Study on the correlation between diffusion capacity for carbon monoxide and pulmonary ventilation function in elderly patients with chronic obstructive pulmonary disease

doi:10.3877/cma.j.issn.1674-6902.2026.04.017

Abstract

Abstract:

Objective

To analyze the correlation between diffusing capacity for carbon monoxide (DLCO) and pulmonary ventilation function in elderly patients with chronic obstructive pulmonary disease (COPD), and to evaluate the diagnostic performance of DLCOrelated indicators with emphasis on sexspecific differences.

Methods

In this casecontrol study, 535 elderly patients (age ≥60 years) who underwent pulmonary function tests and chest CT between June 2022 and June 2024 were enrolled and classified into a COPD group 275 cases and a control group 260 cases according to the GOLD criteria. Collected data included demographics, spirometric parameters (FEV₁, FEV1%pred, FVC, FEV₁/FVC), DLCOrelated measures (DLCO, DLCO%pred, DLCO/VA), and CTderived emphysema index (LAA%). Pearson correlation and multivariate linear regression were used to assess associations and independent predictors of DLCO%pred. Diagnostic performance was evaluated using receiveroperatingcharacteristic (ROC) curves.

Results

Compared with controls, the COPD group showed significantly lower values in all DLCOrelated and spirometric indices (all P<0.05). DLCO%pred was strongly correlated with FEV1%pred (r=0.708, P<0.01). Multivariate analysis identified age, FEV1%pred, and LAA% as independent determinants of DLCO%pred (all P<0.01). The overall AUC of DLCO%pred for diagnosing COPD was 0.844 (95%CI: 0.799~0.889). Sexspecific cutoffs improved diagnostic accuracy: in males, DLCO%pred ≤59.75% yielded an AUC of 0.883 (95%CI: 0.842~0.924); in females, ≤65.50% yielded an AUC of 0.861 (95%CI: 0.778~0.943).

Conclusion

DLCOrelated indices correlate closely with ventilatory impairment and emphysema severity in elderly COPD patients and provide valuable diagnostic information. Sexstratified thresholds can enhance screening accuracy and support a more individualized assessment approach.

Key words: Chronic obstructive pulmonary disease, Elderly patients, Respiratory function test, Diffusion capacity for carbon monoxide, Diagnosis significance

Yalin Wang, Dong Cao, Yimin Huang, Yingzhu Chen, Hui Chen, Muyun Zhu. Study on the correlation between diffusion capacity for carbon monoxide and pulmonary ventilation function in elderly patients with chronic obstructive pulmonary disease[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2026, 19(04): 645-650.

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References 24

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临床指标	观察组(n＝275)	对照组(n＝260)	t值	P值
血红蛋白[g/dl，(±s)]	14.61±2.52	14.92±1.93	1.591	0.112
LAA%(±s)	18.37±7.13	1.32±0.38	－38.505	0.000
FEV₁[L，(±s)]	1.23±0.48	2.33±0.65	22.349	0.000
FVC[L，(±s)]	2.33±0.70	2.98±0.81	9.947	0.000
FEV1%pred(±s)	50.40±20.92	104.04±21.69	29.116	0.000
DLCO[mmol/min/kPa，(±s)]	3.46±1.57	5.53±1.81	14.152	0.000
DLCO%pred(±s)	45.17±21.35	74.68±21.37	15.972	0.000
TLC[L，(±s)]	4.80±1.04	4.79±0.94	－0.116	0.907
DLCO/VA[mmol/min/kPa/L，(±s)]	0.74±0.35	1.81±0.29	38.386	0.000

临床指标	观察组(n＝275)	对照组(n＝260)	t值	P值
血红蛋白[g/dl，(±s)]	14.61±2.52	14.92±1.93	1.591	0.112
LAA%(±s)	18.37±7.13	1.32±0.38	－38.505	0.000
FEV₁[L，(±s)]	1.23±0.48	2.33±0.65	22.349	0.000
FVC[L，(±s)]	2.33±0.70	2.98±0.81	9.947	0.000
FEV1%pred(±s)	50.40±20.92	104.04±21.69	29.116	0.000
DLCO[mmol/min/kPa，(±s)]	3.46±1.57	5.53±1.81	14.152	0.000
DLCO%pred(±s)	45.17±21.35	74.68±21.37	15.972	0.000
TLC[L，(±s)]	4.80±1.04	4.79±0.94	－0.116	0.907
DLCO/VA[mmol/min/kPa/L，(±s)]	0.74±0.35	1.81±0.29	38.386	0.000

相关参数	FEV₁	FVC	FEV₁/FVC	FEV₁ pred	LAA%	年龄
DLCO	0.759^a	0.651^a	0.589^a	0.590^a	－0.308^a	－0.379^a
DLCO%pred	0.675^a	0.503^a	0.662^a	0.708^a	－0.460^a	－0.255^a
DLCO/VA	0.610^a	0.428^a	0.658^a	0.603^a	－0.396^a	－0.348^a
TLC	0.388^a	0.546^a	－0.072	0.089	0.163	－0.238^a
TLC%pred	0.354^a	0.289^a	0.122	0.574^a	0.159	－0.153^b

相关参数	FEV₁	FVC	FEV₁/FVC	FEV₁ pred	LAA%	年龄
DLCO	0.759^a	0.651^a	0.589^a	0.590^a	－0.308^a	－0.379^a
DLCO%pred	0.675^a	0.503^a	0.662^a	0.708^a	－0.460^a	－0.255^a
DLCO/VA	0.610^a	0.428^a	0.658^a	0.603^a	－0.396^a	－0.348^a
TLC	0.388^a	0.546^a	－0.072	0.089	0.163	－0.238^a
TLC%pred	0.354^a	0.289^a	0.122	0.574^a	0.159	－0.153^b

变　量	β系数(95%CI)	标准误	标准化β系数	t值	P值
常量	89.874(78.312 ，101.436)	5.752	－	15.621	0.001
年龄	－0.497(－0.768，－0.226)	0.137	－0.142	－3.621	0.001
FEV1%pred	0.641(0.542，0.740)	0.051	0.503	12.589	0.001
LAA%	－1.856(－2.360，－1.352)	0.255	－0.288	－7.285	0.001

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