TY - JOUR
T1 - Wheezing and bronchial hyper-responsiveness in early childhood as predictors of newly diagnosed asthma in early adulthood
T2 - a longitudinal birth-cohort study
AU - Stern, Debra A.
AU - Morgan, Wayne J.
AU - Halonen, Marilyn
AU - Wright, Anne L.
AU - Martinez, Fernando D.
N1 - Funding Information:
This work is supported by grant HL-56177 from the National Heart Lung and Blood Institute. We gratefully acknowledge the contributions of Lynn Taussig who started the Tucson Children's Respiratory Study in 1980. We thank Bruce Saul for data management and our study nurses, Marilyn Lindell and Lydia de la Ossa, for data collection and participant follow-up.
PY - 2008
Y1 - 2008
N2 - Background: Incidence of asthma increases during early adulthood. We aimed to estimate the contributions of sex and early life factors to asthma diagnosed in young adults. Methods: 1246 healthy newborn babies were enrolled in the Tucson Children's Respiratory Study. Parental characteristics, early-life wheezing phenotypes, airway function, and bronchial hyper-responsiveness to cold dry air and sensitisation to Alternaria alternata were determined before age 6 years. Physician-diagnosed asthma, both chronic and newly diagnosed, and airway function were recorded at age 22 years. Findings: Of 1246 babies enrolled, 849 had follow-up data at 22 years. Average incidence of asthma at age 16-22 years was 12·6 per thousand person-years. 49 (27%) of all 181 cases of active asthma at 22 years were newly diagnosed, of which 35 (71%) were women. Asthma remittance by 22 years was higher in men than in women (multinomial odds ratio [M-OR] 2·0, 95% CI 1·2-3·2, p=0·008). Age at diagnosis was linearly associated with the ratio of forced expiratory volume at 1 s to forced vital capacity at age 22 years. Factors independently associated with chronic asthma at 22 years included onset at 6 years (7·4, 3·9-14·0) and persistent wheezing (14·0, 6·8-28·0) in early life, sensitisation to A alternata (3·6, 2·1-6·4), low airway function at age 6 years (2·1, 1·1-3·9), and bronchial hyper-responsiveness at 6 years (4·5, 1·9-10·0). Bronchial hyper-responsiveness (6·9, 2·3-21·0), low airway function at 6 years (2·8, 1·1-6·9), and late-onset (4·6, 1·7-12·0) and persistent wheezing (4·0, 1·2-14·0) predicted newly diagnosed asthma at age 22 years. Interpretation: Asthma with onset in early adulthood has its origins in early childhood. Funding: National Heart Lung and Blood Institute.
AB - Background: Incidence of asthma increases during early adulthood. We aimed to estimate the contributions of sex and early life factors to asthma diagnosed in young adults. Methods: 1246 healthy newborn babies were enrolled in the Tucson Children's Respiratory Study. Parental characteristics, early-life wheezing phenotypes, airway function, and bronchial hyper-responsiveness to cold dry air and sensitisation to Alternaria alternata were determined before age 6 years. Physician-diagnosed asthma, both chronic and newly diagnosed, and airway function were recorded at age 22 years. Findings: Of 1246 babies enrolled, 849 had follow-up data at 22 years. Average incidence of asthma at age 16-22 years was 12·6 per thousand person-years. 49 (27%) of all 181 cases of active asthma at 22 years were newly diagnosed, of which 35 (71%) were women. Asthma remittance by 22 years was higher in men than in women (multinomial odds ratio [M-OR] 2·0, 95% CI 1·2-3·2, p=0·008). Age at diagnosis was linearly associated with the ratio of forced expiratory volume at 1 s to forced vital capacity at age 22 years. Factors independently associated with chronic asthma at 22 years included onset at 6 years (7·4, 3·9-14·0) and persistent wheezing (14·0, 6·8-28·0) in early life, sensitisation to A alternata (3·6, 2·1-6·4), low airway function at age 6 years (2·1, 1·1-3·9), and bronchial hyper-responsiveness at 6 years (4·5, 1·9-10·0). Bronchial hyper-responsiveness (6·9, 2·3-21·0), low airway function at 6 years (2·8, 1·1-6·9), and late-onset (4·6, 1·7-12·0) and persistent wheezing (4·0, 1·2-14·0) predicted newly diagnosed asthma at age 22 years. Interpretation: Asthma with onset in early adulthood has its origins in early childhood. Funding: National Heart Lung and Blood Institute.
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U2 - 10.1016/S0140-6736(08)61447-6
DO - 10.1016/S0140-6736(08)61447-6
M3 - Article
C2 - 18805334
AN - SCOPUS:52049088955
SN - 0140-6736
VL - 372
SP - 1058
EP - 1064
JO - The Lancet
JF - The Lancet
IS - 9643
ER -