Prediction of adolescent asthma outcomes using childhood lung function

Abstract

Prediction of adolescent asthma outcomes using childhood lung function

Background: Asthma is associated with a low lung function; however, it is uncertain if a low childhood lung function precedes asthma onset and persistence in adolescence.

Aim: We aimed to investigate the association between childhood lung function and onset and persistence of asthma in adolescence.

Method: In the BAMSE (Sweden) and PIAMA (Netherlands) birth cohorts, we analyzed the association of FEV₁, FVC, FEV₁/FVC at age 8 with asthma onset and persistence in adolescence (age 12-16) using cohort-specific logistic regression analysis adjusted for BMI, socio-economic status and allergic sensitization followed by meta-analysis. Given sex-differences in lung function and asthma prevalence, we stratified for sex.

Results: In the BAMSE and PIAMA cohorts, 6.1% (112/1824) and 3.4% (36/1049) of subjects developed asthma during adolescence and 8.2% and 6.4% had persistent asthma. In the non-stratified analysis, childhood lung function was not associated with adolescent-onset or persistence of asthma. In males, meta-analysis of BAMSE and PIAMA results showed that a higher FEV₁% and FEV₁/FVC were associated with a lower odds of adolescent onset asthma (OR: 0.97 (95% CI:0.95–0.99), p= 0.029, 0.95 (0.91–0.99) p= 0.028). In the BAMSE cohort, a higher FEV₁% was associated with a lower odds of asthma persistence in males (0.96 (0.92–0.99) p=0.031). Childhood lung function was not associated with asthma onset or persistence in females.

Conclusion: Our findings show that lower lung function was present before asthma onset in adolescence and that these associations are mainly seen in males. Low lung function in childhood may contribute to asthma onset and persistence.