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Title: Patterns of Growth and Decline in Lung Function in Persistent Childhood Asthma
Authors: McGeachie, Michael J.
Yates, Katherine P.
Zhou, Xiaobo
Guo, Feng
Sternberg, Alice L.
Van Natta, Mark L.
Wise, Robert A.
Szefler, Stanley J.
Sharma, Sunita
Kho, Alvin T.
Cho, Michael H.
Croteau-Chonka, Damien C.
Castaldi, Peter J.
Jain, Gaurav
Sanyal, Amartya
Zhan, Ye
Lajoie, Bryan R.
Dekker, Job
Stamatoyannopoulos, John
Covar, Ronina A.
Zeiger, Robert S.
Adkinson, N. Franklin
Williams, Paul V.
Kelly, H. William
Grasemann, Hartmut
Vonk, Judith M.
Koppelman, Gerard H.
Postma, Dirkje S.
Raby, Benjamin A.
Houston, Isaac
Lu, Quan
Fuhlbrigge, Anne L.
Tantisira, Kelan G.
Silverman, Edwin K.
Tonascia, James
Weiss, Scott T.
Strunk, Robert C.
Keywords: Medicine
Biological Sciences
Issue Date: 2016
Source: McGeachie, M. J., Yates, K. P., Zhou, X., Guo, F., Sternberg, A. L., Van Natta, M. L., et al. (2016). Patterns of Growth and Decline in Lung Function in Persistent Childhood Asthma. New England Journal of Medicine, 374(19), 1842-1852.
Series/Report no.: New England Journal of Medicine
Abstract: BACKGROUND: Tracking longitudinal measurements of growth and decline in lung function in patients with persistent childhood asthma may reveal links between asthma and subsequent chronic airflow obstruction. METHODS: We classified children with asthma according to four characteristic patterns of lung-function growth and decline on the basis of graphs showing forced expiratory volume in 1 second (FEV1), representing spirometric measurements performed from childhood into adulthood. Risk factors associated with abnormal patterns were also examined. To define normal values, we used FEV1 values from participants in the National Health and Nutrition Examination Survey who did not have asthma. RESULTS: Of the 684 study participants, 170 (25%) had a normal pattern of lung-function growth without early decline, and 514 (75%) had abnormal patterns: 176 (26%) had reduced growth and an early decline, 160 (23%) had reduced growth only, and 178 (26%) had normal growth and an early decline. Lower baseline values for FEV1, smaller bronchodilator response, airway hyperresponsiveness at baseline, and male sex were associated with reduced growth (P<0.001 for all comparisons). At the last spirometric measurement (mean [±SD] age, 26.0±1.8 years), 73 participants (11%) met Global Initiative for Chronic Obstructive Lung Disease spirometric criteria for lung-function impairment that was consistent with chronic obstructive pulmonary disease (COPD); these participants were more likely to have a reduced pattern of growth than a normal pattern (18% vs. 3%, P<0.001). CONCLUSIONS: Childhood impairment of lung function and male sex were the most significant predictors of abnormal longitudinal patterns of lung-function growth and decline. Children with persistent asthma and reduced growth of lung function are at increased risk for fixed airflow obstruction and possibly COPD in early adulthood. (Funded by the Parker B. Francis Foundation and others; number, NCT00000575).
ISSN: 0028-4793
DOI: 10.1056/NEJMoa1513737
Schools: School of Biological Sciences 
Lee Kong Chian School of Medicine (LKCMedicine) 
Rights: © 2016 Massachusetts Medical Society. This paper was published in New England Journal of Medicine and is made available as an electronic reprint (preprint) with permission of Massachusetts Medical Society. The published version is available at: []. One print or electronic copy may be made for personal use only. Systematic or multiple reproduction, distribution to multiple locations via electronic or other means, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper is prohibited and is subject to penalties under law.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles
SBS Journal Articles

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