Related Experiment Video
Updated: Mar 21, 2026
Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Patterns of Growth and Decline in Lung Function in Persistent Childhood Asthma
Insights
Childhood asthma can lead to abnormal lung function growth patterns, increasing the risk of chronic airflow obstruction and COPD in early adulthood. Male sex and early lung function impairment are key predictors.
Area of Science:
- Pulmonology
- Pediatric Asthma Research
- Chronic Airflow Obstruction
Background:
- Persistent childhood asthma may predict future chronic airflow obstruction.
- Longitudinal lung function tracking is crucial for understanding disease progression.
Purpose of the Study:
- To classify patterns of lung function growth and decline in individuals with childhood asthma.
- To identify risk factors associated with abnormal lung function trajectories.
- To assess the link between childhood asthma patterns and adult chronic obstructive pulmonary disease (COPD).
Main Methods:
- Classified 684 participants into four lung function growth/decline patterns using spirometry (FEV1) from childhood to adulthood.
- Examined risk factors for abnormal patterns, using National Health and Nutrition Examination Survey data for normal FEV1 values.
- Assessed adult lung function against Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria for COPD.
Main Results:
- 75% of participants exhibited abnormal lung function patterns (reduced growth, early decline, or both).
- Lower baseline FEV1, reduced bronchodilator response, airway hyperresponsiveness, and male sex predicted reduced lung function growth.
- 11% met GOLD criteria for COPD at mean age 26, with reduced growth patterns being more common (18% vs. 3%).
Conclusions:
- Childhood lung function impairment and male sex are significant predictors of abnormal lung function trajectories.
- Children with persistent asthma and impaired lung function growth face higher risks of fixed airflow obstruction and COPD.
- Early identification of abnormal lung function patterns in childhood asthma is vital for predicting adult respiratory health outcomes.
Background:
Tracking longitudinal measurements of growth and decline in lung function in patients with persistent childhood asthma may reveal links between asthma and subsequent chronic airflow obstruction.
Methods:
We classified children with asthma according to four characteristic patterns of lung-function growth and decline on the basis of graphs showing forced expiratory volume in 1 second (FEV1), representing spirometric measurements performed from childhood into adulthood. Risk factors associated with abnormal patterns were also examined. To define normal values, we used FEV1 values from participants in the National Health and Nutrition Examination Survey who did not have asthma.
Results:
Of the 684 study participants, 170 (25%) had a normal pattern of lung-function growth without early decline, and 514 (75%) had abnormal patterns: 176 (26%) had reduced growth and an early decline, 160 (23%) had reduced growth only, and 178 (26%) had normal growth and an early decline. Lower baseline values for FEV1, smaller bronchodilator response, airway hyperresponsiveness at baseline, and male sex were associated with reduced growth (P<0.001 for all comparisons). At the last spirometric measurement (mean [±SD] age, 26.0±1.8 years), 73 participants (11%) met Global Initiative for Chronic Obstructive Lung Disease spirometric criteria for lung-function impairment that was consistent with chronic obstructive pulmonary disease (COPD); these participants were more likely to have a reduced pattern of growth than a normal pattern (18% vs. 3%, P<0.001).
Conclusions:
Childhood impairment of lung function and male sex were the most significant predictors of abnormal longitudinal patterns of lung-function growth and decline. Children with persistent asthma and reduced growth of lung function are at increased risk for fixed airflow obstruction and possibly COPD in early adulthood. (Funded by the Parker B. Francis Foundation and others; ClinicalTrials.gov number, NCT00000575.).
Related Concept Videos
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:20Chronic Obstructive Pulmonary Disease-II: Pathophysiology
Chronic Inflammation
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:27Physical Assessment of the Respiratory Tract II: Inspection
Chest Configuration
The chest configuration...