Association Between the Forced Midexpiratory Flow/Forced Vital Capacity Ratio and Bronchial Hyperresponsiveness

Urrutia, I.; Capelastegui, A.; Quintana, J.M.; Muniozguren, N.; Payo, F.; Martínez Moratalla, J.; Maldonado, J.A.; Basagana, X.; Anto, J.M.; Sunyer, J.

doi:10.1016/S1579-2129(06)60342-X

Archivos de Bronconeumología

ISSN: 0300-2896

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Vol. 40. Issue 9.

Pages 397-402 (September 2004)

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Pages 397-402 (September 2004)

Original Articles

DOI: 10.1016/S1579-2129(06)60342-X

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Association Between the Forced Midexpiratory Flow/Forced Vital Capacity Ratio and Bronchial Hyperresponsiveness

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I. Urrutiaa,

Corresponding author

isabhelurrutia@airtel.net

Correspondence: Dra. I. Urrutia. Servicio de Neumología. Hospital de Galdakao. B.° Labeaga, s/n. 48960 Galdakao. Vizcaya. España

, A. Capelasteguia, J.M. Quintanab, N. Muniozgurenc, F. Payod, J. Martínez Moratallae, J.A. Maldonadof, X. Basaganag, J.M. Antoh, J. Sunyerh, the Spanish Group of the European Community Respiratory Health Survey (ECRHS-I) *

a Servicio de Neumología, Hospital de Galdakao, Galdakao, Vizcaya, Spain

b Unidad de Epidemiología de Investigación Clínica, Hospital de Galdakao, Galdakao, Vizcaya, Spain

c Departamento de Sanidad del Gobierno Vasco, Bilbao, Spain

d Hospital de Asturias, Oviedo, Spain

e Complejo Universitario, Albacete, Spain

f Hospital Juan Ramón Jiménez, Huelva, Spain

g Unidad de Investigación Respiratoria y Ambiental, Instituto Municipal de Investigación MeAdica, Barcelona, Spain

h Unidad de Investigación Respiratoria y Ambiental, Instituto Municipal de Investigación Médica, Departamento de Ciencias Experimentales y de la Salud, Universidad Pompeu Fabra, Barcelona, Spain

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Abstract

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Objective

A long-standing hypothesis is that a low ratio of airway caliber to lung size is associated with bronchial hyperresponsiveness (BHR). The aim of our study was to measure the association between airway caliber relative to lung size (expressed as the ratio between forced expiratory flow, midexpiratory phase, divided by forced vital capacity [FEF25%-75%/FVC]) and BHR measured by a methacholine challenge test, adjusting for age, height, sex, smoking history, geographic area, respiratory symptoms, and baseline forced expiratory volume in 1 second (FEV1).

Material and methods

We carried out a multicenter cross-sectional study of the general Spanish population in 2647 subjects from the European Community Respiratory Health Survey (ECRHS I). The ECRHS questionnaire was administered, total and specific immunoglobulin E were measured, and skin tests, spirometry, and a methacholine challenge test were performed.

Results

We show the relationship of the various clinical and sociodemographic variables with the 2 parameters indicative of a positive methacholine test. The lower the FEF25%-75%/FVC ratio was, the greater the risk of HRB, after adjustment for variables (odds ratio [OR]=0.09; 95% confidence interval [CI], 0.04-0.018 for the concentration provoking a 20% decrease in FEV1, and OR=0.06; 95% CI, 0.03-0.12 for the dose provoking a 20% decrease in FEV1).

Conclusions

There is a significant association between the FEF25%-75%/FVC ratio and BHR after adjustment for age, atopy, smoking, geographic area, respiratory symptoms, and initial FEV1.

Key Words:

Bronchial hyperresponsiveness

Lung size

FEF25%-75%/FVC.

Objetivo

La desproporción entre el calibre de la vía aeArea y el pareAnquima pulmonar tiene una relación negativa con la presencia de hiperreactividad bronquial (HRB).

El objetivo del presente estudio es medir la asociación entre el calibre de la vía aeArea relativa a la talla pulmonar, expresado por el cociente entre el flujo mesoespiratorio entre el 25 y el 75% de la capacidad vital forzada dividido por la capacidad vital forzada (FEF25-75%/FVC), con la HRB medida por el test de metacolina, ajustando por edad, altura, sexo, consumo de tabaco, área geográfica, síntomas respiratorios y volumen espiratorio forzado en el primer segundo previo.

Material y Métodos

Estudio multiceAntrico transversal sobre población general española (2.647 sujetos) del Estudio de Salud Respiratoria de la Comunidad Europea (ECRHS-I). Se aplicó un cuestionario llamado ECRHS, se determinó la inmunoglobulina E total y específica, y se realizaron pruebas cutáneas, espirometría y test de metacolina.

Resultados

Se presenta la relación entre las diferentes variables sociodemográficas y clínicas con los 2 parámetros de positividad del test de metacolina. Hay aumento del ries-go de HRB a menor cociente FEF25 75%/FVC ajustado por diferentes variables (odds ratio = 0,09; intervalo de confianza del 95%, 0,04-0,18, para PC20, y odds ratio = 0,06; intervalo de confianza del 95%, 0,03-0,12 para PD20).

Conclusiones

El cociente FEF25-75%/FVC está asociado significativamente a la HRB, independientemente de la edad, la existencia de atopia, el consumo de tabaco, el área geográfica, los síntomas respiratorios y el volumen espiratorio forzado en el primer segundo.

Palabras clave:

Hiperreactividad bronquial

Talla pulmonar

FEF25-75%/FVC.

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The ECRHS has received support from the European Economic Community and grants FIS 91/00160600E-OSE and 93/0393.

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