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Chronic respiratory symptoms, skin test results, and lung function as predictors of peak flow variability
K L Timonen1, J Nielsen, J Schwartz
1Unit of Environmental Epidemiology, National Public Health Institute, Kuopio, Finland.
Insights
Asthma symptoms and allergies in children significantly increase peak expiratory flow (PEF) variability. Spirometry and skin tests help predict these PEF variations in pediatric respiratory health.
Area of Science:
- Pediatric Respiratory Medicine
- Allergy and Immunology
- Pulmonary Function Testing
Background:
- Chronic respiratory symptoms are common in children.
- Peak expiratory flow (PEF) variability can indicate underlying respiratory issues.
- Predictors of PEF variability in children require further investigation.
Purpose of the Study:
- To investigate how chronic respiratory symptoms, skin prick test results, and spirometry predict peak expiratory flow (PEF) variability in children aged 6-12 years.
- To differentiate PEF variability based on symptom severity and diagnosis.
Main Methods:
- A cohort of 1,854 children (6-12 years) underwent skin prick tests and spirometry.
- Children self-reported chronic respiratory symptoms via questionnaire.
- Peak expiratory flow (PEF) was measured daily for 2-3 months.
- Diurnal and day-to-day PEF variations were analyzed.
Main Results:
- Children with asthmatic symptoms showed greater PEF variability than those with only nocturnal cough.
- Doctor-diagnosed asthma and increasing symptom count were associated with higher PEF variability.
- Atopy, positive skin tests (house dust mite, cat), and reduced FEV1/MMEF predicted increased PEF variation.
- These associations were consistent for both diurnal and day-to-day PEF variations.
Conclusions:
- Questionnaire-based respiratory symptoms, spirometry, and skin prick tests are significant predictors of PEF variability in children.
- Asthma and atopy are key factors influencing PEF variability in pediatric populations.
- Findings highlight the utility of these measures in assessing respiratory health in children.
Abstract:
We examined how chronic respiratory symptoms, reported in a questionnaire, and results of skin prick tests and spirometry predicted variability in peak expiratory flow (PEF) among 6-12-yr-old children (n = 1,854). After characterization with skin tests and spirometry, children were followed for 2-3 mo during the winter of 1993-1994. Peak expiratory flow was measured daily in the morning and evenings. Children with asthmatic symptoms (wheeze and/or attacks of shortness of breath with wheeze in the past 12 mo and/or ever doctor diagnosed asthma) had a greater variation in PEF than children with dry nocturnal cough as their only chronic respiratory symptom. Similarly, doctor-diagnosed asthma was associated with a greater variation in PEF, also among children with asthmatic symptoms. Peak flow variability increased with an increasing number of symptoms reported in the questionnaire. Atopy, positive skin test reactions to house dust mite and cat and lowered level (as % of predicted) in FEV1 and in MMEF were also associated with an increased variation in PEF. All the differences were observed in both diurnal and day-to-day variation in PEF. In conclusion, chronic respiratory symptoms reported in a questionnaire, spirometric lung function and skin prick test results among asthmatic children predicted variation in PEF measured during a 2-3 mo follow-up. The difference in morning PEF coefficient of variation (CV) between children with asthmatic symptoms and children with cough only was somewhat bigger in girls than in boys. The effect of atopy on morning PEF CV was somewhat bigger in young than in older children.