0.00%, respectively, in males. In females, the prevalence of mild, moderate, severe and very severe airflow limitation was 2.67, 0.63, 0.02 and 0.00%, respectively. Only 10 cases with airflow limitation reported a previous diagnosis of COPD. These results suggest that screening spirometry during medical check-ups can identify many COPD patients not aware of this disease and highlight the need for enhanced screening efforts, intervention and treatment.
Asunto(s)
Examen Físico , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Espirometría , Adulto , Anciano , Pueblo Asiatico , Femenino , Volumen Espiratorio Forzado , Humanos , Japón/epidemiología , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Prevalencia , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Índice de Severidad de la Enfermedad , Factores Sexuales , Capacidad VitalRESUMEN
A 52-year-old man underwent lung cancer screening with low-dose spiral computed tomography (CT) in a medical check-up at the Japanese Red Cross Kumamoto Health Care Center. He was asymptomatic. Chest x-ray on a medical check-up showed no abnormal shadows. CT scans revealed a nodule in the right lower lung, suggestive of its connection to the descending thoracic aorta. A diagnosis of pulmonary sequestration was considered. He was transferred to Kumamoto University Hospital for further examination. Contrast enhanced multidetector CT images demonstrated that a nodule in the right lower lobe and an anomalous artery ran from the descending thoracic aorta, flowed through the right lower lobe and returned to the right inferior pulmonary vein. Intralobar pulmonary sequestration was confirmed by contrast enhanced multidetector CT. We report this case of asymptomatic intralobar pulmonary sequestration diagnosed using contrast enhanced multidetector CT.
Asunto(s)
Secuestro Broncopulmonar/diagnóstico por imagen , Tomografía Computarizada Espiral , Adulto , Humanos , Neoplasias Pulmonares/prevención & control , Masculino , Tamizaje MasivoRESUMEN
OBJECTIVE: Screening with low-dose spiral CT is a promising new tool for early lung cancer detection. A study was undertaken to assess the prevalence of emphysema detected by CT screening, and to assess the correlation between the extent of emphysema and the severity defined according to the recently published Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. METHODS: After informed consent, CT screening and pulmonary function tests were performed on 615 men between the ages of 40 and 69. Severity of emphysema was assessed visually. Only the pulmonary function data for male subjects were analysed because there were too few female subjects with emphysema. RESULTS: Emphysema was detected in 30.5% of current smokers, 14.1% of former smokers and 3.0% of non-smokers. In male current smokers, airflow obstruction (FEV(1)/FVC < 0.7) was seen in 18.1% of subjects with mild emphysema, and in 33.3% of subjects with moderate emphysema. FEV(1) values were less than 80% of the predicted normal in 8.5% of subjects with mild emphysema, and 28.6% of subjects with moderate emphysema. The percentage of male subjects with emphysema equivalent to GOLD stage 0 was 90.0% for subjects in their 40s, 82.5% for those in their 50s, and 68.2% for those in their 60s. CONCLUSION: A considerable percentage of the subjects with emphysema as detected by CT screening had GOLD stage 0. CT screening assists in detecting early-stage emphysema.