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26th March 2024
Lung function trajectories can be used to predict health status later in life and support personalised treatment, according to researchers in Sweden who have developed an innovative digital tool to monitor lung function over time.
The Lung Function Tracker tool, similar to paediatric height and weight charts used all over the world to monitor children’s growth, can track lung health status throughout life in both children and adults.
The findings, published in The Lancet, highlight how the tracker tool could be implemented in clinical practice and allow for early detection, prompt interventions and optimised management of lung conditions.
Chronic lung diseases are often undetected, under-reported, and untreated despite being recognised as priority non-communicable diseases.
What’s more, different lung function trajectories are associated with different health outcomes. The trajectories most commonly identified in both males and females include average, below average, above average, or accelerated decline. Below average trajectories are associated with respiratory, cardiovascular, metabolic and mental health comorbidities, as well as premature death.
Researchers at Sweden’s Karolinska Institutet, the University of Barcelona, Spain, Imperial College London, UK, and the University of Melbourne, Australia, developed the Lung Function Tracker after analysing data from over 4,000 children who were part of the BAMSE project. This is a longitudinal cohort study based in Sweden focusing on childhood asthma and allergy development.
The Lung Function Tracker is a web-based tool into which clinicians enter lung function measurements. These are calculated using a regular spirometry machine, along with personal data, such as gender and age, and a graph showing the person’s lung function in relation to the expected values is produced.
The tool is free to use and is intended primarily for healthcare professionals and patients who need to check their lung function over time as part of their self-care.
The researchers proposed that in an era of personalised healthcare, the tool would be a simple way to protect and improve lung health at the population level and promote healthy growth and ageing.
As spirometry is low-resource, affordable, well-standardised and non-invasive, it has the potential to be used globally to monitor lung health effectively, they added.
Professor Erik Melén, professor of paediatric medicine at the Department of Clinical Research and Education, Södersjukhuset, Karolinska Institutet, and the paper’s first author, said: ‘Lung diseases and the disease burden they cause aren’t taken as seriously as they ought to be. The symptoms are often severe, and there’s also the risk of secondary problems like cardiovascular disease and reduced life expectancy.
‘By catching abnormal levels in someone’s lung function early, doctors will be able to give personalised treatment to stop things getting worse.’
The researchers hope that the tool will help to increase knowledge and raise awareness of common chronic lung diseases, such as asthma and COPD. They are also ‘planning to gather together experts from around the world to look into the possibility of introducing lung function check-ups at a population level’.
Professor Melén added: ‘There’s a great demand for a tool that can catch patients in the risk zone before they develop a chronic condition. Such a check of lung function development as this, is not only simple and quick, it’s also relatively cheap. Our vision of the tool being used globally requires wide acceptance and engagement, and I feel we have this.’
Efforts to improve the personalisation of patient care have been increasing across Europe in recent months, such as a new project aiming to use artificial intelligence and genomics data to personalise therapies for patients with cardiovascular disease.
14th August 2023
Patients who have low vitamin K levels have a reduced ventilatory capacity and are more likely to self-report asthma, COPD or wheezing, according to a study by researchers from Copenhagen University Hospital and the University of Copenhagen.
The study, which was published in the journal ERJ Open Research, set out to assess whether lower vitamin K status was associated with lung function and lung disease/symptoms. The researchers focused on the measurement of dephosphorylated-uncarboxylated MGP (dp-ucMGP), which serves as an inverse plasma biomarker for vitamin K status.
The team recruited members of the general population and invited them to a health examination to complete questionnaires and undergo spirometry, together with measurement of plasma dp-ucMGP. Lung function assessments were the forced expiratory volume during the first second (FEV1) and forced vital capacity (FVC). FEV1/FVC-ratio was calculated as the ratio between these two measurements.
In the questionnaires, researchers asked participants whether they had ever been diagnosed with either asthma or COPD, or whether they had experienced wheezing during the last 12 months. They then used multivariable logistic regression to assess the associations between dp-ucMGP and the dichotomous variables, COPD, asthma and wheezing.
A total of 4,092 individuals aged 24-77 years were included in the analysis.
Lower vitamin K status, reflected by higher dp-ucMGP levels, was associated with lower FEV1 and FVC. However, dp-ucMGP was not associated with the FEV1/FVC-ratio. A lower status was significantly associated with COPD (Odds ratio, OR = 2.24, 95% CI 1.53 – 3.27), wheezing (OR = 1.81 95% CI 1.44 – 2.28) and asthma (OR = 1.44 95% CI 1.12 – 1.83).
Lead author of the study, Dr Torkil Jespersen, said: ‘We already know that vitamin K has an important role in the blood, and research is beginning to show that it’s also important in heart and bone health, but there’s been very little research looking at vitamin K and the lungs.
‘To our knowledge, this is the first study on vitamin K and lung function in a large general population. Our results suggest that [it] could play a part in keeping our lungs healthy.‘
The vitamin is found in leafy green vegetables, vegetable oils and cereal grains. It plays a role in blood clotting, although, clinically, vitamin K antagonists are used as anticoagulants to control bleeding.