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Spirometric patterns in young and middle-aged adults: a 20-year European study
ISGlobal, Campus Mar, Catalunya, Barcelona, Spain; Universita Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Biometrics, RTI-Health Solutions, Barcelona, Spain.
ISGlobal, Campus Mar, Catalunya, Barcelona, Spain; Universita Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, VIC, Parkville, Australia.
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2024 (English)In: Thorax, ISSN 0040-6376, E-ISSN 1468-3296, Vol. 79, no 2, p. 153-162Article in journal (Refereed) Published
Abstract [en]

Background: Understanding the natural history of abnormal spirometric patterns at different stages of life is critical to identify and optimise preventive strategies. We aimed to describe characteristics and risk factors of restrictive and obstructive spirometric patterns occurring before 40 years (young onset) and between 40 and 61 years (mid-adult onset).

Methods: We used data from the population-based cohort of the European Community Respiratory Health Survey (ECRHS). Prebronchodilator forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were assessed longitudinally at baseline (ECRHS1, 1993-1994) and again 20 years later (ECRHS3, 2010-2013). Spirometry patterns were defined as: restrictive if FEV1/FVC≥LLN and FVC<10th percentile, obstructive if FEV1/FVC<LLN or normal otherwise. Five spirometry patterns were derived depending on whether participants never developed restrictive/obstructive (normal), developed restrictive/obstructive at baseline (young onset) or at last follow-up (mid-adult onset). The characteristics and risk factors associated with these patterns were described and assessed using multilevel multinomial logistic regression analysis adjusting for age, sex, sample (random or symptomatic) and centre.

Results: Among 3502 participants (mean age=30.4 (SD 5.4) at ECRHS1, 50.4 (SD 5.4) at ECRHS3), 2293 (65%) had a normal, 371 (11%) a young restrictive, 301 (9%) a young obstructive, 187 (5%) a mid-adult onset restrictive and 350 (10%) a mid-adult onset obstructive spirometric pattern. Being lean/underweight in childhood and young adult life was associated with the occurrence of the young spirometric restrictive pattern (relative risk ratio (RRR)=1.61 95% CI=1.21 to 2.14, and RRR=2.43 95% CI=1.80 to 3.29; respectively), so were respiratory infections before 5 years (RRR=1.48, 95% CI=1.05 to 2.08). The main determinants for young obstructive, mid-adult restrictive and mid-adult obstructive patterns were asthma, obesity and smoking, respectively.

Conclusion: Spirometric patterns with onset in young and mid-adult life were associated with distinct characteristics and risk factors.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024. Vol. 79, no 2, p. 153-162
Keywords [en]
Clinical Epidemiology, COPD epidemiology
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:umu:diva-215238DOI: 10.1136/thorax-2022-219696ISI: 001076902900001PubMedID: 37758456Scopus ID: 2-s2.0-85173063186OAI: oai:DiVA.org:umu-215238DiVA, id: diva2:1805229
Available from: 2023-10-16 Created: 2023-10-16 Last updated: 2024-05-08Bibliographically approved

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Forsberg, Bertil

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