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

Citation

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, 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, 196, (1) pp. 39-46. ISSN 1073-449X (2017) [Refereed Article]


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Copyright Statement

Copyright © 2017 by the American Thoracic Society

DOI: doi:10.1164/rccm.201606-1272OC

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 Details

Item Type:Refereed Article
Keywords:childhood lung function, early life, asthma–COPD overlap syndrome
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Respiratory Diseases
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Respiratory System and Diseases (incl. Asthma)
Author:Walters, EH (Professor Haydn Walters)
ID Code:125222
Year Published:2017
Web of Science® Times Cited:13
Deposited By:Medicine (Discipline)
Deposited On:2018-04-09
Last Modified:2018-09-11
Downloads:8 View Download Statistics

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