Am. J. Respir. Crit. Care Med., Volume 160, Number 6, December 1999, 1883-1887

Predictors of Longitudinal Change in Diffusing Capacity over 8 Years

DUANE L. SHERRILL, PAUL L. ENRIGHT, WALTER T. KALTENBORN, and MICHAEL D. LEBOWITZ

Respiratory Sciences and Arizona Prevention Centers, University of Arizona, Tucson, Arizona

Low single-breath diffusing capacity (DL_CO) values are associated with anatomic emphysema, but the predictors of longitudinal change in DL_CO over many years are unknown. Study subjects were adult participants in the longitudinal Tucson Epidemiology Study of Obstructive Lung Disease who had at least one DL_CO measurement during either of two surveys 8 yr apart (n = 543). Smoking status was determined at each examination (current, former, or never smoker). Quitters were defined as those currently smoking at the baseline DL_CO examination (1982-1983) and self-reported as no longer smoking at the follow-up exam (1990-1991). The longitudinal DL_CO data were analyzed using repeated measures analysis; because of missing observations this was done using a saturated random effects model. The results showed that males had higher levels of DL_CO than females, current smokers had significantly lower levels of DL_CO than never smokers, but there was no difference in their mean slopes over time. Smoking history, assessed using pack-years of smoking, was associated with reduced DL_CO levels, independent of whether current or ex-smokers. Males and females demonstrated equivalent rates of decline in DL_CO that accelerated with increasing age, and mean DL_CO declines were associated with declines in FEV₁ between surveys. Sherrill DL, Enright PL, Kaltenborn WT, Lebowitz MD. Predictors of longitudinal change in diffusing capacity over 8 years.

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