Outcomes of Childhood Asthma and Wheezy Bronchitis

A 50-Year Cohort Study

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Abstract

Rationale: Cohort studies suggest that airflow obstruction is established early in life, manifests as childhood asthma and wheezy bronchitis, and continues into early adulthood. Although an association between childhood asthma and chronic obstructive pulmonary disease (COPD) in later life has been demonstrated, it is unclear if childhood wheezy bronchitis is associated with COPD.
Objectives: To investigate whether childhood wheezy bronchitis increases the risk of COPD in the seventh decade.
Methods: A cohort of children recruited in 1964 at age 10 to 15 years, which was followed up in 1989, 1995, and 2001, was followed up again in 2014 when at age 60 to 65 years. Discrete time-to-event and linear mixed effects models were used.
Measurements and Main Results: FEV1 and FVC were measured. COPD was defined as post-bronchodilator FEV1/FVC <0.7. Childhood wheezing phenotype was related to 1989, 1995, 2001, and 2014 spirometry data. Three hundred thirty subjects, mean age 61 years, were followed up: 38 with childhood asthma; 53 with childhood wheezy bronchitis; and 239 control subjects (of whom 57 developed adulthood-onset wheeze between ages 16 and 46 yr). In adjusted multivariate analyses, childhood asthma was associated with an increased risk of COPD (odds ratio, 6.37; 95% confidence interval, 3.73–10.94), as was childhood wheezy bronchitis (odd ratio 1.81; 95% confidence interval, 1.12–2.91). The COPD risk increased with childhood asthma, and wheezy bronchitis was associated with reduced FEV1 that was evident by the fifth decade and not an accelerated rate of FEV1 decline. In contrast, adulthood-onset wheeze was associated with accelerated FEV1 decline.
Conclusions: Childhood wheezy bronchitis and asthma are associated with an increased risk of COPD and reduced ventilatory function.
Original languageEnglish
Pages (from-to)23-30
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume193
Issue number1
Early online date9 Sep 2015
DOIs
Publication statusPublished - 1 Jan 2016

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Bronchitis
Chronic Obstructive Pulmonary Disease
Cohort Studies
Asthma
Odds Ratio
Confidence Intervals
Bronchodilator Agents
Spirometry
Respiratory Sounds
Multivariate Analysis
Phenotype

Keywords

  • childhood wheezing phenotypes
  • chronic obstructive pulmonary disease
  • pulmonary function decline
  • asthma

Cite this

@article{4b3542e5d2d24efabf2f4adbe418d089,
title = "Outcomes of Childhood Asthma and Wheezy Bronchitis: A 50-Year Cohort Study",
abstract = "Rationale: Cohort studies suggest that airflow obstruction is established early in life, manifests as childhood asthma and wheezy bronchitis, and continues into early adulthood. Although an association between childhood asthma and chronic obstructive pulmonary disease (COPD) in later life has been demonstrated, it is unclear if childhood wheezy bronchitis is associated with COPD.Objectives: To investigate whether childhood wheezy bronchitis increases the risk of COPD in the seventh decade.Methods: A cohort of children recruited in 1964 at age 10 to 15 years, which was followed up in 1989, 1995, and 2001, was followed up again in 2014 when at age 60 to 65 years. Discrete time-to-event and linear mixed effects models were used.Measurements and Main Results: FEV1 and FVC were measured. COPD was defined as post-bronchodilator FEV1/FVC <0.7. Childhood wheezing phenotype was related to 1989, 1995, 2001, and 2014 spirometry data. Three hundred thirty subjects, mean age 61 years, were followed up: 38 with childhood asthma; 53 with childhood wheezy bronchitis; and 239 control subjects (of whom 57 developed adulthood-onset wheeze between ages 16 and 46 yr). In adjusted multivariate analyses, childhood asthma was associated with an increased risk of COPD (odds ratio, 6.37; 95{\%} confidence interval, 3.73–10.94), as was childhood wheezy bronchitis (odd ratio 1.81; 95{\%} confidence interval, 1.12–2.91). The COPD risk increased with childhood asthma, and wheezy bronchitis was associated with reduced FEV1 that was evident by the fifth decade and not an accelerated rate of FEV1 decline. In contrast, adulthood-onset wheeze was associated with accelerated FEV1 decline.Conclusions: Childhood wheezy bronchitis and asthma are associated with an increased risk of COPD and reduced ventilatory function.",
keywords = "childhood wheezing phenotypes, chronic obstructive pulmonary disease, pulmonary function decline, asthma",
author = "Narga Tagiyeva and Graham Devereux and Shona Fielding and Stephen Turner and Graham Douglas",
note = "Supported by Chest Heart and Stroke Scotland",
year = "2016",
month = "1",
day = "1",
doi = "10.1164/rccm.201505-0870OC",
language = "English",
volume = "193",
pages = "23--30",
journal = "American Journal of Respiratory and Critical Care Medicine",
issn = "1073-449X",
publisher = "American Thoracic Society - AJRCCM",
number = "1",

