Childhood lung function predicts adult COPD and asthma-COPD overlap syndrome (ACOS)
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
RATIONALE: There are limited data on early life risk factors for COPD phenotypes. OBJECTIVE: To investigate the role of childhood lung function in adult spirometrically defined COPD phenotypes. METHOD: Pre-bronchodilator (BD) spirometry was performed for a cohort of 7-year old Tasmanian children. A sub-sample underwent pre-and post-BD spirometry at 45 years. For this analysis, COPD was spirometrically defined as a post-BD FEV1/FVC<lower limit of normal (LLN). 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. RESULTS: At age 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, COPD alone and ACOS were 13.5%, 4.1%, and 2.9%, respectively. The lowest quartile of FEV1 at 7 years was associated with ACOS (OR=2.93; 95%CI, 1.32-6.52), but not COPD alone or asthma alone. The lowest quartile of FEV1/FVC ratio was associated with ACOS (OR=16.3; 95%CI, 4.7-55.9) and COPD alone (OR=5.76; 95%CI 1.9-17.4), but not asthma alone. CONCLUSION: Being in the lowest quartile for lung function at age 7 years may have long-term consequences for the development of COPD and ACOS by middle age. Screening of lung function levels in school age children may identify a high risk group that can be targeted for intervention. Further research is needed to understand possible modifiers of these associations and develop interventions for children with impaired lung function.
Date Issued
2017-02-01
Date Acceptance
2017-02-01
Citation
American Journal of Respiratory and Critical Care Medicine, 2017, 196 (1), pp.39-46
ISSN
1535-4970
Publisher
American Thoracic Society
Start Page
39
End Page
46
Journal / Book Title
American Journal of Respiratory and Critical Care Medicine
Volume
196
Issue
1
Copyright Statement
© 2017 by the American Thoracic Society
Sponsor
Commission of the European Communities
Identifier
http://www.ncbi.nlm.nih.gov/pubmed/28146643
Grant Number
633212
Subjects
Science & Technology
Life Sciences & Biomedicine
Critical Care Medicine
Respiratory System
General & Internal Medicine
childhood lung function
early life
asthma-COPD overlap syndrome
REFERENCE VALUES
MIDDLE-AGE
COPD
SPIROMETRY
SMOKING
RISK
asthma–COPD overlap syndrome
11 Medical And Health Sciences
Publication Status
Published
Coverage Spatial
United States