Spirometric phenotypes from early childhood to young adulthood: a Chronic Airway Disease Early Stratification study

CADSET Clinical Res Collaboration, Gang Wang, Jenny Hallberg, Dimitrios Charalampopoulos, Maribel Casas Sanahuja, Robab Breyer-Kohansal, Arnulf Langhammer, Raquel Granell, Judith M. Vonk, Annemiek Mian, Nuria Olvera, Lisbeth Molgaard Laustsen, Eva Ronmark, Alicia Abellan, Alvar Agusti, Syed Hasan Arshad, Anna Bergstrom, H. Marike Boezen, Marie-Kathrin Breyer, Otto BurghuberAnneli Clea Bolund, Adnan Custovic, Graham Devereux, Gavin C. Donaldson, Liesbeth Duijts, Ana Esplugues, Rosa Faner, Ferran Ballester, Judith Garcia-Aymerich, Ulrike Gehring, SadiaHaider, Sylvia Hartl, HelenaBackman, 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 Schlunssen, Torben Sigsgaard, Angela Simpson, Jordi Sunyer, Maties Torrent, Stephen Turner, Maarten Van den Berge, Roel C. H. Vermeulen, Sigrid Anna Aalberg Vikjord

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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 (410, >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

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), preterrn 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 (a0R=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 (a0R=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.

Original languageEnglish
Article number457
Number of pages15
JournalERJ Open Research
Issue number4
Publication statusPublished - 1-Oct-2021



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