Heterogeneity of reduced FEV1 in early adulthood: A looking forward, looking backwards analysis
Background Some individuals never achieve normal peak FEV1 in early adulthood. It is unknown if this is due to airflow limitation and/or lung restriction. Methods To investigate this, we: (1) looked forward in 19,791 participants in the Dutch Lifelines general population cohort aged 25–35 years with...
| Autores: | , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Universidad de Oviedo (UNIOVI) |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:dnet:ubarcelona__::8016a522a37e7c1a92ba3ff000d4f3fe |
| Acceso en línea: | https://hdl.handle.net/2445/229706 |
| Access Level: | acceso abierto |
| Palabra clave: | Bronquitis Factors d&apos edat en les malalties Emfisema pulmonar Bronchitis Age factors in disease Pulmonary emphysema |
| Sumario: | Background Some individuals never achieve normal peak FEV1 in early adulthood. It is unknown if this is due to airflow limitation and/or lung restriction. Methods To investigate this, we: (1) looked forward in 19,791 participants in the Dutch Lifelines general population cohort aged 25–35 years with 5-year follow-up; and (2) looked backwards in 2032 participants in the Swedish BAMSE birth cohort with spirometry at 24 years of age but also at 16 and/or 8 years. Results (1) In Lifelines 8.5% of participants had reduced FEV1 at 25–35 years, 68% due to Preserved Ratio Impaired Spirometry (‘PRISm’) and 32% to airflow limitation (‘low-limited’); besides, 3.8% participants with normal FEV1 showed airflow-limitation (‘normal-limited’). Low-limited and normal-limited, but not PRISm, reported higher smoking exposures and asthma diagnosis than normal (p < 0.05). At 5-year follow-up, 91.2% of participants remained in the same group, and FEV1 decline was similar in normal and normal-limited participants, but statistically smaller (p < 0.05) in PRISm and low-limited; (2) these observations were largely reproduced in BAMSE at 24 years of age; and, (3) in BAMSE, low-limited or PRISm individuals were already identifiable at 8–16 years of age. Conclusion Low peak FEV1 in early adulthood is most often due to PRISm and results in a significant burden of respiratory symptoms. Only low-limited and normal-limited, but not PRISm, associate with a doctor diagnosis of asthma, and FEV1 decline was statistically different in PRISm indicating a need for differentiated clinical approaches. These spirometric abnormalities can be already identified in childhood and adolescence. |
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