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- Title
Childhood Lung Function Predicts Adult Chronic Obstructive Pulmonary Disease and Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome.
- Authors
Bui, Dinh S.; Burgess, John A.; Lowe, Adrian J.; Perret, Jennifer L.; Lodge, Caroline J.; Bui, Minh; Morrison, Stephen; Thompson, Bruce R.; Thomas, Paul S.; Giles, Graham G.; Garcia-Aymerich, Judith; Jarvis, Debbie; Abramson, Michael J.; Walters, E. Haydn; Matheson, Melanie C.; Dharmage, Shyamali C.
- Abstract
<bold>Rationale: </bold>The burden of chronic obstructive pulmonary disease (COPD) is increasing, yet there are limited data on early life risk factors.<bold>Objectives: </bold>To investigate the role of childhood lung function in adult COPD phenotypes.<bold>Methods: </bold>Prebronchodilator spirometry was performed for a cohort of 7-year-old Tasmanian children (n = 8,583) in 1968 who were resurveyed at 45 years, and a selected subsample (n = 1,389) underwent prebronchodilator and post-bronchodilator spirometry. For this analysis, COPD was spirometrically defined as a post-bronchodilator FEV1/FVC less than the lower limit of normal. Asthma-COPD overlap syndrome (ACOS) was defined as the coexistence of both COPD and current asthma. Associations between childhood lung function and asthma/COPD/ACOS were examined using multinomial regression.<bold>Measurements and Main Results: </bold>At 45 years, 959 participants had neither current asthma nor COPD (unaffected), 269 had current asthma alone, 59 had COPD alone, and 68 had ACOS. The reweighted prevalence of asthma alone was 13.5%, COPD alone 4.1%, and ACOS 2.9%. The lowest quartile of FEV1 at 7 years was associated with ACOS (odds ratio, 2.93; 95% confidence interval, 1.32-6.52), but not COPD or asthma alone. The lowest quartile of FEV1/FVC ratio at 7 years was associated with ACOS (odds ratio, 16.3; 95% confidence interval, 4.7-55.9) and COPD (odds ratio, 5.76; 95% confidence interval, 1.9-17.4), but not asthma alone.<bold>Conclusions: </bold>Being in the lowest quartile for lung function at age 7 may have long-term consequences for the development of COPD and ACOS by middle age. Screening of lung function in school age children may identify a high-risk group that could be targeted for intervention. Further research is needed to understand possible modifiers of these associations and develop interventions for children with impaired lung function.
- Subjects
TASMANIA; ASTHMA; LUNGS; OBSTRUCTIVE lung diseases; RESPIRATORY measurements; PULMONARY function tests; SPIROMETRY; SYNDROMES; PREDICTIVE tests; VITAL capacity (Respiration)
- Publication
American Journal of Respiratory & Critical Care Medicine, 2017, Vol 196, Issue 1, p39
- ISSN
1073-449X
- Publication type
journal article
- DOI
10.1164/rccm.201606-1272OC