Circadian rhythm and variability of large and small airway spirometric variables in healthy individuals

Abstract

Objective: To assess the diurnal rhythm and variability of lung function in healthy individuals, encompassing both large and small airways.

Methods: A prospective study enrolled 35 healthy adults without a history of smoking. Initial spirometry and a bronchodilation test were performed using the Jaeger spirometer, followed by a seven-day continuous home monitoring using the GOSPT2000. We evaluated repeatability using the intraclass correlation coefficient and agreement through linear regression and Bland-Altman analyses. Circadian rhythm and variability in spirometric measurements were analyzed using the coefficient of variation (CV) and daily variation rate.

Results: The GOSPT2000 demonstrated strong repeatability and high agreement with the Jaeger spirometer. Notable findings included a decrease in nocturnal forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), and FEV₃ by 44, 59, and 53 mL, respectively. In contrast, peak expiratory flow at noon showed an increase of 0.143L/min. Small-airway variables, including forced expiratory flow at 50% and 75% of the FVC and maximum midexpiratory flow, showed no significant diurnal variation. The nocturnal CV for large-airway variables was ≤ 4%, while for small-airway variables, it was ≤ 11.89%.

Conclusion: This study has established a spectrum of variability for both large and small airways in healthy populations. The variability of small-airway variables is higher than that of large-airway variables. The investigation into the diurnal rhythms and variability characteristics of both large and small airway variables in the healthy population can serve as a foundation for diagnosing asthma or assessing the efficacy of asthma treatments.

Keywords: Pulmonary function; circadian rhythm; home monitoring; portable spirometer; variation.

Figure 1.

Schematic presentation of study design.

Figure 2.

ICC and Bland–Altman analysis.

Figure 3.

Circadian rhythm of large- and small-airway function variables in GOSPT2000 spirometer.

Figure 4.

The diurnal CVs and nocturnal CVs of GOSPT2000 spirometry indicators for seven days.

Figure 5.

The daily variation rate of variables by GOSPT2000.