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Childhood lung function predicts adult chronic obstructive pulmonary disease and asthma-chronic obstructive pulmonary disease overlap syndrome

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Bui, DS, Burgess, JA, Lowe, AJ, Perret, JL, Lodge, CJ, Bui, M, Morrison, S, Thompson, BR, Thomas, PS, Giles, GG, Garcia-Aymerich, J, Jarvis, D, Abramson, MJ, Walters, EH ORCID: 0000-0002-0993-4374, Matheson, MC and Dharmage, SC 2017 , 'Childhood lung function predicts adult chronic obstructive pulmonary disease and asthma-chronic obstructive pulmonary disease overlap syndrome' , American Journal of Respiratory and Critical Care Medicine, vol. 196, no. 1 , pp. 39-46 , doi: 10.1164/rccm.201606-1272OC.

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Abstract

Rationale:The burden of chronic obstructive pulmonary disease (COPD) is increasing, yet there are limited data on early life risk factors.Objectives:To investigate the role of childhood lung function in adult COPD phenotypes.Method: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.Measurements and main results: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.Conslusions: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.

Item Type: Article
Authors/Creators:Bui, DS and Burgess, JA and Lowe, AJ and Perret, JL and Lodge, CJ and Bui, M and Morrison, S and Thompson, BR and Thomas, PS and Giles, GG and Garcia-Aymerich, J and Jarvis, D and Abramson, MJ and Walters, EH and Matheson, MC and Dharmage, SC
Keywords: childhood lung function, early life, asthma–COPD overlap syndrome
Journal or Publication Title: American Journal of Respiratory and Critical Care Medicine
Publisher: American Lung Association
ISSN: 1073-449X
DOI / ID Number: 10.1164/rccm.201606-1272OC
Copyright Information:

Copyright © 2017 by the American Thoracic Society

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