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Phenotypes of symptomatic airways disease in China and New Zealand

James Fingleton, Kewu Huang, Mark Weatherall, Yanfei Guo, Stefan Ivanov, Piet Bruijnzeel, Hong Zhang, Wei Wang, Richard Beasley, Chen Wang
European Respiratory Journal 2017 50: 1700957; DOI: 10.1183/13993003.00957-2017
James Fingleton
Medical Research Institute of New Zealand, Wellington, New ZealandCapital and Coast District Health Board, Wellington, New ZealandVictoria University of Wellington, Wellington, New ZealandJoint first authors
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  • ORCID record for James Fingleton
  • For correspondence: james.fingleton@mrinz.ac.nz
Kewu Huang
Dept of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR ChinaJoint first authors
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Mark Weatherall
Capital and Coast District Health Board, Wellington, New ZealandUniversity of Otago Wellington, Wellington, New Zealand
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Yanfei Guo
Dept of Pulmonary and Critical Care Medicine, Beijing Hospital, Ministry of Health, Beijing, PR China
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Stefan Ivanov
AstraZeneca, Molndal, Sweden
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Piet Bruijnzeel
AstraZeneca, Molndal, Sweden
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Hong Zhang
Dept of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
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Wei Wang
Dept of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
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Richard Beasley
Medical Research Institute of New Zealand, Wellington, New ZealandCapital and Coast District Health Board, Wellington, New ZealandVictoria University of Wellington, Wellington, New ZealandJoint last authors
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Chen Wang
Dept of Pulmonary and Critical Care Medicine, Beijing Hospital, Ministry of Health, Beijing, PR ChinaDept of Pulmonary and Critical Care Medicine, China–Japan Friendship Hospital, Beijing, PR ChinaCapital Medical University, Beijing, PR ChinaJoint last authors
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Abstract

It is uncertain whether phenotypes of asthma and chronic obstructive pulmonary disease (COPD) vary between populations with different genetic and environmental characteristics. Here, our objective was to compare the phenotypes of airways disease in two separate populations.

This was a cross-sectional observational study in adult populations from New Zealand and China. Participants aged 40–75 years who reported wheeze and breathlessness in the last 12 months were randomly selected from the general population and underwent detailed characterisation. Complete data for cluster analysis were available for 345 participants. Hierarchical cluster analysis was undertaken, based on 12 variables: forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity ratio, bronchodilator reversibility, peak expiratory flow variability, transfer coefficient of the lung for carbon monoxide, exhaled nitric oxide fraction, total IgE, C-reactive protein, age of symptom onset, body mass index, health status and cigarette smoke exposure.

Cluster analysis of the combined dataset described five phenotypes: “severe late-onset asthma/COPD overlap group”, “moderately severe early-onset asthma/COPD overlap group”, “moderate to severe asthma group with type 2 predominant disease”, and two groups with minimal airflow obstruction, differentiated by age of onset. Separate analyses by country showed similar patterns; however, a distinct obese/comorbid group was observed in the New Zealand population.

Cluster analysis of adults with symptomatic airways disease suggests the presence of similar asthma/COPD overlap phenotypes within populations with different genetic and environmental characteristics, and an obese/comorbid phenotype in a Western population.

Abstract

Evidence of asthma/COPD overlap phenotypes in China and NZ populations and obese/comorbid group in NZ http://ow.ly/APWk30eVBm5

Footnotes

  • This article has supplementary material available from erj.ersjournals.com

  • The NZRHS is registered with the Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) with identifier number ACTRN12610000666022

  • Support statement: Primary funder: AstraZeneca AB, Sweden. Secondary funding: Health Research Council of New Zealand (reference 10/174), a Government funding organisation; the Medical Research Institute of New Zealand receives funding from the Health Research Council of New Zealand through the Independent Research Organisations Capability Fund (14/1002); the Research Special Fund for Capital Health Development (Shou-Fa 2011-1004-01); Project in the National Science and Technology Pillar Program during the Twelfth Five-Year Plan Period (2012BAI05B02, 2014BAI08B04, 2013BAI09B10). This was an investigator-sponsored and -designed study. The primary funder had the opportunity to review and comment on the study protocol prior to initiation of the study. Funding information for this article has been deposited with the Crossref Funder Registry.

  • Conflict of interest: Disclosures can be found alongside this article at erj.ersjournals.com

  • Received May 9, 2017.
  • Accepted August 29, 2017.
  • Copyright ©ERS 2017
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Phenotypes of symptomatic airways disease in China and New Zealand
James Fingleton, Kewu Huang, Mark Weatherall, Yanfei Guo, Stefan Ivanov, Piet Bruijnzeel, Hong Zhang, Wei Wang, Richard Beasley, Chen Wang
European Respiratory Journal Dec 2017, 50 (6) 1700957; DOI: 10.1183/13993003.00957-2017

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Phenotypes of symptomatic airways disease in China and New Zealand
James Fingleton, Kewu Huang, Mark Weatherall, Yanfei Guo, Stefan Ivanov, Piet Bruijnzeel, Hong Zhang, Wei Wang, Richard Beasley, Chen Wang
European Respiratory Journal Dec 2017, 50 (6) 1700957; DOI: 10.1183/13993003.00957-2017
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