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

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 ORCID: https://orcid.org/0000-0002-0024-4887, 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 and Melén, Erik (2021) 'Spirometric phenotypes from early childhood to young adulthood: a Chronic Airway Disease Early Stratification study'. ERJ Open Research, Vol 7, Issue 4, 00457.

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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 (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.

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 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.

Item Type:	Article
Subjects:	WF Respiratory System > WF 140 Diseases of the respiratory system (General) WF Respiratory System > WF 20 Research (General) WF Respiratory System > Lungs > WF 600 Lungs
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1183/23120541.00457-2021
Depositing User:	Julie Franco
Date Deposited:	14 Dec 2021 09:33
Last Modified:	14 Dec 2021 09:33
URI:	https://archive.lstmed.ac.uk/id/eprint/19644

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