Patterns of Growth and Decline in Lung Function in Persistent Childhood Asthma.
Document Type
Article
Publication Date
5-12-2016
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
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.).
Publisher
Massachusetts Medical Society.
Publication Title
The New England journal of medicine
ISSN
1533-4406
Volume
374
Issue
19
First Page
1842
Last Page
1852
Recommended Citation
McGeachie, M J; K P Yates; X Zhou; F Guo; A L Sternberg; M L Van Natta; R A Wise; S J Szefler; S Sharma; A T Kho; M H Cho; D C Croteau-Chonka; P J Castaldi; G Jain; A Sanyal; Y Zhan; B R Lajoie; J Dekker; J Stamatoyannopoulos; R A Covar; R S Zeiger; N F Adkinson; P V Williams; H W Kelly; H Grasemann; J M Vonk; G H Koppelman; D S Postma; B A Raby; I Houston; Q Lu; A L Fuhlbrigge; K G Tantisira; E K Silverman; J Tonascia; S T Weiss; and R C Strunk.
"Patterns of Growth and Decline in Lung Function in Persistent Childhood Asthma.."
The New England journal of medicine
