Contribution of peripheral airways dysfunction to poor quality of life in sarcoidosis
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background
Sarcoidosis is characterized by reduced quality of life (QoL), yet QoL is correlated poorly to conventional spirometric lung function tests.
Research Question
What is the relationship of a QoL measure with comprehensive lung function assessment using oscillometry in sarcoidosis?
Study Design and Methods
Sixty-two patients with pulmonary sarcoidosis completed the St. George’s Respiratory Questionnaire (SGRQ), a respiratory QoL measure, and underwent lung function assessment including oscillometry, spirometry, diffusion capacity, fractional exhaled nitric oxide (Feno), and body plethysmography. Relationships of lung function parameters with SGRQ results were determined with Spearman rank coefficient (ρ), and receiver operating characteristic curves were plotted. Logistic regression and hierarchy cluster analysis of parameters from multiple lung function techniques were performed.
Results
Oscillometric indices describing peripheral lung dysfunction showed significant associations with SGRQ score (resistance at 5 Hz [R5], ρ = 0.43 [P < .01]; R5 minus resistance at 20 Hz [R20], ρ = 0.35 [P < .01]; reactance at 5 Hz [X5], ρ = –0.42 [P < .01]; reactance area under the curve [Ax], ρ = 0.44 [P < .01]), whereas FVC % predicted and residual volume to total lung capacity ratio, were related weakly to SGRQ score (ρ = –0.30 [P = .02] and ρ = 0.30 [P = .02], respectively). Oscillometry reactance, measuring elastic properties of the lung, predicted an impaired QoL (area under the receiver operating characteristic curve: Ax, 0.80 [P < .001] and X5, 0.78 [P < .001]), even in patients with absence of an obstructive or restrictive spirometry pattern. Ax remained associated significantly with SGRQ score even after adjustment for FVC and Scadding stage on multivariable analysis (P = .005). Feno was not associated with SGRQ score. Peripheral airway function parameters (R5 minus R20, Ax, and residual volume to total lung capacity ratio) were grouped in an independent cluster, whereas X5 constituted a single cluster.
Interpretation
Our results indicate that oscillometric lung function parameters, especially those of peripheral airway dysfunction, are correlated more strongly to a QoL measure than spirometry in patients with sarcoidosis.
Sarcoidosis is characterized by reduced quality of life (QoL), yet QoL is correlated poorly to conventional spirometric lung function tests.
Research Question
What is the relationship of a QoL measure with comprehensive lung function assessment using oscillometry in sarcoidosis?
Study Design and Methods
Sixty-two patients with pulmonary sarcoidosis completed the St. George’s Respiratory Questionnaire (SGRQ), a respiratory QoL measure, and underwent lung function assessment including oscillometry, spirometry, diffusion capacity, fractional exhaled nitric oxide (Feno), and body plethysmography. Relationships of lung function parameters with SGRQ results were determined with Spearman rank coefficient (ρ), and receiver operating characteristic curves were plotted. Logistic regression and hierarchy cluster analysis of parameters from multiple lung function techniques were performed.
Results
Oscillometric indices describing peripheral lung dysfunction showed significant associations with SGRQ score (resistance at 5 Hz [R5], ρ = 0.43 [P < .01]; R5 minus resistance at 20 Hz [R20], ρ = 0.35 [P < .01]; reactance at 5 Hz [X5], ρ = –0.42 [P < .01]; reactance area under the curve [Ax], ρ = 0.44 [P < .01]), whereas FVC % predicted and residual volume to total lung capacity ratio, were related weakly to SGRQ score (ρ = –0.30 [P = .02] and ρ = 0.30 [P = .02], respectively). Oscillometry reactance, measuring elastic properties of the lung, predicted an impaired QoL (area under the receiver operating characteristic curve: Ax, 0.80 [P < .001] and X5, 0.78 [P < .001]), even in patients with absence of an obstructive or restrictive spirometry pattern. Ax remained associated significantly with SGRQ score even after adjustment for FVC and Scadding stage on multivariable analysis (P = .005). Feno was not associated with SGRQ score. Peripheral airway function parameters (R5 minus R20, Ax, and residual volume to total lung capacity ratio) were grouped in an independent cluster, whereas X5 constituted a single cluster.
Interpretation
Our results indicate that oscillometric lung function parameters, especially those of peripheral airway dysfunction, are correlated more strongly to a QoL measure than spirometry in patients with sarcoidosis.
Date Issued
2025-08-01
Date Acceptance
2025-03-01
Citation
CHEST, 2025, 168 (2), pp.423-434
ISSN
0012-3692
Publisher
Elsevier BV
Start Page
423
End Page
434
Journal / Book Title
CHEST
Volume
168
Issue
2
Copyright Statement
© 2025 The Author(s). Published by Elsevier Inc under license from the American College of Chest Physicians. This is an open access article under the CC BY license (http://creativecommons.org/ licenses/by/4.0/).
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/40081657
PII: S0012-3692(25)00286-7
Subjects
exhaled nitric oxide
lung function
oscillometry
peripheral airways
quality of life
sarcoidosis
Humans
Quality of Life
Male
Female
Middle Aged
Sarcoidosis, Pulmonary
Adult
Spirometry
Respiratory Function Tests
Surveys and Questionnaires
ROC Curve
Oscillometry
Plethysmography, Whole Body
Lung
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2025-03-11