Emphysema Identified in Adults With Normal Spirometry

TUESDAY, July 19, 2022 (HealthDay News) — Emphysema can be present when spirometry findings are normal, especially among Black men, according to a study published online July 19 in Annals of Internal Medicine.

Gabrielle Y. Liu, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues examined the difference in emphysema prevalence between Black and White adults with different measures of normal spirometry results in an observational study using data from the Coronary Artery Risk Development in Young Adults study. A computed tomography scan and spirometry were both available for analysis for 2,674 participants (485 Black men, 762 Black women, 659 White men, and 768 White women).

The researchers found that 6.5 percent of participants with a race-specific forced expiratory volume in one second (FEV₁) between 80 and 99 percent of predicted had emphysema. The prevalence of emphysema in this group was 3.9- and 1.9-fold higher among Black than White men and women, respectively. Overall, 4.0 percent of participants with a race-specific FEV₁ between 100 and 120 percent of predicted had emphysema. In this category, the prevalence of emphysema was 6.4-fold higher for Black versus White men, while prevalence was similar for Black and White women. Racial differences in emphysema prevalence were attenuated among men and eliminated among women with the use of race-neutral equations to identify participants with an FEV₁ predicted between 80 and 120 percent.

“Reliance on spirometry alone to differentiate lung health from lung disease may result in the underrecognition of impaired respiratory health and exacerbate racial disparities,” the authors write.

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