Outcomes of childhood asthma to the age of 50 years

Tai, Andrew; Tran, Haily; Roberts, Mary Flynn; Clarke, Nadeene; Gibson, Anne-Marie; Vidmar, Suzanna; Wilson, John W.; Robertson, Colin F.

doi:10.1016/j.jaci.2013.12.1033

Cited by 192 publications

(169 citation statements)

References 37 publications

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“…Although our data precluded consideration to disease severity, disease severity is associated with a greater odds of asthma persistence (Tai et al, 2014) and oral steroid use (Schofield, 2014), both of which have been associated with delayed attainment of adult height (Martin et al, 1981). Within-pair analyses of asthma and height yielded a pattern of results that was attenuated compared to that of the entire cohort.…”

Section: Figurementioning

confidence: 80%

Asthma and Height in Twins: A Cohort and Within-Pair Analyses Study

2015

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In singletons, asthma may be associated with shorter height and delayed growth during adolescence. Yet, these studies do not account for heritability of asthma, puberty/menarche, and height. We aimed to study the association between asthma and puberty in boys and menarche in girls, and height, in a cohort of twins and subsequently in same-sex twin pairs discordant for asthma. From a Swedish twin cohort, parentand self-reported data on asthma, puberty/menarche, and height were collected. Pubertal staging was established via the Petersen index. Logistic and linear regression was used to estimate associations between asthma and puberty/menarche and height, respectively. For within-pair analyses in twins discordant for asthma, conditional logistic and linear regression were used. Data on 2,658 (49.1% boys) twins were included. Among boys, asthma prevalence was 8.2% at 8-9 years and 10.2% at 13-14 years. Corresponding numbers for girls were 4.2% and 4.9%, respectively. In the entire cohort, no statistically significant associations were found between current asthma and puberty/menarche. Boys with asthma were shorter than boys without asthma at 8-9 years (on average, 1.86 [0.17-3.56] cm, p = .03) and at 13-14 years (on average, 2.94 [0.98-4.91] cm, p = .003) but not at 19-20 years. No such associations were found for girls. Within same-sex twin pairs discordant for asthma, no statistically significant associations were found for either sex. Twin boys, but not girls, with asthma were shorter than those without asthma. Non-statistically significant estimates from within-pair analyses suggest the association is partly confounded by genetic or familial environmental factors.

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Section: Figurementioning

confidence: 80%

Asthma and Height in Twins: A Cohort and Within-Pair Analyses Study

2015

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“…They comprised 6 birth cohorts [17][18][19][20][21][22] and 19 population-based longitudinal studies. [12,13,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Tables 1 and 2 give an overview of the included studies. The reasons for rejecting the remaining 30 papers [9,10, are summarised in Table 3.…”

Section: Resultsmentioning

confidence: 99%

“…[12,13] The vast majority of those with COPD aged 50 years came from the severe asthma group recruited at 10 years of age.…”

Section: Page 13 Of 24mentioning

confidence: 99%

“…[11] The assumption that children with reduced lung function will continue to have poor respiratory health is supported by the Melbourne Asthma Cohort in that those with severe asthma added to the study at the age of 10 years already then demonstrating low lung function, were much more likely to develop COPD by 55 years of age. [12,13] A c c e p t e d M a n u s c r i p t 4 …”

Section: Introductionmentioning

confidence: 99%

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A systematic review of early life factors which adversely affect subsequent lung function

Kouzouna

Gilchrist

Ball

et al. 2016

Paediatric Respiratory Reviews

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It has been known for many years that multiple early life factors can adversely affect lung function and future respiratory health. This is the first systematic review to attempt to analyse all these factors simultaneously. We adhered to strict a priori criteria for inclusion and exclusion of studies.The initial search yielded 29,351 citations of which 208 articles were reviewed in full and 25 were included in the review. This included 6 birth cohorts and 19 longitudinal population studies. The 25 studies reported the effect of 74 childhood factors (on their own or in combinations with other factors) on subsequent lung function reported as percent predicted forced expiration in one second (FEV 1 ). The childhood factors that were associated with a significant reduction in future FEV 1 could be grouped as: early infection, bronchial hyper-reactivity (BHR) / airway lability, a diagnosis of asthma, wheeze, family history of atopy or asthma, respiratory symptoms and prematurity / low birth weight. A complete mathematical model will only be possible if the raw data from all previous studies is made available. This highlights the need for increased cooperation between researchers and the need for international consensus about the outcome measures for future longitudinal studies.

