Restricted spirometry and cardiometabolic comorbidities: results from the international population based BOLD study

K. Kulbacka-Ortiz, F.J.J. Triest, F.M.E. Franssen, E.F.M. Wouters, M. Studnicka, W.M. Vollmer, B. Lamprecht, P.G.J. Burney, A.F.S. Amaral, L.E.G.W. Vanfleteren*

*Corresponding author for this work

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Background Whether restricted spirometry, i.e. low Forced Vital Capacity (FVC), predicts chronic cardiometabolic disease is not definitely known. In this international population-based study, we assessed the relationship between restricted spirometry and cardiometabolic comorbidities. Methods A total of 23,623 subjects (47.5% males, 19.0% current smokers, age: 55.1 +/- 10.8 years) from five continents (33 sites in 29 countries) participating in the Burden of Obstructive Lung Disease (BOLD) study were included. Restricted spirometry was defined as post-bronchodilator FVC < 5th percentile of reference values. Self-reports of physician-diagnosed cardiovascular disease (CVD; heart disease or stroke), hypertension, and diabetes were obtained through questionnaires. Results Overall 31.7% of participants had restricted spirometry. However, prevalence of restricted spirometry varied approximately ten-fold, and was lowest (8.5%) in Vancouver (Canada) and highest in Sri Lanka (81.3%). Crude odds ratios for the association with restricted spirometry were 1.60 (95% CI 1.37-1.86) for CVD, 1.53 (95% CI 1.40-1.66) for hypertension, and 1.98 (95% CI 1.71-2.29) for diabetes. After adjustment for age, sex, education, Body Mass Index (BMI) and smoking, the odds ratios were 1.54 (95% CI 1.33-1.79) for CVD, 1.50 (95% CI 1.39-1.63) for hypertension, and 1.86 (95% CI 1.59-2.17) for diabetes. Conclusion In this population-based, international, multi-site study, restricted spirometry associates with cardiometabolic diseases. The magnitude of these associations appears unattenuated when cardiometabolic risk factors are taken into account.
Original languageEnglish
Article number34
Number of pages13
JournalRespiratory Research
Issue number1
Publication statusPublished - 17 Feb 2022


  • Restricted spirometry
  • Lung function impairment
  • Cardiovascular disease
  • Hypertension
  • Diabetes
  • Comorbidity
  • RISK
  • COPD

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