Spirometric patterns in young and middle-aged adults: a 20-year European study

Area of Science:

• Pulmonary Medicine
• Epidemiology
• Respiratory Health

Background:

• Understanding the natural history of abnormal spirometric patterns across different life stages is crucial for developing effective preventive strategies.
• This study focuses on identifying characteristics and risk factors for restrictive and obstructive spirometric patterns in young adults (onset before 40) and mid-adults (onset between 40-61).

Purpose of the Study:

• To describe the characteristics and risk factors associated with restrictive and obstructive spirometric patterns that emerge in young adulthood and mid-adulthood.
• To differentiate the determinants of spirometric abnormalities based on age of onset.

Main Methods:

• Utilized longitudinal data from the European Community Respiratory Health Survey (ECRHS) cohort.
• Assessed prebronchodilator forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) over 20 years.
• Defined spirometry patterns (restrictive, obstructive, normal) and analyzed characteristics and risk factors using multilevel multinomial logistic regression.

Main Results:

• Among 3502 participants, distinct spirometric patterns were identified: normal (65%), young restrictive (11%), young obstructive (9%), mid-adult restrictive (5%), and mid-adult obstructive (10%).
• Childhood and young adulthood leanness and early respiratory infections (<5 years) were associated with young restrictive spirometry.
• Asthma, obesity, and smoking were identified as key determinants for young obstructive, mid-adult restrictive, and mid-adult obstructive patterns, respectively.

Conclusions:

• Spirometric patterns emerging in young and mid-adulthood exhibit unique associated characteristics and risk factors.
• These findings highlight the importance of considering age of onset when evaluating spirometric abnormalities and planning interventions.