PT  - JOURNAL ARTICLE
AU  - Bernet Kato
AU  - Peter Burney
TI  - Risk factors for a low FVC in the BOLD project
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - 422
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/422.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/422.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Introduction: A low forced vital capacity (FVC) is associated with a poor prognosis regardless of the presence of airflow limitation or diagnosed restrictive disease. FVC varies markedly across different BOLD sites and is known to be associated with birth weight, poverty and ethnicity. Very little else is known about its determinants.Methods: We have analysed the prevalence of a low FVC, defined by the NHANES Caucasian reference equations, in relation to risk factors measured in the BOLD study and have examined the geographical distribution before and after adjusting for these risk factors.Results: A low FVC was associated with pack years of smoking (OR (95%CI) /20 pack years: 1.28 (1.17, 1.4), a BMI that was underweight (2.9 (1.9, 4.4)), overweight (1.3 (1.14, 1.5)) or obese (2.5 (2.0, 3.1)), education /completed educational level (university, secondary, primary, none) (1.11 (1.01, 1.22)), hospitalisation for breathing problems before the age of 10 years (1.88 (1.36, 2.62))and a history of TB (1.8 (1.3, 2.5)). The effect of adjusting for these factors varied from increasing the prevalence by 26% in men in Pune to reducing it by 17% in men and women in Lexington. After adjusting for all risk factors the prevalence of a low FVC (male; female) was highest in Pune (89;92%), Ife (81;78%), Mumbai (69;75%), Nampicuan (66;70%), Manila (60;65%), Cape Town (55;36%), Srinagar (34;32%), Guangzhou (25;23%), Sousse (12;13%) and London (11;8%) and lowest in Hannover (2;3%).Conclusions: Smoking, BMI, education and a history of TB are associated with a low FVC but do not explain the geographic variation. This is also not simply a reflection of ethnicity. We remain ignorant of the origins of one of the most powerful predictors of mortality.