A distinct low lung function trajectory from childhood to the fourth decade of life

Cristine E. Berry, Dean Billheimer, Isaac C. Jenkins, Zhenqiang J. Lu, Debra A. Stern, Lynn B. Gerald, Tara F. Carr, Stefano Guerra, Wayne J. Morgan, Anne L Wright, Fernando D. Martinez

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65 Citations (Scopus)

Abstract

Rationale: Low maximally attained lung function increases the risk of chronic obstructive pulmonary disease irrespective of the subsequent rate of lung function decline. Objectives: We aimed to determine if there were individuals with a distinct, persistently low lung function trajectory in the CRS (Tucson Children's Respiratory Study). Methods: The CRS, an ongoing birth cohort study, enrolled 1,246 participants between 1980 and 1984. Latent class linear mixed effects modeling of the ratio of FEV1 to FVC was used to identify distinct lung function trajectories among participants with two or more spirometry measurements between ages 11 and 32 years. Measurements and Main Results: Among 599 participants with 2,142 observations, a model with two distinct trajectories (a low trajectory [n = 56; 9.3%] and a normal trajectory) fit the data significantly better than a model with only one trajectory (P = 0.0007). As compared with those with a normal trajectory, participants with a persistently low trajectory were more likely to have a history of maternal asthma (20.0% vs. 9.9%; P = 0.02); early life lower respiratory illness caused by respiratory syncytial virus (41.2% vs. 21.4%; P = 0.001); and physician-diagnosed active asthma at age 32 years (43.9% vs. 16.2%; P,0.001). Individuals with a persistently low trajectory also demonstrated lower lung function as measured by average maximal expiratory flow at functional residual capacity during infancy and at age 6 years. Conclusions: A distinct group of individuals in a nonselected population demonstrates a persistently low lung function trajectory that may be partly established at birth and predisposes them to chronic obstructive pulmonary disease later in life.

Original languageEnglish (US)
Pages (from-to)607-612
Number of pages6
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume194
Issue number5
DOIs
StatePublished - Sep 1 2016

Fingerprint

Lung
Chronic Obstructive Pulmonary Disease
Asthma
Parturition
Functional Residual Capacity
Respiratory Syncytial Viruses
Spirometry
Cohort Studies
Mothers
Physicians
Population

Keywords

  • Asthma
  • Chronic obstructive pulmonary disease
  • Epidemiology
  • Respiratory function tests

ASJC Scopus subject areas

  • Medicine(all)
  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

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title = "A distinct low lung function trajectory from childhood to the fourth decade of life",
abstract = "Rationale: Low maximally attained lung function increases the risk of chronic obstructive pulmonary disease irrespective of the subsequent rate of lung function decline. Objectives: We aimed to determine if there were individuals with a distinct, persistently low lung function trajectory in the CRS (Tucson Children's Respiratory Study). Methods: The CRS, an ongoing birth cohort study, enrolled 1,246 participants between 1980 and 1984. Latent class linear mixed effects modeling of the ratio of FEV1 to FVC was used to identify distinct lung function trajectories among participants with two or more spirometry measurements between ages 11 and 32 years. Measurements and Main Results: Among 599 participants with 2,142 observations, a model with two distinct trajectories (a low trajectory [n = 56; 9.3{\%}] and a normal trajectory) fit the data significantly better than a model with only one trajectory (P = 0.0007). As compared with those with a normal trajectory, participants with a persistently low trajectory were more likely to have a history of maternal asthma (20.0{\%} vs. 9.9{\%}; P = 0.02); early life lower respiratory illness caused by respiratory syncytial virus (41.2{\%} vs. 21.4{\%}; P = 0.001); and physician-diagnosed active asthma at age 32 years (43.9{\%} vs. 16.2{\%}; P,0.001). Individuals with a persistently low trajectory also demonstrated lower lung function as measured by average maximal expiratory flow at functional residual capacity during infancy and at age 6 years. Conclusions: A distinct group of individuals in a nonselected population demonstrates a persistently low lung function trajectory that may be partly established at birth and predisposes them to chronic obstructive pulmonary disease later in life.",
keywords = "Asthma, Chronic obstructive pulmonary disease, Epidemiology, Respiratory function tests",
author = "Berry, {Cristine E.} and Dean Billheimer and Jenkins, {Isaac C.} and Lu, {Zhenqiang J.} and Stern, {Debra A.} and Gerald, {Lynn B.} and Carr, {Tara F.} and Stefano Guerra and Morgan, {Wayne J.} and Wright, {Anne L} and Martinez, {Fernando D.}",
year = "2016",
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day = "1",
doi = "10.1164/rccm.201604-0753OC",
language = "English (US)",
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journal = "American Journal of Respiratory and Critical Care Medicine",
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T1 - A distinct low lung function trajectory from childhood to the fourth decade of life

