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

Gang Wang, Jenny Hallberg, CADSET Clinical Research Collaboration, 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 BurghuberAnneli 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

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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 49334 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.

Original languageEnglish
Article number00457-2021
JournalERJ Open Research
Issue number4
Early online date6 Dec 2021
Publication statusPublished - 2021

Bibliographical note

GlaxoSmithKline LLC
AstraZeneca UK Ltd
European Respiratory Society
Menarini and Sanofi-Genzyme

Publisher Copyright: © The authors 2021.


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