ArticleTobacco induced diseases2025
Causal association between cigarette smoking and the prevalence of preserved ratio impaired spirometry (PRISm), and the progression risk factors of PRISm: A study based on Mendelian randomization and meta-analysis.
Article in Tobacco induced diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Preserved Ratio Impaired Spirometry in Low- and Middle-Income Countries: An Emerging Cardiopulmonary Phenotype and Cardiovascular Risk-A Narrative Review.Life (Basel, Switzerland) · 2026Review
- High CALLY index is independently associated with lower odds of preserved ratio impaired spirometry (PRISm) and provides incremental predictive value: a retrospective observational study.Frontiers in medicine · 2026Article
- Occupational associations of preserved ratio impaired spirometry (PRISm) in a population-based study.Frontiers in public health · 2026Article
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5 authors.
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Abstract
introductionPreserved ratio impaired spirometry (PRISm) is a new and variable phenotype of spirometry impairment that was first defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) in 2023. The identification of high-risk factors for the progression from PRISm to COPD remains insufficient at present.
methodsMendelian randomization (MR) analysis was conducted using genome-wide association study (GWAS) summary statistics. Genetic instruments for smoking behavior were derived from the GWAS & Sequencing Consortium of Alcohol and Nicotine use (GSCAN) (n=607291), while PRISm case-control data were sourced from the UK Biobank (n=296282). The inverse-variance weighted (IVW) method served as the primary analytical approach, supplemented by heterogeneity assessment, pleiotropy evaluation, and sensitivity analyses. For the meta-analysis, PubMed, Embase, Cochrane Library, and Web of Science were systematically searched from inception to 31 December 2024, to identify relevant studies that followed up on the changes in spirometry among individuals with PRISm or studies that reported the possible factors related to the changes in spirometry among individuals with PRISm. The risk of bias and the quality of the included studies were assessed using the Newcastle-Ottawa Scale (NOS).
resultsThe MR analysis identified 85 SNPs as genetic instruments, revealing a modest causal link between cigarette smoking and PRISm prevalence (IVW: OR=1.01-1.02, p=0.048). The meta-analysis of 14 studies (n=7336 PRISm cases) shows 20.8% (95% CI: 15.6-25.9) progress to COPD at follow-up, with no significant difference by follow-up duration (<5 vs ≥5 years). Persistent PRISm occurs in 41.5% (95% CI: 35.8-47.2), more frequently in long-term follow-up subgroups. Baseline 'chest distress/dyspnea' (OR=3.81; 95% CI: 1.47-9.84) and 'current smoking' (OR=2.18; 95% CI: 1.14-4.15) significantly predict progression, while respiratory symptoms, FEV
conclusionsOur findings suggest a modest causal link between cigarette smoking and PRISm prevalence. The progression of PRISm to COPD within 5 years is approximately 20.8%. Among individuals with PRISm at the first visit, 'chest distress or dyspnea' and 'current smoking' are potential clinical risk factors for the progression of PRISm to COPD.
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