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Effects of asthma on pulmonary function in children. A longitudinal population-based study
S T Weiss1, T D Tosteson, M R Segal
1Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Insights
Childhood asthma impacts lung function differently in boys and girls. Boys with asthma show improved forced vital capacity (FVC), while girls experience reduced forced expiratory volume in one second (FEV1).
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Epidemiology
Background:
- Childhood asthma is a prevalent condition affecting respiratory health.
- Longitudinal data are crucial for understanding the long-term effects of asthma on lung development.
- Previous studies have shown varied impacts of asthma on lung function, necessitating sex-specific analyses.
Purpose of the Study:
- To investigate the sex-specific effects of childhood asthma on lung function development.
- To quantify the impact of asthma on key spirometric measures in males and females.
- To predict the long-term trajectory of lung function decline in females with asthma.
Main Methods:
- A prospective longitudinal study of 602 white children (aged 5-9 at baseline) over 13 years.
- Yearly spirometry to measure forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and forced expiratory flow between 25-75% of vital capacity (FEF25-75).
- Multivariate analysis adjusting for age, height, smoking, and prior lung function.
Main Results:
- Male asthmatic children (n=42) had significantly larger predicted FVC compared to non-asthmatic males (n=277).
- Female asthmatic children (n=23) showed significantly lower predicted FEV1 compared to non-asthmatic females (n=260).
- Both sexes with active asthma exhibited reduced FEF25-75; females with asthma may experience a 7% FEV1 deficit by age 15.
Conclusions:
- Childhood asthma has distinct, sex-specific effects on lung function development.
- Males with asthma may experience enhanced FVC, whereas females face a greater risk of reduced FEV1.
- Early-onset asthma in females warrants close monitoring due to predicted long-term FEV1 deficits.
Abstract:
Data from a longitudinal study of childhood factors influencing the development of chronic obstructive lung disease were used to assess the effects of asthma on lung function development in male and female children. A population-based cohort of 602 white children, initially aged 5 to 9 yr, was observed prospectively for 13 yr. Spirometry was performed and a standardized respiratory and illness questionnaire was administered by trained interviewers on a yearly basis. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and forced expiratory flow between 25 and 75% of vital capacity (FEF25-75) were used as measures of lung function. The total number of children reporting asthma over the course of the study was 67. Male asthmatic subjects (n = 42) had larger average percentage of predicted FVC than nonasthmatic males (n = 277). Female asthmatic subjects (n = 23) had a lower average percentage of predicted FEV1 than nonasthmatic females (n = 260). In a multivariate analysis of the individual lung function measures, adjusting for previous level of pulmonary function, age, height, change in height, and personal and maternal smoking, males reporting active asthma had a significantly larger FVC than males with no history of asthma. In contrast, females with active asthma had a significantly smaller FEV1 than females with no history of asthma. Both males and females with active asthma had decreased FEF25-75. From our analysis, we would predict that a female who develops asthma at age 7 would experience a 5% reduction in FEV1 by age 10 and a 7% deficit by age 15.(ABSTRACT TRUNCATED AT 250 WORDS)