Evaluation of Clinical Characteristics and Lung Function Trajectories in Young COPD Patients Within the General Population

초록

Purpose: Young chronic obstructive pulmonary disease (COPD), distinct from COPD in older individuals, often remains under-diagnosed despite its potential for early interventions. This study aimed to identify the characteristics of young COPD patients and the patterns of lung function trajectory. Patients and Methods: This study was based on a large community-based cohort database in Korea. Young COPD was defined as COPD diagnosed in patients aged <= 50 years. We analyzed the clinical characteristics and lung function changes over 12 years, comparing young and old COPD patients. Results: Among the 9,577 patients enrolled in this study, 815 (8.5%) were diagnosed with COPD. The young COPD group had a higher proportion of females, never-smokers and a higher body mass index (BMI), compared to the older COPD group. The prevalence of young COPD increased from 117 (3.64%) to 334 (6.88%) according to the lower limit of normal (LLN) criteria. Analysis of lung function over 12 years revealed that the rate of decline in FEV1 (L), FEF25-75% (L), and FEV1/FVC ratio was slower in young COPD than in old COPD. Multivariate Cox analysis identified female sex, higher FEV1 (%), and young COPD as independent predictive factors for time-to-first normalization of airflow obstruction. Old COPD and low FEV1 (%) were identified as independent risk factors for time-to-first dyspnea. Conclusion: Young COPD is characterized by a higher proportion of females, non-smokers, and elevated BMI compared to old COPD. It has potential for lung function recovery and serves as an independent prognostic factor for the normalization of airflow obstruction.

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