AU - Berry, Cristine E.

AU - Billheimer, Dean

AU - Jenkins, Isaac C.

AU - Lu, Zhenqiang J.

AU - Stern, Debra A.

AU - Gerald, Lynn B.

AU - Carr, Tara F.

AU - Guerra, Stefano

AU - Morgan, Wayne J.

AU - Wright, Anne L

AU - Martinez, Fernando D.

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Rationale: Low maximally attained lung function increases the risk of chronic obstructive pulmonary disease irrespective of the subsequent rate of lung function decline. Objectives: We aimed to determine if there were individuals with a distinct, persistently low lung function trajectory in the CRS (Tucson Children's Respiratory Study). Methods: The CRS, an ongoing birth cohort study, enrolled 1,246 participants between 1980 and 1984. Latent class linear mixed effects modeling of the ratio of FEV1 to FVC was used to identify distinct lung function trajectories among participants with two or more spirometry measurements between ages 11 and 32 years. Measurements and Main Results: Among 599 participants with 2,142 observations, a model with two distinct trajectories (a low trajectory [n = 56; 9.3%] and a normal trajectory) fit the data significantly better than a model with only one trajectory (P = 0.0007). As compared with those with a normal trajectory, participants with a persistently low trajectory were more likely to have a history of maternal asthma (20.0% vs. 9.9%; P = 0.02); early life lower respiratory illness caused by respiratory syncytial virus (41.2% vs. 21.4%; P = 0.001); and physician-diagnosed active asthma at age 32 years (43.9% vs. 16.2%; P,0.001). Individuals with a persistently low trajectory also demonstrated lower lung function as measured by average maximal expiratory flow at functional residual capacity during infancy and at age 6 years. Conclusions: A distinct group of individuals in a nonselected population demonstrates a persistently low lung function trajectory that may be partly established at birth and predisposes them to chronic obstructive pulmonary disease later in life.

AB - Rationale: Low maximally attained lung function increases the risk of chronic obstructive pulmonary disease irrespective of the subsequent rate of lung function decline. Objectives: We aimed to determine if there were individuals with a distinct, persistently low lung function trajectory in the CRS (Tucson Children's Respiratory Study). Methods: The CRS, an ongoing birth cohort study, enrolled 1,246 participants between 1980 and 1984. Latent class linear mixed effects modeling of the ratio of FEV1 to FVC was used to identify distinct lung function trajectories among participants with two or more spirometry measurements between ages 11 and 32 years. Measurements and Main Results: Among 599 participants with 2,142 observations, a model with two distinct trajectories (a low trajectory [n = 56; 9.3%] and a normal trajectory) fit the data significantly better than a model with only one trajectory (P = 0.0007). As compared with those with a normal trajectory, participants with a persistently low trajectory were more likely to have a history of maternal asthma (20.0% vs. 9.9%; P = 0.02); early life lower respiratory illness caused by respiratory syncytial virus (41.2% vs. 21.4%; P = 0.001); and physician-diagnosed active asthma at age 32 years (43.9% vs. 16.2%; P,0.001). Individuals with a persistently low trajectory also demonstrated lower lung function as measured by average maximal expiratory flow at functional residual capacity during infancy and at age 6 years. Conclusions: A distinct group of individuals in a nonselected population demonstrates a persistently low lung function trajectory that may be partly established at birth and predisposes them to chronic obstructive pulmonary disease later in life.

KW - Asthma

KW - Chronic obstructive pulmonary disease

KW - Epidemiology

KW - Respiratory function tests

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