}

TY - JOUR

T1 - Outcomes of Childhood Asthma and Wheezy Bronchitis

T2 - A 50-Year Cohort Study

AU - Tagiyeva, Narga

AU - Devereux, Graham

AU - Fielding, Shona

AU - Turner, Stephen

AU - Douglas, Graham

N1 - Supported by Chest Heart and Stroke Scotland

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Rationale: Cohort studies suggest that airflow obstruction is established early in life, manifests as childhood asthma and wheezy bronchitis, and continues into early adulthood. Although an association between childhood asthma and chronic obstructive pulmonary disease (COPD) in later life has been demonstrated, it is unclear if childhood wheezy bronchitis is associated with COPD.Objectives: To investigate whether childhood wheezy bronchitis increases the risk of COPD in the seventh decade.Methods: A cohort of children recruited in 1964 at age 10 to 15 years, which was followed up in 1989, 1995, and 2001, was followed up again in 2014 when at age 60 to 65 years. Discrete time-to-event and linear mixed effects models were used.Measurements and Main Results: FEV1 and FVC were measured. COPD was defined as post-bronchodilator FEV1/FVC <0.7. Childhood wheezing phenotype was related to 1989, 1995, 2001, and 2014 spirometry data. Three hundred thirty subjects, mean age 61 years, were followed up: 38 with childhood asthma; 53 with childhood wheezy bronchitis; and 239 control subjects (of whom 57 developed adulthood-onset wheeze between ages 16 and 46 yr). In adjusted multivariate analyses, childhood asthma was associated with an increased risk of COPD (odds ratio, 6.37; 95% confidence interval, 3.73–10.94), as was childhood wheezy bronchitis (odd ratio 1.81; 95% confidence interval, 1.12–2.91). The COPD risk increased with childhood asthma, and wheezy bronchitis was associated with reduced FEV1 that was evident by the fifth decade and not an accelerated rate of FEV1 decline. In contrast, adulthood-onset wheeze was associated with accelerated FEV1 decline.Conclusions: Childhood wheezy bronchitis and asthma are associated with an increased risk of COPD and reduced ventilatory function.

AB - Rationale: Cohort studies suggest that airflow obstruction is established early in life, manifests as childhood asthma and wheezy bronchitis, and continues into early adulthood. Although an association between childhood asthma and chronic obstructive pulmonary disease (COPD) in later life has been demonstrated, it is unclear if childhood wheezy bronchitis is associated with COPD.Objectives: To investigate whether childhood wheezy bronchitis increases the risk of COPD in the seventh decade.Methods: A cohort of children recruited in 1964 at age 10 to 15 years, which was followed up in 1989, 1995, and 2001, was followed up again in 2014 when at age 60 to 65 years. Discrete time-to-event and linear mixed effects models were used.Measurements and Main Results: FEV1 and FVC were measured. COPD was defined as post-bronchodilator FEV1/FVC <0.7. Childhood wheezing phenotype was related to 1989, 1995, 2001, and 2014 spirometry data. Three hundred thirty subjects, mean age 61 years, were followed up: 38 with childhood asthma; 53 with childhood wheezy bronchitis; and 239 control subjects (of whom 57 developed adulthood-onset wheeze between ages 16 and 46 yr). In adjusted multivariate analyses, childhood asthma was associated with an increased risk of COPD (odds ratio, 6.37; 95% confidence interval, 3.73–10.94), as was childhood wheezy bronchitis (odd ratio 1.81; 95% confidence interval, 1.12–2.91). The COPD risk increased with childhood asthma, and wheezy bronchitis was associated with reduced FEV1 that was evident by the fifth decade and not an accelerated rate of FEV1 decline. In contrast, adulthood-onset wheeze was associated with accelerated FEV1 decline.Conclusions: Childhood wheezy bronchitis and asthma are associated with an increased risk of COPD and reduced ventilatory function.

KW - childhood wheezing phenotypes

KW - chronic obstructive pulmonary disease

KW - pulmonary function decline

KW - asthma

U2 - 10.1164/rccm.201505-0870OC

DO - 10.1164/rccm.201505-0870OC

M3 - Article

VL - 193

SP - 23

EP - 30

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

SN - 1073-449X

IS - 1

ER -