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

Gang Wang, Jenny Hallberg, Dimitrios Charalampopoulos, Maribel Casas Sanahuja, Robab Breyer-Kohansal, Arnulf Langhammer, Raquel Granell, Judith M Vonk, Annemiek Mian, Núria Olvera, Lisbeth Mølgaard Laustsen, Eva Rönmark, Alicia Abellan, Alvar Agusti, Syed Hasan Arshad, Anna Bergström, H Marike Boezen, Marie-Kathrin Breyer, Otto Burghuber, Anneli Clea BolundAdnan Custovic, Graham Devereux, Gavin C Donaldson, Liesbeth Duijts, Ana Esplugues, Rosa Faner, Ferran Ballester, Judith Garcia-Aymerich, Ulrike Gehring, Sadia Haider, Sylvia Hartl, Helena Backman, John W Holloway, Gerard H Koppelman, Aitana Lertxundi, Turid Lingaas Holmen, Lesley Lowe, Sara M Mensink-Bout, Clare S Murray, Graham Roberts, Linnea Hedman, Vivi Schlünssen, Torben Sigsgaard, Angela Simpson, Jordi Sunyer, Maties Torrent, Stephen Turner, Maarten Van den Berge, Roel C H Vermeulen, Sigrid Anna Aalberg Vikjord, the CADSET Clinical Research Collaboration

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Abstract

Background: 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.

Methods: 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 (FEV1)/forced vital capacity (FVC) z-score less than the lower limit of normal (LLN), whereas the restrictive phenotype was defined as FEV1/FVC z-score ≥LLN, and FVC z-score <LLN.

Results: 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-2 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).

Conclusion: 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.

OriginalsprogEngelsk
Artikelnummer00457-2021
TidsskriftERJ Open Research
Vol/bind7
Nummer4
Antal sider15
DOI
StatusUdgivet - 6 dec. 2021

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