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ORIGINAL RESEARCH article

Front. Med.

Sec. Pulmonary Medicine

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1657151

This article is part of the Research TopicApplication of Multimodal Data and Artificial Intelligence in Pulmonary DiseasesView all 10 articles

Relationship between lung function impairment, clinical characteristics and systemic inflammation based on a large-scale population screening

Provisionally accepted
XIAO JUN  MAXIAO JUN MA1,2Yan  YuYan Yu3Wenxia  GuanWenxia Guan2Shuming  GuoShuming Guo2GaoZhancheng  GaoGaoZhancheng Gao3Mengtong  JinMengtong Jin2Peng  LiuPeng Liu2Lianyu  ChengLianyu Cheng2Chunting  ChenChunting Chen2Kaiyu  MaKaiyu Ma2Yujie  ZhouYujie Zhou2Ran  LiRan Li3*Qi  WuQi Wu1*
  • 1Tianjin Medical University General Hospital, Tianjin, China
  • 2Linfen Central Hospital, Linfen, China
  • 3Peking University People's Hospital Department of Respiratory and Critical Care Medicine, Beijing, China

The final, formatted version of the article will be published soon.

Background: Lung function impairment, a hallmark of chronic airway diseases like chronic obstructive pulmonary disease (COPD), is often underdiagnosed in China. Preserved Ratio Impaired Spirometry (PRISm) may represent an early, subclinical stage of this process. However, a comprehensive understanding of their clinical phenotypes, effective predictive strategies for early identification in large populations, and the role of systemic inflammation remains underexplored, particularly in the Chinese context. This study aimed to describe the clinical phenotypes of lung function impairment, identify predictive factors using machine learning, and explore associated systemic inflammation in a large-scale population screening. Methods: A prospective cross-sectional study was conducted in Hongtong County, China (2021China ( -2024)). Participants were classified into airflow obstruction, PRISm, and normal groups via portable spirometry. Using demographic, clinical, and laboratory data, we developed and validated several machine learning (ML) models to predict lung function impairment. Model performance was evaluated by the area under the receiver operating characteristic curve (AUC). Serum cytokines were measured by ELISA in matched sub-cohorts to assess systemic inflammation.Results: Among 9,284 enrolled adults, 51.0% had airflow obstruction, 6.7% had PRISm, and 42.3% were normal. We identified distinct phenotypes: the PRISm group was predominantly female with lower smoking rates but a higher risk of coronary heart disease. The airflow obstruction group was characterized by classical risk factors (older age, male sex, lower BMI, smoking) and specific renal and cerebrovascular comorbidities. The ML models identified older age, male sex, lower BMI, respiratory symptoms (cough, dyspnea), and higher creatinine and hemoglobin as key predictors, demonstrating modest performance with an AUC of 0.635 in the validation set. Immunologically, individuals with airflow obstruction or PRISm showed significantly lower serum IL-2 and higher IL-5 and IL-17A levels compared to controls.: In a large-scale screening, individuals with airflow obstruction and PRISm present with distinct clinical phenotypes. A predictive model using simple clinical variables can help identify individuals at higher risk for lung function impairment, despite modest performance. Serum IL-2, IL-5, and IL-17A are potential biomarkers for the early recognition and understanding of airflow limitation.

Keywords: Lung function impairment, preserved ratio impaired spirometry (PRISm), predictive model, population screening, early diagnosis, Inflammatory biomarkers

Received: 01 Jul 2025; Accepted: 04 Sep 2025.

Copyright: © 2025 MA, Yu, Guan, Guo, Gao, Jin, Liu, Cheng, Chen, Ma, Zhou, Li and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Ran Li, Peking University People's Hospital Department of Respiratory and Critical Care Medicine, Beijing, China
Qi Wu, Tianjin Medical University General Hospital, Tianjin, China

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