Natural Course of the Diffusing Capacity of the Lungs for Carbon Monoxide in COPD: Importance of Sex

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Abstract

Background: The value of the single-breath diffusing capacity of the lungs for carbon monoxide (DLCO) relates to outcomes for patients with COPD. However, little is known about the natural course of DLCO over time, intersubject variability, and factors that may influence DLCO progression. Research Question: What is the natural course of DLCO in patients with COPD over time, and which other factors, including sex differences, could influence this progression? Study Design and Methods: We phenotyped 602 smokers (women, 33%), of whom 506 (84%) had COPD and 96 (16%) had no airflow limitation. Lung function, including DLCO, was monitored annually over 5 years. A random coefficients model was used to evaluate DLCO changes over time. Results: The mean (± SE) yearly decline in DLCO % in patients with COPD was 1.34% ± 0.015%/y. This was steeper compared with non-COPD control subjects (0.04% ± 0.032%/y; P = .004). Sixteen percent of the patients with COPD, vs 4.3% of the control subjects, had a statistically significant DLCO % slope annual decline (4.14%/y). At baseline, women with COPD had lower DLCO values (11.37% ± 2.27%; P

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Casanova, C., Gonzalez-Dávila, E., Martínez-Gonzalez, C., Cosio, B. G., Fuster, A., Feu, N., … Celli, B. R. (2021). Natural Course of the Diffusing Capacity of the Lungs for Carbon Monoxide in COPD: Importance of Sex. Chest, 160(2), 481–490. https://doi.org/10.1016/j.chest.2021.03.069

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