Rationale: Subjects with preserved ratio impaired spirometry (PRISm) experience increased respiratory symptoms, although they present heterogeneous characteristics. However, the longitudinal changes in these symptoms and respiratory function are not well known. Objectives: To investigate PRISm from the viewpoint of respiratory symptoms in a longitudinal, large-scale general population study. Methods: The Nagahama study included 9,789 inhabitants, and a follow-up evaluation was conducted after 5 years. Spirometry and self-administered questionnaires regarding respiratory symptoms, including prolonged cough, sputum and dyspnea, and comorbidities were conducted. Results: In total, 9,760 subjects were analyzed, and 438 subjects had PRISm. Among the subjects with PRISm, 53% presented with respiratory symptoms; dyspnea was independently associated with PRISm. Follow-up assessment revealed that 73% of the subjects with PRISm with respiratory symptoms were consistently symptomatic, whereas 39% of the asymptomatic subjects with PRISm developed respiratory symptoms within 5 years. In addition, among subjects with respiratory symptoms without airflow limitation at baseline, PRISm was a risk factor for the development of airflow limitation independent of smoking history and comorbidities. Conclusions: This study demonstrated that 53% of the subjects with PRISm had respiratory symptoms; dyspnea was a distinct characteristic of PRISm. Approximately three-fourths of the symptomatic subjects with PRISm consistently complained of respiratory symptoms within 5 years. Together with our result that PRISm itself is an independent risk factor for the development of chronic obstructive pulmonary disease among subjects with respiratory symptoms, the clinical course of subjects with PRISm with symptoms requires careful monitoring.

中文翻译：

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纵向变化以及呼吸道症状与保留比率受损肺活量测定 (PRISm) 的关联：Nagahama 研究。

理由：保留比例肺量测定受损 (PRISm) 的受试者会出现呼吸道症状增加，尽管它们呈现出异质性特征。然而，这些症状和呼吸功能的纵向变化尚不清楚。目的：在一项纵向、大规模普通人群研究中从呼吸道症状的角度研究 PRISm。方法：长滨研究纳入了 9,789 名居民，并在 5 年后进行了跟踪评估。进行了肺活量测定和有关呼吸道症状（包括长时间咳嗽、咳痰和呼吸困难）以及合并症的自填问卷。结果：总共分析了 9,760 名受试者，其中 438 名受试者患有 PRISm。在患有 PRISm 的受试者中，53% 出现呼吸道症状；呼吸困难与 PRISm 独立相关。随访评估显示，73% 患有呼吸道症状的 PRISm 受试者始终有症状，而 39% 的无症状 PRISm 受试者在 5 年内出现呼吸道症状。此外，在基线时没有气流受限的呼吸道症状受试者中，PRISm 是发生气流受限的危险因素，与吸烟史和合并症无关。结论：本研究表明，53% 的 PRISm 受试者有呼吸道症状；呼吸困难是 PRISm 的一个明显特征。大约四分之三的有 PRISm 症状的受试者在 5 年内持续抱怨呼吸道症状。结合我们的结果，即 PRISm 本身是有呼吸道症状的受试者中发生慢性阻塞性肺疾病的独立危险因素，有症状的 PRISm 受试者的临床病程需要仔细监测。