Clinical implications of airway obstruction with normal or low FEV1 in childhood and adolescence
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
BACKGROUND: Airway obstruction is defined by spirometry as a low forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio. This impaired ratio may originate from a low FEV1 (classic) or a normal FEV1 in combination with a large FVC (dysanaptic). The clinical implications of dysanaptic obstruction during childhood and adolescence in the general population remain unclear.
AIMS: To investigate the association between airway obstruction with a low or normal FEV1 in childhood and adolescence, and asthma, wheezing and bronchial hyperresponsiveness (BHR).
METHODS: In the BAMSE (Barn/Child, Allergy, Milieu, Stockholm, Epidemiology; Sweden) and PIAMA (Prevention and Incidence of Asthma and Mite Allergy; the Netherlands) birth cohorts, obstruction (FEV1:FVC ratio less than the lower limit of normal, LLN) at ages 8, 12 (PIAMA only) or 16 years was classified as classic (FEV1 <LLN) or dysanaptic (FEV1 ≥LLN) obstruction. Cross-sectional and longitudinal associations between these two types of obstruction and respiratory health outcomes were estimated by cohort-adjusted logistic regression on pooled data.
RESULTS: The prevalence of classic obstruction at ages 8, 12 and 16 in the two cohorts was 1.5%, 1.1% and 1.5%, respectively. Dysanaptic obstruction was slightly more prevalent: 3.9%, 2.5% and 4.6%, respectively. Obstruction, regardless of FEV1, was consistently associated with higher odds of asthma (dysanaptic obstruction: OR 2.29, 95% CI 1.40 to 3.74), wheezing, asthma medication use and BHR compared with the normal lung function group. Approximately one-third of the subjects with dysanaptic obstruction in childhood remained dysanaptic during adolescence.
CLINICAL IMPLICATIONS: Children and adolescents with airway obstruction had, regardless of their FEV1 level, a higher prevalence of asthma and wheezing. Follow-up and treatment at these ages should be guided by the presence of airway obstruction.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Thorax - (2024) vom: 21. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Koefoed, Hans Jacob Lohne [VerfasserIn] |
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| Links: |
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| Themen: |
Asthma |
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| Anmerkungen: |
Date Revised 21.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1136/thorax-2023-220952 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370037618 |
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| 100 | 1 | |a Koefoed, Hans Jacob Lohne |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clinical implications of airway obstruction with normal or low FEV1 in childhood and adolescence |
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| 520 | |a © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a BACKGROUND: Airway obstruction is defined by spirometry as a low forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio. This impaired ratio may originate from a low FEV1 (classic) or a normal FEV1 in combination with a large FVC (dysanaptic). The clinical implications of dysanaptic obstruction during childhood and adolescence in the general population remain unclear | ||
| 520 | |a AIMS: To investigate the association between airway obstruction with a low or normal FEV1 in childhood and adolescence, and asthma, wheezing and bronchial hyperresponsiveness (BHR) | ||
| 520 | |a METHODS: In the BAMSE (Barn/Child, Allergy, Milieu, Stockholm, Epidemiology; Sweden) and PIAMA (Prevention and Incidence of Asthma and Mite Allergy; the Netherlands) birth cohorts, obstruction (FEV1:FVC ratio less than the lower limit of normal, LLN) at ages 8, 12 (PIAMA only) or 16 years was classified as classic (FEV1 <LLN) or dysanaptic (FEV1 ≥LLN) obstruction. Cross-sectional and longitudinal associations between these two types of obstruction and respiratory health outcomes were estimated by cohort-adjusted logistic regression on pooled data | ||
| 520 | |a RESULTS: The prevalence of classic obstruction at ages 8, 12 and 16 in the two cohorts was 1.5%, 1.1% and 1.5%, respectively. Dysanaptic obstruction was slightly more prevalent: 3.9%, 2.5% and 4.6%, respectively. Obstruction, regardless of FEV1, was consistently associated with higher odds of asthma (dysanaptic obstruction: OR 2.29, 95% CI 1.40 to 3.74), wheezing, asthma medication use and BHR compared with the normal lung function group. Approximately one-third of the subjects with dysanaptic obstruction in childhood remained dysanaptic during adolescence | ||
| 520 | |a CLINICAL IMPLICATIONS: Children and adolescents with airway obstruction had, regardless of their FEV1 level, a higher prevalence of asthma and wheezing. Follow-up and treatment at these ages should be guided by the presence of airway obstruction | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Asthma | |
| 650 | 4 | |a Asthma Epidemiology | |
| 650 | 4 | |a Asthma Guidelines | |
| 650 | 4 | |a Clinical Epidemiology | |
| 650 | 4 | |a Lung Physiology | |
| 650 | 4 | |a Paediatric asthma | |
| 700 | 1 | |a Wang, Gang |e verfasserin |4 aut | |
| 700 | 1 | |a Gehring, Ulrike |e verfasserin |4 aut | |
| 700 | 1 | |a Ekstrom, Sandra |e verfasserin |4 aut | |
| 700 | 1 | |a Kull, Inger |e verfasserin |4 aut | |
| 700 | 1 | |a Vermeulen, Roel |e verfasserin |4 aut | |
| 700 | 1 | |a Boer, Jolanda M A |e verfasserin |4 aut | |
| 700 | 1 | |a Bergstrom, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Koppelman, Gerard H |e verfasserin |4 aut | |
| 700 | 1 | |a Melén, Erik |e verfasserin |4 aut | |
| 700 | 1 | |a Vonk, Judith M |e verfasserin |4 aut | |
| 700 | 1 | |a Hallberg, Jenny |e verfasserin |4 aut | |
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