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Accelerated decline in lung function in adults with a history of remitted childhood asthma
European Respiratory Journal ( IF 16.6 ) Pub Date : 2022-01-13 , DOI: 10.1183/13993003.00305-2021
Shinichiro Miura 1 , Hiroshi Iwamoto 2 , Keitaro Omori 3 , Kakuhiro Yamaguchi 1 , Shinjiro Sakamoto 1 , Yasushi Horimasu 1 , Takeshi Masuda 1 , Shintaro Miyamoto 1 , Taku Nakashima 1 , Kazunori Fujitaka 1 , Hironobu Hamada 1 , Akihito Yokoyama 4 , Noboru Hattori 1
Affiliation  

Background

A significant number of children with asthma show remission in adulthood. Although these adults are often diagnosed with COPD in later life, the effect of clinically remitted childhood asthma on the decline in lung function during adulthood is uncertain. We examined whether clinical remission of childhood asthma was associated with an accelerated decline in lung function in apparently nonasthmatic adults.

Methods

3584 participants (mean (range) age 48.1 (35–65) years) who did not have adulthood asthma and other lung diseases and had normal lung function at the baseline visit were included. They were categorised as those with remitted childhood asthma (n=121) and healthy controls (n=3463) according to their self-reported childhood asthma history. Spirometry was performed at baseline and follow-up visits.

Results

The mean follow-up was 5.3 years. Multivariate regression analysis showed that remitted childhood asthma and smoking were independently associated with a rapid decline in forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Smoking was an independent predictor of a rapid decline in FEV1/FVC. The annual decline in FEV1 and FVC was significantly greater in participants with remitted childhood asthma than in healthy controls, and the differences remained significant after adjusting for the propensity score.

Conclusions

A history of clinically remitted childhood asthma is an independent risk factor for accelerated decline in lung function in adults. Remitted childhood asthma and smoking may additively accelerate the development of obstructive lung disease.



中文翻译:

有缓解儿童哮喘病史的成人肺功能加速下降

背景

相当数量的哮喘儿童在成年期表现出缓解。尽管这些成年人经常在晚年被诊断出患有慢性阻塞性肺病,但临床缓解的儿童哮喘对成年期肺功能下降的影响尚不确定。我们检查了儿童哮喘的临床缓解是否与明显非哮喘成人的肺功能加速下降有关。

方法

纳入了 3584 名参与者(平均(范围)年龄 48.1(35-65)岁),他们没有成年期哮喘和其他肺部疾病,并且在基线访问时肺功能正常。根据他们自我报告的儿童哮喘病史,他们被分为缓解儿童哮喘(n=121)和健康对照组(n=3463)。在基线和随访时进行肺活量测定。

结果

平均随访时间为 5.3 年。多变量回归分析表明,缓解儿童哮喘和吸烟与 1 秒用力呼气量 (FEV 1 ) 和用力肺活量 (FVC)的快速下降独立相关。吸烟是 FEV 1 /FVC快速下降的独立预测因素。与健康对照组相比,儿童哮喘缓解的参与者的 FEV 1和 FVC的年度下降幅度显着大于健康对照组,并且在调整倾向评分后差异仍然显着。

结论

临床缓解的儿童哮喘病史是成人肺功能加速下降的独立危险因素。缓解的儿童哮喘和吸烟可能会加速阻塞性肺病的发展。

更新日期:2022-01-13
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