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Published on: May 14, 2012
The role of small airway function parameters in preschool asthmatic children
Liangqin Yi1, Yan Zhao1, Ziyao Guo1
1Chongqing Key Laboratory of Pediatrics, International Science and Technology Cooperation base of Child Development and Critical Disorders, Department of Children's Hospital of Chongqing Medical, Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Department of Clinical Laboratory center, University of Education, 400014, Chongqing, China.
Insights
Small airway dysfunction significantly correlates with impaired lung function and airway hyperresponsiveness in preschool asthmatic children. These findings suggest small airway function parameters are crucial for managing childhood asthma.
Area of Science:
- Pediatric Pulmonology
- Asthma Research
- Respiratory Physiology
Background:
- Small airways are primary sites of inflammation and remodeling in asthma.
- The role of small airway function in preschool asthmatic children remains understudied.
Purpose of the Study:
- To investigate small airway function parameters for evaluating airway dysfunction, airflow limitation, and airway hyperresponsiveness (AHR) in preschool asthmatic children.
Main Methods:
- Retrospective analysis of 851 preschool children with asthma.
- Utilized curve estimation, Spearman's correlation, and ROC curves to assess small airway dysfunction (SAD) and AHR.
Main Results:
- SAD prevalence was 19.5%. Small airway parameters strongly correlated with large airway function (FEV1%, FEV1/FVC%, PEF%).
- Small airway dysfunction parameters showed significant correlations with AHR, with FEF25-75% and FEF50% demonstrating higher predictive value than FEV1% for AHR.
- Children with SAD were older, had a family history of asthma, and exhibited more severe airflow obstruction and AHR.
Conclusions:
- Small airway dysfunction is closely linked to impaired large airway function, severe airflow obstruction, and AHR in preschool asthmatics.
- Small airway function parameters are essential for effective management of asthma in this age group.
Background:
Small airways are the major sites of inflammation and airway remodeling in all severities of asthma patients. However, whether small airway function parameters could reflect the airway dysfunction feature in preschool asthmatic children remain unclear. We aim to investigate the role of small airway function parameters in evaluating airway dysfunction, airflow limitation and airway hyperresponsiveness (AHR).
Methods:
Eight hundred and fifty-one preschool children diagnosed with asthma were enrolled retrospectively to investigate the characteristics of small airway function parameters. Curve estimation analysis was applied to clarify the correlation between small and large airway dysfunction. Spearman's correlation and receiver-operating characteristic (ROC) curves were employed to evaluate the relationship between small airway dysfunction (SAD) and AHR.
Results:
The prevalence of SAD was 19.5% (166 of 851) in this cross-sectional cohort study. Small airway function parameters (FEF25-75%, FEF50%, FEF75%) showed strong correlations with FEV1% (r = 0.670, 0.658, 0.609, p<0.001, respectively), FEV1/FVC% (r = 0.812, 0.751, 0.871, p<0.001, respectively) and PEF% (r = 0.626, 0.635, 0.530, p<0.01, respectively). Moreover, small airway function parameters and large airway function parameters (FEV1%, FEV1/FVC%, PEF%) were curve-associated rather than linear-related (p<0.001). FEF25-75%, FEF50%, FEF75% and FEV1% demonstrated a positive correlation with PC20 (r = 0.282, 0.291, 0.251, 0.224, p<0.001, respectively). Interestingly, FEF25-75% and FEF50% exhibited a higher correlation coefficient with PC20 than FEV1% (0.282 vs. 0.224, p = 0.031 and 0.291 vs. 0.224, p = 0.014, respectively). ROC curve analysis for predicting moderate to severe AHR showed that the area under the curve (AUC) was 0.796, 0.783, 0.738, and 0.802 for FEF25-75%, FEF50%, FEF75%, and the combination of FEF25-75% and FEF75%, respectively. When Compared to children with normal lung function, patients with SAD were slightly older, more likely to have a family history of asthma and airflow obstruction with lower FEV1% and FEV1/FVC%, lower PEF% and more severe AHR with lower PC20 ( all p<0.05).
Conclusion:
Small airway dysfunction is highly correlated with large airway function impairment, severe airflow obstruction and AHR in preschool asthmatic children. Small airway function parameters should be utilized in the management of preschool asthma.
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