Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas.
Department of Medicine, Baylor College of Medicine, Houston, Texas.
Clin Genet. 2018 Dec;94(6):502-511. doi: 10.1111/cge.13440. Epub 2018 Sep 24.
Pulmonary complications are a significant cause for morbidity and mortality in osteogenesis imperfecta (OI). However, to date, there have been few studies that have systematically evaluated pulmonary function in individuals with OI. We analyzed spirometry measurements, including forced vital capacity (FVC) and forced expiratory volume in the first second (FEV ), in a large cohort of individuals with OI (n = 217) enrolled in a multicenter, observational study. We show that individuals with the more severe form of the disease, OI type III, have significantly reduced FVC and FEV which do not follow the expected trends of the normal population. We also show that "normalization" of FVC and FEV using general population data to generate percent predicted values underestimates the pulmonary involvement in OI. Within each subtype of OI, we used linear mixed models to find potential correlations between FEV and FVC with the clinical variables including mobility, bisphosphonate use, and scoliosis. Our results are an important step in understanding the extent of pulmonary involvement in individuals with OI and for developing pulmonary endpoints for use in the routine patient care as well as in the investigation of new therapies.
肺部并发症是成骨不全症(OI)发病率和死亡率的重要原因。然而,迄今为止,很少有研究系统地评估 OI 患者的肺功能。我们分析了在一项多中心观察性研究中招募的 217 名 OI 患者的大量肺活量测定(包括用力肺活量 [FVC] 和第一秒用力呼气量 [FEV])的测量值。我们表明,疾病更严重的 III 型 OI 患者的 FVC 和 FEV 明显降低,这些指标不符合正常人群的预期趋势。我们还表明,使用一般人群数据对 FVC 和 FEV 进行“归一化”以生成预计百分比值会低估 OI 的肺部受累程度。在 OI 的每种亚型内,我们使用线性混合模型发现 FEV 和 FVC 与包括活动能力、双膦酸盐使用和脊柱侧凸在内的临床变量之间的潜在相关性。我们的研究结果是了解 OI 患者肺部受累程度的重要一步,也是为常规患者护理以及新疗法的研究开发肺部终点的重要一步。
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