Spirometric phenotypes from early childhood to young adulthood: a Chronic Airway Disease Early Stratification study

The prevalences of obstructive and restrictive spirometric phenotypes, and their relation to early-life risk factors from childhood to young adulthood remain poorly understood. The aim was to explore these phenotypes and associations with well-known respiratory risk factors across ages and populatio...

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Veröffentlicht in:ERJ open research Jg. 7; H. 4; S. 457
Hauptverfasser: Wang, Gang, Hallberg, Jenny, Charalampopoulos, Dimitrios, Sanahuja, Maribel Casas, Breyer-Kohansal, Robab, Langhammer, Arnulf, Granell, Raquel, Vonk, Judith M., Mian, Annemiek, Olvera, Núria, Laustsen, Lisbeth Mølgaard, Rönmark, Eva, Abellan, Alicia, Agusti, Alvar, Arshad, Syed Hasan, Bergström, Anna, Boezen, H. Marike, Breyer, Marie-Kathrin, Burghuber, Otto, Bolund, Anneli Clea, Custovic, Adnan, Devereux, Graham, Donaldson, Gavin C., Duijts, Liesbeth, Esplugues, Ana, Faner, Rosa, Ballester, Ferran, Garcia-Aymerich, Judith, Gehring, Ulrike, Haider, Sadia, Hartl, Sylvia, Backman, Helena, Holloway, John W., Koppelman, Gerard H., Lertxundi, Aitana, Holmen, Turid Lingaas, Lowe, Lesley, Mensink-Bout, Sara M., Murray, Clare S., Roberts, Graham, Hedman, Linnea, Schlünssen, Vivi, Sigsgaard, Torben, Simpson, Angela, Sunyer, Jordi, Torrent, Maties, Turner, Stephen, Van den Berge, Maarten, Vermeulen, Roel C.H., Vikjord, Sigrid Anna Aalberg, Wedzicha, Jadwiga A., Maitland van der Zee, Anke H., Melén, Erik
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England European Respiratory Society 01.10.2021
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ISSN:2312-0541, 2312-0541
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Zusammenfassung:The prevalences of obstructive and restrictive spirometric phenotypes, and their relation to early-life risk factors from childhood to young adulthood remain poorly understood. The aim was to explore these phenotypes and associations with well-known respiratory risk factors across ages and populations in European cohorts. We studied 49 334 participants from 14 population-based cohorts in different age groups (≤10, >10-15, >15-20, >20-25 years, and overall, 5-25 years). The obstructive phenotype was defined as forced expiratory volume in 1 s (FEV )/forced vital capacity (FVC) z-score less than the lower limit of normal (LLN), whereas the restrictive phenotype was defined as FEV /FVC z-score ≥LLN, and FVC z-score <LLN. The prevalence of obstructive and restrictive phenotypes varied from 3.2-10.9% and 1.8-7.7%, respectively, without clear age trends. A diagnosis of asthma (adjusted odds ratio (aOR=2.55, 95% CI 2.14-3.04), preterm birth (aOR=1.84, 1.27-2.66), maternal smoking during pregnancy (aOR=1.16, 95% CI 1.01-1.35) and family history of asthma (aOR=1.44, 95% CI 1.25-1.66) were associated with a higher prevalence of obstructive, but not restrictive, phenotype across ages (5-25 years). A higher current body mass index (BMI was more often observed in those with the obstructive phenotype but less in those with the restrictive phenotype (aOR=1.05, 95% CI 1.03-1.06 and aOR=0.81, 95% CI 0.78-0.85, per kg·m increase in BMI, respectively). Current smoking was associated with the obstructive phenotype in participants older than 10 years (aOR=1.24, 95% CI 1.05-1.46). Obstructive and restrictive phenotypes were found to be relatively prevalent during childhood, which supports the early origins concept. Several well-known respiratory risk factors were associated with the obstructive phenotype, whereas only low BMI was associated with the restrictive phenotype, suggesting different underlying pathobiology of these two phenotypes.
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content type line 23
ISSN:2312-0541
2312-0541
DOI:10.1183/23120541.00457-2021