Reduced FEV3/FVC as an Early Indicator of COPD in Individuals with Normal Spirometry: A Prospective Analysis from the ECOPD Study

作者：Yuemao Li, Jingwen Li, Suyin Huang, Fan Wu, Zhishan Deng, Jieqi Peng, Kunning Zhou, Gaoying Tang, Qi Wan, Cuiqiong Dai, Lifei Lu, Xiaohui Wu, Xianliang Zeng, Fangyan Wu, Changli Yang, Shengtang Chen, Yongqing Huang, Shuqing Yu, Yumin Zhou, Pixin Ran · 发表于：International Journal of COPD · 年份：2025 · DOI：10.2147/copd.s566651 · 被引用次数：2 · 研究领域：Chronic Obstructive Pulmonary Disease (COPD) Research、Pulmonary Hypertension Research and Treatments、Respiratory and Cough-Related Research

Purpose: This study aimed to evaluate the association between the forced expiratory volume in 3 s (FEV 3 ) to forced vital capacity (FVC) and computed tomography (CT)-defined abnormalities, and to assess its potential value in predicting incident chronic obstructive pulmonary disease (COPD) over a 3-year period. Participants and Methods: This 3-year community-based cohort study enrolled participants with normal lung function (post-bronchodilator FEV 1 /FVC ≥ 0.70 and FEV 1 ≥ 80% predicted). Baseline assessments included questionnaires, spirometry, CT scans, and impulse oscillometry. Participants were stratified by post-bronchodilator FEV 3 /FVC tertiles. Outcomes included acute respiratory events, annual lung function decline, and COPD incidence. Data were analyzed using mixed-effects models, log-binomial regression, and zero-inflated negative binomial models. Results: Of the 981 participants with normal baseline lung function stratified by post-bronchodilator FEV 3 /FVC tertiles (high: ≥ 95.5%, medium: 91.9– 95.4%, low: ≤ 91.8%), 807 completed the 3-year follow-up. Compared to the high-FEV 3 /FVC group, participants in the low-FEV 3 /FVC group tended to be older (60.5 vs 55.7 years) and included more males (80.4% vs 38.8%) and smokers. The low-FEV 3 /FVC group also demonstrated a lower baseline post-bronchodilator FEV 1 /FVC (74.0% vs 85.1%) and higher prevalence of emphysema (53.5% vs 18.3%). Longitudinal analysis revealed a greater annual post-bronchodilator FEV 1 decline ...