Prevalence and Characteristics of Individuals with Preserved Ratio Impaired Spirometry (PRISm) and/or Impaired Lung Function in Japan: The OCEAN Study

Figures & data

Table 1 Characteristics of Participants with Airflow Limitation, PRISm, or No Airflow Limitation/PRISm

	AL* (n=52)	PRISm^† (n=420)	No AL/PRISm (n=2046)
Age, mean (SD), years	54.7 (10.9)	52.5 (8.6)	51.8 (8.8)
Age categories, n (%)
40–49 years	24 (46.2)	189 (45.0)	981 (48.0)
50–59 years	9 (17.3)	147 (35.0)	647 (31.6)
60–69 years	13 (25.0)	69 (16.4)	341 (16.7)
≥70 years	6 (11.5)	15 (3.6)	77 (3.8)
Sex, n (%)
Male	30 (57.7)	296 (70.5)	1061 (51.9)
Female	22 (42.3)	124 (29.5)	985 (48.1)
Height, mean (SD), cm	162.1 (9.3)	163.8 (8.3)	162.1 (9.0)
Weight, mean (SD), kg	63.2 (12.8)	68.8 (15.7)	63.4 (13.0)
Smoking history, n (%)
Not reported	0	0	1 (0.1)
Never	15 (28.9)	178 (42.4)	944 (46.1)
Past	13 (25.0)	109 (26.0)	634 (31.0)
Current	24 (46.2)	133 (31.7)	467 (22.8)
Pack years, n (%)
0 (never smoked)	15 (28.9)	178 (42.4)	944 (46.1)
<10	3 (5.8)	41 (9.8)	391 (19.1)
≥10	34 (65.4)	201 (47.9)	710 (34.7)
CMH^‡, n (%)	2 (3.9)	10 (2.4)	33 (1.6)
Medical history, n (%)
Asthma	23 (44.2)	73 (17.4)	214 (10.5)
Stroke	2 (3.9)	13 (3.1)	21 (1.0)
Heart disease	3 (5.8)	18 (4.3)	50 (2.4)
Chronic renal failure	0	1 (0.2)	8 (0.4)
Anemia	6 (11.5)	34 (8.1)	296 (14.5)
Lung function, mean (SD)
FEV1 (L)	1.88 (0.53)	2.24 (0.50)	2.72 (0.65)
FVC (L)	2.89 (0.80)	2.78 (0.65)	3.24 (0.78)
FEV1/FVC	0.65 (0.05)	0.81 (0.06)	0.84 (0.05)
FEV1% predicted	66.9 (14.0)	73.1 (6.2)	94.8 (9.5)

Notes: *AL was defined as FEV₁/FVC <0.7; ^†PRISm was defined as FEV₁/FVC ≥0.7 and FEV₁ <80% predicted; ^‡CMH was defined as chronic cough with production of phlegm for at least 3 months in 2 successive years.

Abbreviations: AL, airflow limitation; CMH, chronic mucus hypersecretion; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; PRISm, Preserved Ratio Impaired Spirometry; SD, standard deviation.

Table 2 Prevalence of PRISm Among Participants 40–49 Years of Age by Smoking History

	History of Smoking
	Not Reported	Never	Past	Current	All
Age 40–49 years, n (%)	1 (0.1)	531 (44.5)	317 (26.5)	345 (28.9)	1194 (100)
Age 40–49 years with PRISm*, n (%)	0	92 (48.7)	32 (16.9)	65 (34.4)	189 (100)
Age 40–49 years, percentage of PRISm* by smoking history	0	17.3	10.1	18.8	15.8

Note: *PRISm was defined as FEV₁/FVC ≥0.7 and FEV₁ <80% predicted.

Abbreviations: FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; PRISm, Preserved Ratio Impaired Spirometry.

Figure 1 Metabolic comorbidities in participant subgroups.

Notes: *p<0.05 for comparison against PRISm group. Airflow limitation was defined as FEV₁/FVC <0.7; PRISm was defined as FEV₁/FVC ≥0.7 and FEV₁ <80% predicted.

Abbreviations: BMI, body mass index; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; PRISm, Preserved Ratio Impaired Spirometry.

