{
  "abstract": "Purpose\n\nTo compare short-term transitions among four pre-bronchodilator spirometric states, assess subsequent airflow obstruction risk by baseline state and the distribution of these states among observed events, and examine the association between repeated isolated spirometry-defined small-airway dysfunction (sSAD) and subsequent airflow obstruction.Patients and methods\n\nWe analyzed spirometry data from three Chinese community cohorts (2019-2023). Modified Poisson regression assessed subsequent pre-bronchodilator airflow obstruction (AFO) by baseline state. Logistic models additionally adjusted for baseline FEV₁/FVC. Repeated isolated sSAD was examined using bias-reduced logistic models before and after adjustment for prior FEV₁/FVC values.Results\n\nAmong 13,220 participants, 74.1% retained their baseline state. Among 11,551 without baseline AFO, follow-up AFO proportions were 0.61%, 8.11% and 18.60% for preserved spirometry, isolated sSAD and preserved ratio impaired spirometry (PRISm), respectively. In logistic models, additional baseline FEV₁/FVC adjustment reduced standardized risk ratios from 12.44 to 2.33 (95% CI 1.58-3.44) for isolated sSAD and from 26.75 to 4.32 (2.69-6.92) for PRISm. Baseline isolated sSAD accounted for 392 of 492 AFO events (79.7%). Among 3947 participants with preserved spirometry or isolated sSAD at both initial examinations, the OR for two versus no isolated-sSAD detections decreased from 34.49 (12.02-99.00) to 1.99 (0.63-6.31; P=0.242) after adjustment for both prior FEV₁/FVC values.Conclusion\n\nPRISm was associated with the highest subsequent pre-bronchodilator AFO risk, whereas most events occurred in participants with baseline isolated sSAD. Associations were attenuated but persisted after baseline FEV₁/FVC adjustment. The repeated-sSAD association was attenuated and no longer statistically significant after adjustment for both prior ratios.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pulmonary and Critical Care Medicine, West China Hospital, State Key Laboratory of Respiratory Health and Multimorbidity, Sichuan University, Chengdu, Sichuan, People's Republic of China.",
    "Institute of Respiratory Health, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.",
    "Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.",
    "The Research Units of West China, Chinese Academy of Medical Sciences, West China Hospital, Chengdu, Sichuan, People's Republic of China.",
    "Institute of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.",
    "General Office, Cohort Study Center, Institute of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1,
        2,
        3,
        4
      ],
      "name": "Dongyu He"
    },
    {
      "affs": [
        0,
        1,
        2,
        3,
        4
      ],
      "name": "Jiaxuan Wu"
    },
    {
      "affs": [
        0,
        1,
        2,
        3,
        4
      ],
      "name": "Junyi Ke"
    },
    {
      "affs": [
        0
      ],
      "name": "Lan Yang",
      "orcid": "0000-0001-9112-4137"
    },
    {
      "affs": [
        5
      ],
      "name": "Rui Zhang"
    },
    {
      "affs": [
        0,
        1,
        2,
        3,
        4
      ],
      "name": "Weimin Li",
      "orcid": "0000-0001-6685-0161"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5kv2nee0xb87t.bib",
  "cited_by": 0,
  "doi": "10.2147/copd.s655213",
  "fulltext_url": "https://europepmc.org/articles/PMC13693795",
  "id": "5kv2nee0xb87t",
  "issns": [
    "1176-9106",
    "1178-2005"
  ],
  "landing_url": "https://europepmc.org/article/MED/42921268",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Chronic Obstructive Pulmonary Disease (COPD) Research"
    ]
  ],
  "openalex": "W7222869879",
  "pdf_url": "https://europepmc.org/articles/PMC13693795?pdf=render",
  "pmcid": "PMC13693795",
  "pmid": "42921268",
  "published": "2026-10-19",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5kv2nee0xb87t.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:33Z",
      "native_id": "MED:42921268",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42921268"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Chronic Obstructive Pulmonary Disease (COPD) Research",
      "subfield": "general"
    }
  ],
  "title": "Transitions Among Four Spirometric States and Subsequent Pre-Bronchodilator Airflow Obstruction: A Community Cohort Study.",
  "title_text": "Transitions Among Four Spirometric States and Subsequent Pre-Bronchodilator Airflow Obstruction: A Community Cohort Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:33Z",
  "url": "https://research.draconitic.com/paper/5kv2nee0xb87t",
  "venue": "International journal of chronic obstructive pulmonary disease",
  "versions": []
}