ERJ Open Research (Dec 2021)
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 Bolund,
- Adnan 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,
- Jadwiga A. Wedzicha,
- Anke H. Maitland van der Zee,
- Erik Melén
Affiliations
- Gang Wang
- Dept of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Sichuan, China
- Jenny Hallberg
- Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Dimitrios Charalampopoulos
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Maribel Casas Sanahuja
- ISGlobal, Barcelona, Spain
- Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Arnulf Langhammer
- Dept of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Levanger, Norway
- Raquel Granell
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Judith M. Vonk
- Dept of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Annemiek Mian
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Núria Olvera
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Lisbeth Mølgaard Laustsen
- Dept of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- Eva Rönmark
- Dept of Public Health and Clinical Medicine, Section for Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
- Alicia Abellan
- ISGlobal, Barcelona, Spain
- Alvar Agusti
- Institut d'investigacions biomediques August Pi I Sunyer, Barcelona, Spain
- Syed Hasan Arshad
- David Hide Asthma and Allergy Research Centre, Newport, UK
- Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- H. Marike Boezen
- Dept of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
- Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Otto Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Anneli Clea Bolund
- Dept of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
- Graham Devereux
- Liverpool School of Tropical Medicine, Liverpool, UK
- Gavin C. Donaldson
- National Heart and Lung Institute, Imperial College London, London, UK
- Liesbeth Duijts
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Ana Esplugues
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Rosa Faner
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Ferran Ballester
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Sadia Haider
- National Heart and Lung Institute, Imperial College London, London, UK
- Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Helena Backman
- Dept of Public Health and Clinical Medicine, Section for Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
- John W. Holloway
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
- Gerard H. Koppelman
- University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, University of Groningen, Groningen, The Netherlands
- Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Turid Lingaas Holmen
- Dept of Public Health and General Practice, HUNT Research Center, NTNU, Levanger, Norway
- Lesley Lowe
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester Academic Health Science Centre, NIHR, Manchester, UK
- Sara M. Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Clare S. Murray
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester Academic Health Science Centre, NIHR, Manchester, UK
- Graham Roberts
- David Hide Asthma and Allergy Research Centre, Newport, UK
- Linnea Hedman
- Dept of Public Health and Clinical Medicine, Section for Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
- Vivi Schlünssen
- Dept of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- Torben Sigsgaard
- Dept of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- Angela Simpson
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester Academic Health Science Centre, NIHR, Manchester, UK
- Jordi Sunyer
- ISGlobal, Barcelona, Spain
- Maties Torrent
- ib-salut, Area de Salut de Menorca, Menorca, Spain
- Stephen Turner
- Royal Aberdeen Children's Hospital NHS Grampian, Aberdeen, UK
- Maarten Van den Berge
- University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, University of Groningen, Groningen, The Netherlands
- Roel C.H. Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Sigrid Anna Aalberg Vikjord
- Dept of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Levanger, Norway
- Jadwiga A. Wedzicha
- National Heart and Lung Institute, Imperial College London, London, UK
- Anke H. Maitland van der Zee
- Dept of Respiratory Medicine, Amsterdam University Medical Centers (UMC), University of Amsterdam
- Erik Melén
- Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- DOI
- https://doi.org/10.1183/23120541.00457-2021
- Journal volume & issue
-
Vol. 7,
no. 4
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.
