Asthma-like symptoms in young children increase the risk of COPD,Journal of Allergy and Clinical Immunology

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Asthma-like symptoms in young children increase the risk of COPD
Journal of Allergy and Clinical Immunology ( IF 11.4 ) Pub Date : 2020-06-12 , DOI: 10.1016/j.jaci.2020.05.043
Hans Bisgaard ₁ , Sarah Nørgaard ₁ , Astrid Sevelsted ₁ , Bo Lund Chawes ₁ , Jakob Stokholm ₁ , Erik Lykke Mortensen ₂ , Charlotte Suppli Ulrik ₃ , Klaus Bønnelykke ₁

Affiliation

Background

Chronic obstructive pulmonary disease (COPD) may originate in early life and share disease mechanisms with asthma-like symptoms in early childhood. This possibility remains unexplored on account of the lack of long-term prospective studies from infancy to the onset of COPD.

Objective

We aimed to investigate the relationship between asthma-like symptoms in young children and development of COPD.

Methods

In a population-based cohort of women who gave birth at the central hospital in Copenhagen during period from 1959 to 1961, we investigated data from 3290 mother-child pairs who attended examinations during pregnancy and when the children were aged 1, 3, and 6 years. COPD was assessed from the Danish national registries on hospitalizations and prescription medication since 1994. A subgroup of 930 individuals underwent spirometry testing at age 50 years.

Results

Of the 3290 children, 1 in 4 had a history of asthma-like symptoms in early childhood. The adjusted hazard ratio for hospitalization for COPD was 1.88 (95% CI = 1.32-2.68), and the odds ratio for prescription of long-acting muscarinic antagonists was 2.27 (95% CI = 1.38-3.70). Asthma-like symptoms in early childhood were also associated with a reduced FEV₁ percent predicted and an FEV₁-to–forced vital capacity ratio at age 50 years (–3.36% [95% CI = –5.47 to –1.24] and –1.28 [95% CI = –2.17 to –0.38], respectively) and with COPD defined according to Global Initiative for Chronic Obstructive Lung Disease stage higher than 1 (odds ratio = 1.96 [95% CI = 1.13-3.34]).

Conclusion

This 60-year prospective follow-up of a mother-child cohort demonstrated a doubled risk for COPD from childhood asthma-like symptoms.

中文翻译：

幼儿的哮喘样症状会增加患 COPD 的风险

背景

慢性阻塞性肺疾病 (COPD) 可能起源于生命早期，并与儿童早期的哮喘样症状共享疾病机制。由于缺乏从婴儿到 COPD 发病的长期前瞻性研究，这种可能性仍未得到探索。

客观的

我们旨在调查幼儿哮喘样症状与 COPD 发展之间的关系。

方法

在 1959 年至 1961 年期间在哥本哈根市中心医院分娩的以人群为基础的妇女队列中，我们调查了 3290 对在怀孕期间和孩子 1、3 和 6 岁时参加检查的母婴对的数据年。自 1994 年以来，丹麦国家登记处就住院和处方药对 COPD 进行了评估。一个由 930 人组成的亚组在 50 岁时接受了肺量测定法测试。

结果

在 3290 名儿童中，四分之一的儿童在儿童早期有哮喘样症状。COPD 住院的调整风险比为 1.88（95% CI = 1.32-2.68），长效毒蕈碱拮抗剂处方的优势比为 2.27（95% CI = 1.38-3.70）。哮喘样在儿童早期症状也具有降低的FEV关联_1个预测百分比和FEV ₁在50岁-to-用力肺活量比（-3.36％[95％CI = -5.47至-1.24]和-1.28 [分别为 95% CI = –2.17 至 –0.38]）和根据全球慢性阻塞性肺疾病倡议定义的 COPD 分期高于 1（优势比 = 1.96 [95% CI = 1.13-3.34]）。