UMMS Affiliation

Program in Systems Biology; Department of Biochemistry and Molecular Pharmacology

Date

5-12-2016

Document Type

Article

Disciplines

Pediatrics | Physiology | Respiratory System | Respiratory Tract Diseases

Abstract

BACKGROUND: Tracking longitudinal measurements of growth and decline in lung function in patients with persistent childhood asthma may reveal links between asthma and subsequent chronic airflow obstruction.

METHODS: We classified children with asthma according to four characteristic patterns of lung-function growth and decline on the basis of graphs showing forced expiratory volume in 1 second (FEV1), representing spirometric measurements performed from childhood into adulthood. Risk factors associated with abnormal patterns were also examined. To define normal values, we used FEV1 values from participants in the National Health and Nutrition Examination Survey who did not have asthma.

RESULTS: Of the 684 study participants, 170 (25%) had a normal pattern of lung-function growth without early decline, and 514 (75%) had abnormal patterns: 176 (26%) had reduced growth and an early decline, 160 (23%) had reduced growth only, and 178 (26%) had normal growth and an early decline. Lower baseline values for FEV1, smaller bronchodilator response, airway hyperresponsiveness at baseline, and male sex were associated with reduced growth (P < 0.001 for all comparisons). At the last spirometric measurement (mean [+/-SD] age, 26.0+/-1.8 years), 73 participants (11%) met Global Initiative for Chronic Obstructive Lung Disease spirometric criteria for lung-function impairment that was consistent with chronic obstructive pulmonary disease (COPD); these participants were more likely to have a reduced pattern of growth than a normal pattern (18% vs. 3%, P < 0.001).

CONCLUSIONS: Childhood impairment of lung function and male sex were the most significant predictors of abnormal longitudinal patterns of lung-function growth and decline. Children with persistent asthma and reduced growth of lung function are at increased risk for fixed airflow obstruction and possibly COPD in early adulthood. (Funded by the Parker B. Francis Foundation and others; ClinicalTrials.gov number, NCT00000575.).

Rights and Permissions

Citation: N Engl J Med. 2016 May 12;374(19):1842-52. doi: 10.1056/NEJMoa1513737. Link to article on publisher's site

Comments

Full author list omitted for brevity. For full list of authors see article.

PDF posted after 6 months embargo in accordance with the publisher's author rights policy at http://www.nejm.org/page/author-center/permissions.

Related Resources

Link to Article in PubMed

Journal Title

The New England journal of medicine

PubMed ID

27168434

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