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 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

doi:10.1183/23120541.00457-2021

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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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 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 language	English
Article number	00457-2021
Journal	ERJ Open Research
Volume	7
Issue number	4
DOIs	https://doi.org/10.1183/23120541.00457-2021
Publication status	E-pub ahead of print - 6 Dec 2021

Bibliographical note

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

Publisher Copyright: © The authors 2021.

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Wang, G., Hallberg, J., CADSET Clinical Research Collaboration, Charalampopoulos, D., Sanahuja, M. C., Breyer-Kohansal, R., Langhammer, A., Granell, R., Vonk, J. M., Mian, A., Olvera, N., Laustsen, L. M., Rönmark, E., Abellan, A., Agusti, A., Arshad, S. H., Bergström, A., Boezen, H. M., Breyer, M. K., ... Vikjord, S. A. A. (2021). Spirometric phenotypes from early childhood to young adulthood: a Chronic Airway Disease Early Stratification study. ERJ Open Research, 7(4), [00457-2021]. https://doi.org/10.1183/23120541.00457-2021

@article{86f78220d311488893661f3cb97f4b3d,

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

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 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.",

author = "Gang Wang and Jenny Hallberg and {CADSET Clinical Research Collaboration} and Dimitrios Charalampopoulos and Sanahuja, {Maribel Casas} and Robab Breyer-Kohansal and Arnulf Langhammer and Raquel Granell and Vonk, {Judith M.} and Annemiek Mian and N{\'u}ria Olvera and Laustsen, {Lisbeth M{\o}lgaard} and Eva R{\"o}nmark and Alicia Abellan and Alvar Agusti and Arshad, {Syed Hasan} and Anna Bergstr{\"o}m and Boezen, {H. Marike} and Breyer, {Marie Kathrin} and Otto Burghuber and Bolund, {Anneli Clea} and Adnan Custovic and Graham Devereux and Donaldson, {Gavin C.} and Liesbeth Duijts and Ana Esplugues and Rosa Faner and Ferran Ballester and Judith Garcia-Aymerich and Ulrike Gehring and Sadia Haider and Sylvia Hartl and Helena Backman and Holloway, {John W.} and Koppelman, {Gerard H.} and Aitana Lertxundi and Holmen, {Turid Lingaas} and Lesley Lowe and Mensink-Bout, {Sara M.} and Murray, {Clare S.} and Graham Roberts and Linnea Hedman and Vivi Schl{\"u}nssen and Torben Sigsgaard and Angela Simpson and Jordi Sunyer and Maties Torrent and Stephen Turner and {Van den Berge}, Maarten and Vermeulen, {Roel C.H.} and Vikjord, {Sigrid Anna Aalberg}",

note = "FUNDING GlaxoSmithKline LLC AstraZeneca UK Ltd European Respiratory Society Menarini and Sanofi-Genzyme Publisher Copyright: {\textcopyright} The authors 2021.",

year = "2021",

month = dec,

day = "6",

doi = "10.1183/23120541.00457-2021",

language = "English",

volume = "7",

journal = "ERJ Open Research",

issn = "2312-0541",

publisher = "European Respiratory Society",

number = "4",

}

Wang, G, Hallberg, J, CADSET Clinical Research Collaboration, Charalampopoulos, D, Sanahuja, MC, Breyer-Kohansal, R, Langhammer, A, Granell, R, Vonk, JM, Mian, A, Olvera, N, Laustsen, LM, Rönmark, E, Abellan, A, Agusti, A, Arshad, SH, Bergström, A, Boezen, HM, Breyer, MK, Burghuber, O, Bolund, AC, Custovic, A, Devereux, G, Donaldson, GC, Duijts, L, Esplugues, A, Faner, R, Ballester, F, Garcia-Aymerich, J, Gehring, U, Haider, S, Hartl, S, Backman, H, Holloway, JW, Koppelman, GH, Lertxundi, A, Holmen, TL, Lowe, L, Mensink-Bout, SM, Murray, CS, Roberts, G, Hedman, L, Schlünssen, V, Sigsgaard, T, Simpson, A, Sunyer, J, Torrent, M, Turner, S, Van den Berge, M, Vermeulen, RCH & Vikjord, SAA 2021, 'Spirometric phenotypes from early childhood to young adulthood: a Chronic Airway Disease Early Stratification study', ERJ Open Research, vol. 7, no. 4, 00457-2021. https://doi.org/10.1183/23120541.00457-2021

TY - JOUR

T1 - Spirometric phenotypes from early childhood to young adulthood

T2 - a Chronic Airway Disease Early Stratification study

AU - Wang, Gang

AU - Hallberg, Jenny

AU - CADSET Clinical Research Collaboration

AU - Charalampopoulos, Dimitrios

AU - Sanahuja, Maribel Casas

AU - Breyer-Kohansal, Robab

AU - Langhammer, Arnulf

AU - Granell, Raquel

AU - Vonk, Judith M.

AU - Mian, Annemiek

AU - Olvera, Núria

AU - Laustsen, Lisbeth Mølgaard

AU - Rönmark, Eva

AU - Abellan, Alicia

AU - Agusti, Alvar

AU - Arshad, Syed Hasan

AU - Bergström, Anna

AU - Boezen, H. Marike

AU - Breyer, Marie Kathrin

AU - Burghuber, Otto

AU - Bolund, Anneli Clea

AU - Custovic, Adnan

AU - Devereux, Graham

AU - Donaldson, Gavin C.

AU - Duijts, Liesbeth

AU - Esplugues, Ana

AU - Faner, Rosa

AU - Ballester, Ferran

AU - Garcia-Aymerich, Judith

AU - Gehring, Ulrike

AU - Haider, Sadia

AU - Hartl, Sylvia

AU - Backman, Helena

AU - Holloway, John W.

AU - Koppelman, Gerard H.

AU - Lertxundi, Aitana

AU - Holmen, Turid Lingaas

AU - Lowe, Lesley

AU - Mensink-Bout, Sara M.

AU - Murray, Clare S.

AU - Roberts, Graham

AU - Hedman, Linnea

AU - Schlünssen, Vivi

AU - Sigsgaard, Torben

AU - Simpson, Angela

AU - Sunyer, Jordi

AU - Torrent, Maties

AU - Turner, Stephen

AU - Van den Berge, Maarten

AU - Vermeulen, Roel C.H.

AU - Vikjord, Sigrid Anna Aalberg

PY - 2021/12/6

Y1 - 2021/12/6

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85122250374&partnerID=8YFLogxK

U2 - 10.1183/23120541.00457-2021

DO - 10.1183/23120541.00457-2021

M3 - Article

AN - SCOPUS:85122250374

VL - 7

JO - ERJ Open Research

JF - ERJ Open Research

SN - 2312-0541

IS - 4

M1 - 00457-2021

ER -

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

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