Chest Radiograph-Derived Age Acceleration as an Early Marker of Pulmonary Dysfunction in Middle-Aged Asians.
Authors
Affiliations (3)
Affiliations (3)
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 67 Sejongdaero, Jung-gu, Seoul 04514, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea.
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 67 Sejongdaero, Jung-gu, Seoul 04514, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea. Electronic address: [email protected].
Abstract
Deep learning-derived, chest radiographic (CXR) age may capture subclinical structural changes associated with spirometric impairment. Is CXR-based accelerated aging associated with the prevalence and incidence of preserved ratio impaired spirometry (PRISm) and obstructive lung disease (OLD)? This retrospective study included Korean adults who underwent CXRs and spirometry during regular health check-ups between 2006 and 2019. Participants were categorized into decelerated (<-2.0 years), reference (-2.0 to 1.9 years), or accelerated (≥2.0 years) aging groups according to CXR-Lung-Risk scores relative to chronological age derived from baseline CXRs. Prevalent PRISm (FEV<sub>1</sub> <80% predicted with FEV<sub>1</sub>/FVC ≥0.70) and OLD (FEV<sub>1</sub>/FVC <0.70) were defined based on baseline spirometry and assessed using multivariable multinomial logistic regression. Incident PRISm and OLD were evaluated among participants with normal baseline spirometry using follow-up spirometry data through December 31, 2022, and associations were estimated using multivariable Cox proportional hazards models. Among 231,278 participants (mean age, 50.7±8.8 years; 55.0% men), the prevalence of PRISm and OLD was 2.2% (5,161/231,278) and 4.6% (10,557/231,278), respectively. Compared with those in the reference group, participants with accelerated aging had higher odds of prevalent PRISm (adjusted odds ratio [OR], 1.37; 95% CI [confidence interval]: 1.28-1.46) and OLD (adjusted OR, 1.58; 95% CI: 1.51-1.65). In the longitudinal analysis including 104,158 participants (median follow-up, 4.3 years), accelerated aging was associated with higher risks of incident PRISm (adjusted hazard ratio [HR], 1.37; 95% CI: 1.27-1.48) and OLD (adjusted HR, 1.28; 95% CI: 1.20-1.37). Associations were directionally consistent across subgroups defined by age, sex, smoking status, and body mass index, with most subgroup analyses remaining statistically significant. CXR-derived accelerated aging was associated with both current and future PRISm and OLD. These findings support a potential complementary role for routine CXRs in opportunistic identification of pulmonary dysfunction. N/A.