Table 3 Characteristics of Participants According to Smoking History*

	History of Smoking
	Never (N=1137)	Past (N=756)	Current (N=624)
Age, mean (SD), years	52.5 (9.4)	52.8 (8.9)	49.9 (7.2)
Age categories, n (%)
40–49 years	531 (46.7)	317 (41.9)	345 (55.3)
50–59 years	338 (29.7)	253 (33.5)	212 (34.0)
60–69 years	207 (18.2)	152 (20.1)	64 (10.3)
≥70 years	61 (5.4)	34 (4.5)	3 (0.5)
Sex, n (%)
Male	402 (35.4)	509 (67.3)	476 (76.3)
Female	735 (64.6)	247 (32.7)	148 (23.7)
Height, mean (SD), cm	159.3 (8.8)	164.0 (8.0)	166.1 (8.1)
Weight, mean (SD), kg	61.6 (14.2)	66.2 (12.2)	67.2 (13.4)
BMI, mean (SD), kg/m^2	24.1 (4.4)	24.5 (3.7)	24.3 (4.1)
Pack years, mean (SD)	–	13.9 (14.3)	23.0 (14.2)
Pack years, n (%)
≥10	–	403 (53.3)	542 (87.0)
<10	–	353 (46.7)	81 (13.0)
CAAT total score, mean (SD)	4.3 (4.4)	4.5 (4.3)	5.7 (4.8)
CAPTURE total score, mean (SD)	0.8 (1.1)	0.8 (1.1)	0.8 (1.1)
COPD-Q total score, mean (SD)	1.2 (1.0)	2.6 (1.3)	2.7 (1.3)
PROMIS total score, mean (SD)	19.8 (0.9)	19.9 (0.7)	19.8 (0.6)
AL^†, n (%)	15 (1.3)	13 (1.7)	24 (3.9)
PRISm^‡, n (%)	178 (15.7)	109 (14.4)	133 (21.3)
No AL/PRISm, n (%)	944 (83.0)	634 (83.9)	467 (74.8)
History of:
COPD, n (%)	1 (0.1)	1 (0.1)	0
CB, n (%)	30 (2.6)	23 (3.0)	16 (2.6)
PE, n (%)	3 (0.3)	2 (0.3)	5 (0.8)
Asthma, n (%)	140 (12.3)	90 (11.9)	80 (12.8)
Other respiratory disease, n (%)	26 (2.3)	26 (3.4)	18 (2.9)
Stroke, n (%)	13 (1.1)	9 (1.2)	14 (2.2)
Heart disease, n (%)	29 (2.6)	32 (4.2)	10 (1.6)
CKD, n (%)	4 (0.4)	3 (0.4)	2 (0.3)
Anemia, n (%)	185 (16.3)	91 (12.0)	60 (9.6)
Airflow limitation at:
GOLD Stage 2	10 (0.9)	9 (1.2)	22 (3.5)
GOLD Stage 3	1 (0.1)	3 (0.4)	1 (0.2)
Current treatment for:
COPD/CB/PE, n (%)	3 (0.3)	1 (0.1)	2 (0.3)
Bronchodilators, n (%)	2 (0.2)	0	0
Hypertension, n (%)	205 (18.0)	161 (21.3)	82 (13.1)
Diabetes, n (%)	48 (4.2)	30 (4.0)	34 (5.5)
Hyperlipidemia, n (%)	109 (9.6)	74 (9.8)	43 (6.9)

Notes: *One female participant did not report smoking history and was therefore not included in this analysis; ^†AL was defined as FEV₁/FVC <0.7; ^‡PRISm was defined as FEV₁/FVC ≥0.7 and FEV₁ <80% predicted.

Abbreviations: AL, airflow limitation; BMI, body mass index; CAAT, Chronic Airways Assessment Test; CAPTURE, Chronic Airways Assessment Test; CB, chronic bronchitis; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; COPD-Q, COPD screening questionnaire; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; GOLD, Global Initiative for Chronic Obstructive Lung Disease; PE, pulmonary embolism; No-AL/PRISm, without AL or PRISm; PRISm, Preserved Ratio Impaired Spirometry; PROMIS, Patient-Reported Outcomes Measurement Information System; SD, standard deviation.