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Isolated, reduced diffusing capacity for carbon monoxide in the population - relations to symptoms, smoking and comorbidities.

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Τίτλος: Isolated, reduced diffusing capacity for carbon monoxide in the population - relations to symptoms, smoking and comorbidities.
Συγγραφείς: Hamrefors V; Department of Clinical Sciences, Clinical Research Centre, Lund University and Department of Internal Medicine, Skåne University Hospital, Box 50332, Malmö, 202 13, Sweden. viktor.hamrefors@med.lu.se., Westerbergh J; Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden., Behndig A; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden., Blomberg A; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden., Brandberg J; Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.; Department of Radiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden., Carlén A; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.; Department of Clinical Physiology in Linköping, Region Östergötland, Linköping, Sweden., Egesten A; Respiratory Medicine, Allergology, and Palliative Medicine, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden., Ekbom E; Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden., Emilsson ÖI; Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.; Faculty of Medicine, Reykjavik and Department of Respiratory Medicine, University of Iceland, Landspitali University Hospital, Reykjavik, Iceland., Eriksson MJ; Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.; Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden., Frølich A; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden., Grote L; Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden., Janson C; Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden., Karimi R; Division of Immunology and Respiratory Medicine, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.; Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden., Moberg A; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden., Persson HL; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.; Department of Respiratory Medicine in Linköping, Linköping University, Linköping, Sweden., Pesonen I; Division of Immunology and Respiratory Medicine, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.; Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden., Sköld M; Division of Immunology and Respiratory Medicine, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.; Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden., Sörensen K; Department of Diagnostics and Intervention, Umeå University, Umeå, Sweden., Tanash H; Department of Medicine, Skåne University Hospital, Lund University, Lund, Sweden., Torén K; Section of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden., Vanfleteren L; Department of Internal Medicine and Clinical Nutrition, COPD Center, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden., Wollmer P; Department of Translational Medicine, Lund University, Malmö, Sweden., Malinovschi A; Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden.
Πηγή: BMC pulmonary medicine [BMC Pulm Med] 2026 Aug 31; Vol. 26 (1). Date of Electronic Publication: 2026 Aug 31.
Τύπος έκδοσης: Journal Article; Multicenter Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: BioMed Central Country of Publication: England NLM ID: 100968563 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2466 (Electronic) Linking ISSN: 14712466 NLM ISO Abbreviation: BMC Pulm Med Subsets: MEDLINE
Imprint Name(s): Original Publication: London : BioMed Central, [2001]-
Ιατρικοί όροι (MeSH): Smoking*/epidemiology , Smoking*/physiopathology , Carbon Monoxide*/metabolism , Pulmonary Emphysema*/epidemiology , Pulmonary Emphysema*/physiopathology , Lung Diseases, Interstitial*/epidemiology , Lung Diseases, Interstitial*/physiopathology , Pulmonary Diffusing Capacity*, Sweden/epidemiology ; Chest Pain/epidemiology ; Humans ; Middle Aged ; Male ; Female ; Spirometry ; Forced Expiratory Volume ; Comorbidity ; Vital Capacity ; Tomography, X-Ray Computed ; Multivariate Analysis
Περίληψη: Background: Diffusing capacity for carbon monoxide (DLCO) is a measure of gas exchange in the lungs. Reduced DLCO with normal spirometry is a common finding that is incompletely understood.
Aim: To assess determinants of isolated, reduced DLCO in an unselected population.
Methods: The Swedish CArdioPulmonary bioImage Study (SCAPIS) is a multicentre population-based study of adults aged 50-64 years. The 5th percentile of DLCO in healthy never smokers was used as the lower limit of normal (LLN). Using multivariable analysis, we studied factors associated with DLCO < LLN in 24 261 subjects with normal spirometry, defined as FEV1, FVC and FEV1/FVC > LLN. Emphysema and interstitial lung abnormalities (ILA) were assessed through computed tomography, physical activity through accelerometry and other factors through questionnaires.
Results: Isolated DLCO < LLN (n = 1 472) was independently associated with emphysema (odds ratio and 95% confidence interval: 2.6 (2.2, 3.2)), lung disease other than asthma or COPD (1.8 (1.2, 2.8)), exertional chest pain (1.6 (1.3, 2.1)), smoking (per-10-pack-years) (1.6 (1.4, 1.9)), ILA (1.4 (1.2, 1.7)), breathing problems (1.4 (1.1, 1.8)), male sex (1.3 (1.1, 1.6)) and coughing (1.2 (1.1, 1.5)). DLCO < LLN was less likely if subjects were older, had asthma or had higher BMI, haemoglobin, FVC or physical activity.
Conclusion: Isolated, reduced DLCO in a large middle-aged population cohort is associated with numerous previously known factors, including emphysema, ILA, smoking and self-reported lung disease. However, several symptoms, including exertional chest pain, breathing problems and coughing, are also independently associated with isolated reduced DLCO.
(© 2026. The Author(s).)
Competing Interests: Declarations. Ethics approval and consent to participate: The ethical review board in Umeå approved SCAPIS as a multicentre study (Dnr 2010–228-31 M), with subsequent approval of analysis of pulmonary function (Dnr 2017/14–31). The study adhered to the Declaration of Helsinki and all participants provided written informed consent. Consent for publication: Not applicable. Competing interests: JB reports leadership position within the Swedish Society of Radiology, and stocks in AstraZeneca and Novo Nordisk. AE reports consulting fees from Arcede Pharma and BioCyst. ÖIE reports honoraria for lectures from MSD, AstraZeneca and Boehringer Ingelheim, payment for expert testimony from MSD, and participation on advisory boards for MSD, AstraZeneca and Boehringer Ingelheim, not related to this manuscript. LG reports shared ownership of a patent on pharmacological therapy in sleep apnea licensed to Desitin GMBH, payment for participation in speakers bureau from Lundbeck, Resmed and AstraZeneca, payment for participation on advisory board for Onera, as well as being Chair of the Swedish Sleep Apnea Registry (SESAR), the national working group on sleep apnea in adults and the ERS-CRC for the European Sleep Apnea Database (ESADA). VH reports support for this manuscript from the Swedish Heart Lung Foundation, Skåne University Hospital Funds, and the governmental funding of clinical research within the Swedish National Health Service. HLP reports consulting fees from the Swedish Medical Products Agency, personal payments for lectures and presentations from AstraZeneca AB, and personal payments from GlaxoSmithKline AB for participation on advisory boards. IP reports consulting fees and payment for lectures from Boehringer Ingelheim. LEGW reports grants from the Swedish Heart Lung Foundation, the Kamprad foundation, Vinnova, AstraZeneca and the Swedish Government and county council (ALF grant ALFGBG-824371), payment for lectures from AstraZeneca, Chiesi, Grifols, GSK, Pulmonx, and Novartis, support for meeting attendance from Menarin Foundation, and participation on advisory board for AstraZeneca. The rest of the authors declare no conflicts of interest relating to this manuscript.
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Contributed Indexing: Keywords: Diffusion capacity for carbon monoxide; Emphysema; General population; Lung function; Smoking
Substance Nomenclature: 7U1EE4V452 (Carbon Monoxide)
Entry Date(s): Date Created: 20260901 Date Completed: 20260901 Latest Revision: 20260908
Update Code: 20260908
PubMed Central ID: PMC13531966
DOI: 10.1186/s12890-026-04662-9
PMID: 42675482
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1471-2466
DOI:10.1186/s12890-026-04662-9