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Lung function, bronchial responsiveness, and asthma in a community cohort of 6-year-old children

Jacqui Joseph-Bowen1, Nicholas H de Klerk, Martin J Firth

  • 1Division of Clinical Sciences, Biostatiscs and Genetic Epidemiology, Population Sciences and Cell Biology, Telethon Institute for Child Health Research, University of Western, Australia, Perth, Australia. peters@ichr.uwa.edu.au

American Journal of Respiratory and Critical Care Medicine
|January 27, 2004
PubMed

Insights

Spirometry and methacholine challenge tests are feasible in 6-year-old children. Current asthma is linked to reduced lung function and increased bronchial responsiveness, aiding diagnosis.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Child Health Research

Background:

  • Spirometry is feasible in children as young as 6 years.
  • Limited data exists on lung function and bronchial responsiveness in 6-year-olds with asthma.
  • A birth cohort study assessed children at age 6.

Purpose of the Study:

  • To describe the relationship between current asthma, lung function, and bronchial responsiveness at age 6.
  • To evaluate the feasibility and utility of lung function testing and methacholine challenge in young children.
  • To identify factors influencing lung function in 6-year-olds.

Main Methods:

  • Assessed 2,537 children from a birth cohort at age 6.
  • Utilized history, physical examination, standard spirometry, and methacholine challenge.
  • Analyzed lung function parameters (FVC, FEV1) and bronchial responsiveness.

Main Results:

  • Males had greater FVC and FEV1 than females.
  • Height, sex, birth weight, and early wheezing influenced lung function.
  • Children with asthma showed reduced lung function and heightened methacholine sensitivity.
  • An optimal cutpoint for bronchial responsiveness was identified (15% FEV1 fall at 1.8 mg/ml).
  • A negative methacholine challenge had a 92% negative predictive value for asthma.

Conclusions:

  • Lung function testing and methacholine challenge are feasible in 5- to 7-year-old children.
  • These tests can contribute to the clinical management of pediatric asthma.
  • Findings provide insights into asthma, lung function, and bronchial responsiveness at age 6.
Abstract

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