Childhood respiratory risk profiles associate with lung function and COPD among the old population
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Published on: February 9, 2022
Chenyuan Qin1, Jian Gao2, Xingang Sang3
1School of Public Health, Peking University, Beijing, China.
Insights
Childhood respiratory issues significantly impact long-term lung function and increase the risk of chronic obstructive pulmonary disease (COPD) in older adults. Early-life respiratory health is crucial for maintaining lung capacity throughout life.
Area of Science:
- Pulmonary Medicine
- Epidemiology
- Public Health
Background:
- Childhood respiratory risk factors significantly influence long-term respiratory health.
- The interplay of these early-life factors on adult lung function and COPD remains underexplored.
Purpose of the Study:
- To investigate the association between childhood respiratory risk profiles and lung function in old age.
- To determine the impact of early-life respiratory risk factors on the development of chronic obstructive pulmonary disease (COPD).
Main Methods:
- Latent class analysis (LCA) was used on Health and Retirement Study data to identify childhood respiratory risk profiles.
- Linear and logistic regressions assessed associations between identified profiles and lung function (PEF) and COPD prevalence.
Main Results:
- Six distinct childhood respiratory risk profiles were identified among 12,296 participants.
- Early-life respiratory issues, such as asthma and allergic conditions, were linked to reduced peak expiratory flow (PEF) and increased COPD risk.
- Profiles including asthma, allergic conditions, and ear problems in childhood showed significantly higher odds of diminished lung function and COPD.
Conclusions:
- Early-life respiratory challenges are associated with significant declines in lung function and elevated risks of COPD later in life.
- Findings highlight the critical role of early respiratory health in determining long-term lung function trajectories.
Background:
Childhood, often characterized by multiple concurrent risk factors, holds significant influence over long-term respiratory outcomes, with the intricate interplay among these factors representing an intriguing but underexplored avenue for research. We aimed to determine if respiratory risk factors during childhood affect lung function and chronic obstructive pulmonary disease (COPD) in old age.
Methods:
Participants were drawn from the Health and Retirement Study cohort. Latent class analysis (LCA) was applied with six variables used to develop the early-life respiratory risk profiles. Linear regressions and logistic regressions were used to assess the associations between childhood respiratory risk profiles and lung function, including peak expiratory flow (PEF) value, PEF value <80% of the predicted value and COPD.
Results:
A total of 12,296 participants (5017 males and 7279 females) with an average age of 68 years were recruited. We identified six distinct childhood respiratory risk profiles: (1) 'Asthma and respiratory disorders in early childhood' (n = 241, 1.96%), (2) 'Unexposed or least exposed' (n = 3874, 31.51%), (3) 'Smokers at home' (n = 7609, 61.88%), (4) 'Ear problems and respiratory disorders in early childhood' (n = 162, 1.32%), (5) 'Allergic conditions and respiratory disorders in early childhood' (n = 220, 1.79%) and (6) 'Allergic conditions and respiratory disorders in later childhood' (n = 190, 1.55%). Profile 2 served as the reference. The highest reduction of PEF was seen for profile 1 (-30.07 L/min), followed by profile 6 (-22.24 L/min) and profile 5 (-18.47 L/min). Profile 6, profile 3 and profile 1 related to 1.98-, 1.52- and 1.66-fold increased risks of diminished PEF values, respectively. The highest risk of COPD was observed in profile 5 (aOR = 4.16, 95% CI: 3.75-4.57), followed by profile 6 (aOR = 4.10, 3.69-4.51), profile 4 (aOR = 3.70, 3.25-4.15), profile 1 (aOR = 3.46, 3.07-3.85) and profile 3 (aOR = 1.41, 1.25-1.57).
Conclusions:
People exposed to early-life respiratory challenges experienced larger declines in lung function and increased risks of COPD later in life. Our findings underscore the importance of early-life respiratory health in shaping lung function trajectories.
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