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  • Title: Childhood Lung Function Predicts Adult Chronic Obstructive Pulmonary Disease and Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome.
    Author: Bui DS, Burgess JA, Lowe AJ, Perret JL, Lodge CJ, Bui M, Morrison S, Thompson BR, Thomas PS, Giles GG, Garcia-Aymerich J, Jarvis D, Abramson MJ, Walters EH, Matheson MC, Dharmage SC.
    Journal: Am J Respir Crit Care Med; 2017 Jul 01; 196(1):39-46. PubMed ID: 28146643.
    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. METHODS: 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. CONCLUSIONS: 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.
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