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Lifetime spirometric patterns of obstruction and restriction: risk factors and outcomes

Shyamali Dharmage, Dinh Bui, Haydn Walters, Andrian Lowe, Bruce Thompson, Paul Thomas, Judith Garcia-Aymerich, Garun Hamilton, Davids John, Peter Frith, Rosa Faner, Alvar Agusti, Michael Abramson, Jennifer Perret, Caroline Lodge
European Respiratory Journal 2021 58: PA3511; DOI: 10.1183/13993003.congress-2021.PA3511
Shyamali Dharmage
1University of Melbourne, Melbourne, Australia
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  • For correspondence: s.dharmage@unimelb.edu.au
Dinh Bui
2University of Melbourne, Pascoe Vale, Australia
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Haydn Walters
1University of Melbourne, Melbourne, Australia
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Andrian Lowe
1University of Melbourne, Melbourne, Australia
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Bruce Thompson
3Swinburne University, Melbourne, Australia
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Paul Thomas
4University of New South Wales, Sydney, Australia
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Judith Garcia-Aymerich
5ISGlobal, Barcelona, Spain
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Garun Hamilton
6Monash University, Melbourne, Australia
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Davids John
7University of Tasmania, Horbart, Australia
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Peter Frith
8Flinder University, Adelaide, Australia
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Rosa Faner
9Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Barcelona, Spain
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Alvar Agusti
9Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Barcelona, Spain
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Michael Abramson
6Monash University, Melbourne, Australia
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Jennifer Perret
1University of Melbourne, Melbourne, Australia
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Caroline Lodge
1University of Melbourne, Melbourne, Australia
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Abstract

Rationale & Aim: There is increasing interest in lung function trajectories but the focus to date has been on obstructive patterns without taking restrictive patterns into account. We investigated these patterns concurrently over the lifespan

Methods: Using group-based trajectory modelling of spirometry collected from 7 to 53 years in the Tasmanian Longitudinal Health Study (n=2,438), 6 FEV1/FVC and 5 FVC trajectories were identified. Three FEV1/FVC trajectories were collectively recognised as ‘low’ and one FVC trajectory as ‘low’. Based on whether trajectories of FEV1/FVC and FVC were ‘low’, 4 patterns of lifetime spirometry trajectories were identified. Risk factors and consequences of these patterns were investigated

Results: The prevalence of the lifetime patterns were: low FEV1/FVC-only 25.8%; low FVC-only 10.4%; both low FEV1/FVC and low FVC, labelled as ‘mixed’ 3.5%, and neither low (60.2%). Those with the mixed pattern had the highest prevalence of COPD at age 53 years (36.9%) followed by the low FEV1/FVC-only pattern (21.6%). Those with the mixed pattern had the highest prevalence of parental asthma, childhood respiratory illnesses, adult asthma and mental health disorders. Those with the low FVC-only pattern had low total lung capacity and residual volume and had the highest prevalence of childhood underweight, adult obesity, diabetes and cardiovascular conditions

Conclusion: We identified physiological patterns of lifetime spirometric airway obstruction, restriction and both/mixed. Mixed and obstructive patterns identify those who may benefit from early interventions. The restrictive pattern identifies those at higher risk of multi-morbidity by middle-age

  • COPD
  • Lung growth/development
  • Comorbidities

Footnotes

Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3511.

This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2021
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Lifetime spirometric patterns of obstruction and restriction: risk factors and outcomes
Shyamali Dharmage, Dinh Bui, Haydn Walters, Andrian Lowe, Bruce Thompson, Paul Thomas, Judith Garcia-Aymerich, Garun Hamilton, Davids John, Peter Frith, Rosa Faner, Alvar Agusti, Michael Abramson, Jennifer Perret, Caroline Lodge
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3511; DOI: 10.1183/13993003.congress-2021.PA3511

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Lifetime spirometric patterns of obstruction and restriction: risk factors and outcomes
Shyamali Dharmage, Dinh Bui, Haydn Walters, Andrian Lowe, Bruce Thompson, Paul Thomas, Judith Garcia-Aymerich, Garun Hamilton, Davids John, Peter Frith, Rosa Faner, Alvar Agusti, Michael Abramson, Jennifer Perret, Caroline Lodge
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3511; DOI: 10.1183/13993003.congress-2021.PA3511
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