Chami Hassan A, Houjeij Nourhan, Makki Maha, Itani Lina, Tamim Hani, Al Mulla Ahmad, Celli Bartolome, Zeineldine Salah
School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America, Beirut, Lebanon.
Department of Medicine and Clinical Research Institute, American University of Beirut, Beirut, Lebanon.
Ann Thorac Med. 2023 Jan-Mar;18(1):23-30. doi: 10.4103/atm.atm_165_22. Epub 2023 Jan 25.
Waterpipe smoking is increasing in popularity, yet the evidence implicating waterpipe smoking in lung disease is limited. We hypothesized that impulse oscillometry (IOS) would detect airway abnormalities in waterpipe smokers (WPS).
We studied 210 participants, 40 years or older, from the community, of whom 92 were exclusive WPS and 118 were never-smokers. Waterpipe smoking history was assessed using a validated questionnaire. All participants underwent spirometry, and IOS and absolute and percentage predicted results (for age, sex, height, and weight) were compared between WPS and nonsmokers. The association of IOS parameters with waterpipe smoking duration and extent (waterpipe smoked/day * smoking duration) was evaluated using linear regression.
WPS smoked on average 1.8 ± 1.2 waterpipes/day, over an average duration of 23.3 ± 39.8 years. WPS and nonsmokers were largely asymptomatic and had similar age, body mass index, sex distribution, and spirometric values. Nevertheless, WPS had higher IOS measured resistance at 5Hz compared to nonsmokers, (0.53 ± 0.2 vs. 0.48 ± 0.2 kPa/L/s, = 0.03) and higher percentage-predicted resistance (124.5 ± 36.3 vs. 115.7% ± 35.6%, = 0.04). Waterpipe smoking duration was also associated with resistance (β = 0.04 kPa/L/s/year, = 0.01) and with percentage-predicted resistance (β = 0.05/year, = 0.02). Waterpipe smoking extent was associated with resistance (β = 0.009 kPa/L/s/waterpipe-year, = 0.04), while the association with percentage-predicted resistance was near significance (β = 0.009/waterpipe-year, = 0.07).
Waterpipe smoking is associated with increased airway resistance assessed by IOS but not by spirometry in largely asymptomatic individuals from the community.
水烟吸食正日益流行，但将水烟吸食与肺部疾病联系起来的证据有限。我们假设脉冲振荡法（IOS）能检测出水烟吸食者（WPS）的气道异常情况。
我们研究了来自社区的210名40岁及以上的参与者，其中92名是单纯水烟吸食者，118名从不吸烟。使用经过验证的问卷评估水烟吸食史。所有参与者均接受了肺活量测定，并比较了水烟吸食者和非吸烟者之间IOS以及绝对和预测百分比结果（根据年龄、性别、身高和体重）。使用线性回归评估IOS参数与水烟吸食持续时间和程度（每天吸食水烟数×吸食持续时间）之间的关联。
水烟吸食者平均每天吸食1.8±1.2次水烟，平均持续时间为23.3±39.8年。水烟吸食者和非吸烟者大多无症状，且在年龄、体重指数、性别分布和肺活量测定值方面相似。然而，与非吸烟者相比，水烟吸食者在5Hz时的IOS测量阻力更高（0.53±0.2 vs. 0.48±0.2 kPa/L/s，P = 0.03），预测阻力百分比也更高（124.5±36.3 vs. 115.7%±35.6%，P = 0.04）。水烟吸食持续时间也与阻力相关（β = 0.04 kPa/L/s/年，P = 0.01）以及与预测阻力百分比相关（β = 0.05/年，P = 0.02）。水烟吸食程度与阻力相关（β = 0.009 kPa/L/s/水烟 - 年，P = 0.04），而与预测阻力百分比的关联接近显著（β = 0.009/水烟 - 年，P = 0.07）。
在社区中大多无症状的个体中，水烟吸食与通过IOS评估的气道阻力增加有关，但与肺活量测定无关。