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“…Several longitudinal studies confirm that the initial severity of asthma is a major factor predicting outcomes of persistence and impaired lung function in adult life [13]. Many children with moderate-to-severe asthma are now adults with persistent airflow obstruction and a degree of irreversibility.…”

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confidence: 95%

Smoking, asthma, chronic airflow obstruction and COPD

Sears

2015

Eur Respir J

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@ERSpublications Persistent asthma can lead to chronic airflow obstruction independently of smoking but smoking increases the risk http://ow.ly/GVfIJ Cigarette smoking is the most prevalent risk factor for the development of adult-onset respiratory diseases associated with airflow obstruction, namely emphysema and chronic bronchitis, commonly called chronic obstructive pulmonary disease (COPD). Regrettably, childhood asthma does not reduce the likelihood of initiation of smoking [1] but it is not fully clear how smoking impacts pre-existing airway diseases such as asthma. Does smoking worsen asthma or superimpose another disease? How does asthma itself, irrespective of smoking, impact lung function in adulthood? What characteristics of asthma increase the risk of smoking-induced worsening of airflow obstruction? Does asthma lead to COPD? Classically, the term COPD has been used for a cluster of diseases characterised by a combination of respiratory symptoms (cough, sputum production, dyspnoea and wheezing) with airflow limitation detected by spirometry, with incomplete reversibility. However, many studies of the prevalence of COPD conducted over the last decade have defined COPD physiologically, using a fixed cut-point for the post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio of 0.7 and an FEV1 below 80% of the predicted value to indicate airflow obstruction, without considering accompanying symptoms [2,3].The use of a fixed ratio for defining airflow obstruction has been strongly criticised [4,5], as the normal ratio declines with increasing age and height even in healthy nonsmokers, resulting in up to 50% overdiagnosis above the age of 45 years. In contrast, in younger adults, the fixed ratio underestimates the presence of airflow obstruction [6]. Support for a revised definition of airflow obstruction based on age-specific lower limits of normal (LLNs) for the FEV1/FVC ratio was provided by the Third National Health and Nutrition Examination Survey (NHANES III), in which a ratio less that the fifth percentile of the distribution of Z-scores correctly identified persons with an increased risk of death and prevalence of respiratory symptoms [7].Data from Wave 2 of the UK Household Longitudinal Survey and the Health Survey for England 2010 were used to determine the prevalence of chronic airflow obstruction in 7879 participants aged 40-95 years without diagnosed asthma and good-quality spirometry data [8]. Three definitions were applied: self-reported physician-diagnosed COPD; an FEV1/FVC cut-point of 0.7; and an age-, sex-, height-and ethnicity-specific LLN of the FEV1/FVC ratio. Of those studied, 22.2% had chronic airflow obstruction according to the fixed ratio cut-point, compared with 13.1% when using LLN criteria and, remarkably, only 2.8% reported physician-diagnosed COPD.In this issue of the European Respiratory Journal, AANERUD et al.[9] present data from the general-population-based European Community Respiratory Health Survey (ECRHS) to address the impact of s...

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Outcomes of childhood asthma to the age of 50 years

Cited by 192 publications

References 37 publications

Asthma and Height in Twins: A Cohort and Within-Pair Analyses Study

Asthma and Height in Twins: A Cohort and Within-Pair Analyses Study

A systematic review of early life factors which adversely affect subsequent lung function

Smoking, asthma, chronic airflow obstruction and COPD

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