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(Chest. 2004;125:446-452.)
© 2004 American College of Chest Physicians

Clinical Significance of Elevated Diffusing Capacity*

Ghulam Saydain, MD, FCCP; Kenneth C. Beck, PhD; Paul A. Decker, MS; Clayton T. Cowl, MD, MS, FCCP and Paul D. Scanlon, MD, FCCP

* From the Pulmonary and Critical Care Division (Dr. Saydain), Nassau University Medical Center, East Meadow, NY; Department of Radiology (Dr. Beck), University of Iowa, Iowa City, IA; Mayo Clinic and Mayo Medical School (Mr. Decker, and Drs. Cowl and Scanlon), Rochester, MN.

Correspondence to: Ghulam Saydain MD, FCCP, Pulmonary and Critical Care Division, 10th floor, Nassau University Medical Center, 2201 Hempstead Tpk, East Meadow, NY, 11554; e-mail: gsaydain{at}numc.edu

Study objective: Single-breath diffusing capacity of the lung for carbon monoxide (DLCO) is used as a pulmonary function test (PFT) to assess gas transfer in the lungs. The implications of a low DLCO are well-recognized, but the clinical significance of a high DLCO is not clear. The aim of this study was to identify the clinical correlates of a high DLCO.

Patients and methods: We identified 245 patients with a high DLCO (ie, > 140% predicted) and a matched group of 245 patients with normal DLCO (ie, 85 to 115% predicted), who were selected from a laboratory database of 45,000 patients tested between January 1997 and December 1999. We compared the demographic features, clinical diagnoses, and PFT data between the two groups.

Settings: Large multispecialty group practice.

Results: The patients in the high DLCO group were heavier (mean [± SD] weight, 96.0 ± 22.9 vs 85.0 ± 21.3 kg, respectively; p < 0.001), had a higher mean body mass index (32.9 ± 7.4 vs 29.4 ± 6.4 kg/m2, respectively; p < 0.001), larger body surface area (p < 0.001), and larger mean total lung capacity (p = 0.007) and alveolar volume (p < 0.001). The clinical diagnoses of obesity (p < 0.001) and asthma (p < 0.001) were more common among patients with high DLCO values. The majority of patients (62%) with a high DLCO had a diagnosis of obesity, asthma, or both. Polycythemia, hemoptysis, and left-to-right shunt were uncommon.

Conclusion: A high DLCO on a PFT is most frequently associated with large lung volumes, obesity, and asthma. Other conditions are much less common. A clinical condition, which typically reduces DLCO, may deceptively normalize DLCO in such patients.

Key Words: asthma • diffusing capacity • obesity • pulmonary function test




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The effects of body mass index on lung volumes.
Chest, September 1, 2006; 130(3): 827 - 833.
[Abstract] [Full Text] [PDF]


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