Small airway disease and early airflow limitation predict onset of COPD: Results from the KORA study

Pott, Hendrik; Bertrams, Wilhelm; Vogelmeier, Claus Franz; Weckle, Barbara Christine; Heier, Margit ; Peters, Anette; Schmeck, Bernd und Karrasch, Stefan (2025): Small airway disease and early airflow limitation predict onset of COPD: Results from the KORA study. ERS: European Respiratory Society Congress 2025, Amsterdam, 07. September - 01. Oktober 2025. European Respiratory Society (Hrsg.), European Respiratory Journal. Bd. 66, Nr. Supplement 69, PA5768 Lausanne: European Respiratory Society.

Abstract

Chronic obstructive pulmonary disease (COPD) is a common non-communicable disease with insidious onset. Various phenotypes pre-COPD have been linked to COPD development, yet the prevalence and prognostic utility across age groups remains unclear. Therefore, we investigated pre-COPD phenotypes and their association with COPD incidence in two sub-cohorts from the KORA study (F4, AGE) followed over a period of 3.5 – 7 years.

2255 participants from KORA (Cooperative Health Research in the Region Augsburg) were analysed (F4: n=1320, AGE: n=935). Pre-COPD phenotypes defined as early airflow limitation (FEV1/FVC > 0.7 and < 10th percentile or < 0.7 and between 5-10th percentile), preserved-ratio impaired-spirometry (PRISm), chronic bronchitis and small airway disease (SAD, based on FEF25-75) were assessed at each study visit, based on pre-bronchodilation spirometry. Logistic regression models were applied to investigate associations with onset of COPD.

Overall, pre-COPD prevalence was 19% in F4 (41-62y) and 21% in AGE (65-90y). Newly developed COPD over follow-up was observed in 158 participants. SAD was observed in 7% (F4) and 4% (AGE) of participants, while early airflow limitation was observed in 5% and 7%, and PRISm in 5–6% of participants. SAD varied considerably between visits, persisting in 26 – 33 % of cases between years. In both F4 and AGE, SAD and early airflow limitation, but not chronic bronchitis and PRISm, were associated with an increased risk for COPD onset.

Our results indicate the prognostic relevance of SAD and early airflow limitation as key pre-COPD phenotypes for medium-term COPD development, regardless of age.

• Dokumententyp: Konferenzbeitrag (Abstract)
• Fakultät: Medizin > Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Ort: Lausanne
• Bemerkung: This article was presented at the 2025 ERS Congress, in session “Monitoring airway diseases”.
• Sprache: Englisch