作者@article {Akkermans54 = {Akkermans Reinier P. and Biermans, Marion and Robberts, Bas and ter Riet, Gerben and Jacobs, Annelies and van Weel, Chris and Wensing, Michel and Schermer, Tjard}, title = {COPD prognosis in relation to diagnostic criteria for airflow obstruction in smokers}, volume = {43}, number = {1}, pages = {54--63}, year = {2014}, doi = {10.1183/09031936.00158212}, publisher = {European Respiratory Society}, abstract = {The aim of this study was to establish which cut-off point for the forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio (i.e. fixed 0.70 or lower limit of normal (LLN) cut-off point) best predicts accelerated lung function decline and exacerbations in middle-aged smokers. We performed secondary analyses on the Lung Health Study dataset. 4045 smokers aged 35{\textendash}60 years with mild-to-moderate obstructive pulmonary disease were subdivided into categories based on presence or absence of obstruction according to both FEV1/FVC cut-off points. Post-bronchodilator FEV1 decline served as the primary outcome to compare subjects between the categories. 583 (14.4\%) subjects were nonobstructed and 3230 (79.8\%) subjects were obstructed according to both FEV1/FVC cut-off points. 173 (4.3\%) subjects were obstructed according to the fixed cut-off point, but not according to the LLN cut-off point ({\textquotedblleft}discordant{\textquotedblright} subjects). Mean{\textpm}se post-bronchodilator FEV1 decline was 41.8{\textpm}2.0 mL{\textperiodcentered}year-1 in nonobstructed subjects, 43.8{\textpm}3.8 mL{\textperiodcentered}year-1 in discordant subjects and 53.5{\textpm}0.9 mL{\textperiodcentered}year-1 in obstructed subjects (p\<0.001). Our study showed that FEV1 decline in subjects deemed obstructed according to a fixed criterion (FEV1/FVC \<0.70), but non-obstructed by a sex- and age-specific criterion (LLN) closely resembles FEV1 decline in subjects designated as non-obstructed by both criteria. Sex and age should be taken into account when assessing airflow obstruction in middle-aged smokers. Lower limit of normal cut-off best predicts accelerated lung function decline and exacerbation in middle-aged smokers http://ow.ly/qaZnz}, issn = {0903-1936}, URL = {//www.qdcxjkg.com/content/43/1/54}, eprint = {//www.qdcxjkg.com/content/43/1/54.full.pdf}, journal = {European Respiratory Journal} }