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Cited by 147

The DOI matches its Crossref record; 6 of the 6 references it cites were found in a registry or an index.

Clinical and Radiographic Predictors of GOLD–Unclassified Smokers in the COPDGene Study

Wan, Emily S., Hokanson, John E., Murphy, James R., Regan, Elizabeth A., Make, Barry J., Lynch, David A., Crapo, James D., Silverman, Edwin K.·2011·American Journal of Respiratory and Critical Care Medicine
DOI 10.1164/rccm.201101-0021oc
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Abstract

Rationale: A significant proportion of smokers have lung function impairment characterized by a reduced FEV1 with a preserved FEV1/FVC ratio. These smokers are a poorly characterized group due to their systematic exclusion from chronic obstructive pulmonary disease (COPD) studies. Objectives: To characterize the clinical, functional, and radiographic features of Global Initiative for Chronic Obstructive Lung Disease (GOLD)-Unclassified (FEV1/FVC ≥ 0.7 and FEV1 < 80% predicted) and lower limits of normal (LLN)-unclassified (FEV1/FVC ≥ LLN and FEV1 < LLN) subjects compared to smokers with normal lung function and subjects with COPD. Methods: Data from the first 2,500 subjects enrolled in the COPDGene study were analyzed. All subjects had 10 or more pack-years of smoking and were between the ages of 45 and 80 years. Multivariate regression models were constructed to determine the clinical and radiological variables associated with GOLD-Unclassified (GOLD-U) and LLN-Unclassified status. Separate multivariate regressions were performed in the subgroups of subjects with complete radiologic measurement variables available. Measurements and Main Results: GOLD-U smokers account for 9% of smokers in COPDGene and have increased body mass index (BMI), a disproportionately reduced total lung capacity, and a higher proportion of nonwhite subjects and subjects with diabetes. GOLD-U subjects exhibit increased airway wall thickness compared to smoking control subjects and decreased gas trapping and bronchodilator responsiveness compared to subjects with COPD. When LLN criteria were used to define the “unclassified” group, African American subjects were no longer overrepresented. Both GOLD-U and LLN-Unclassified subjects demonstrated a wide range of lung function impairment, BMI, and percentage of total lung emphysema. Conclusions: Subjects with reduced FEV1 and a preserved FEV1/FVC ratio are a heterogeneous group with significant symptoms and functional limitation who likely have a variety of underlying etiologies beyond increased BMI. Clinical trial registered with www.clinicaltrials.gov (NCT000608764).

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Metadata

Authors
Wan, E. S., Hokanson, J. E., Murphy, J. R., Regan, E. A., Make, B. J., Lynch, D. A., Crapo, J. D., & Silverman, E. K.
Venue
American Journal of Respiratory and Critical Care Medicine
Publisher
Oxford University Press (OUP)
Published
2011-07-01
Volume
184
Issue
1
Pages
57-63
ISSN
  • 1073-449X
  • 1535-4970
DOI
10.1164/rccm.201101-0021oc
Cited by
147
References
6
Language
en
Licence
academic.oup.com/pages/standard-publication-reuse-rights (vor)

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CoChat. (2026). Citation check: Clinical and Radiographic Predictors of GOLD–Unclassified Smokers in the COPDGene Study. https://app.cochat.ai/papers/10.1164/rccm.201101-0021oc
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Wan, E. S., Hokanson, J. E., Murphy, J. R., Regan, E. A., Make, B. J., Lynch, D. A., Crapo, J. D., & Silverman, E. K. (2011). Clinical and Radiographic Predictors of GOLD–Unclassified Smokers in the COPDGene Study. American Journal of Respiratory and Critical Care Medicine. https://doi.org/10.1164/rccm.201101-0021oc

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