Outcome of Asthma and Wheezing in the First 6 Years of Life: Follow-up through Adolescence
The effect of early life wheezing on respiratory function and continued symptoms through adolescence has not been fully described. Using data from a population-based birth cohort in Tucson, Arizona, we previously described four phenotypes based on the occurrence of wheezing lower respiratory illness...
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| Published in | American journal of respiratory and critical care medicine Vol. 172; no. 10; pp. 1253 - 1258 |
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| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
New York, NY
Am Thoracic Soc
15.11.2005
American Lung Association American Thoracic Society |
| Subjects | |
| Online Access | Get full text |
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| Summary: | The effect of early life wheezing on respiratory function and continued symptoms through adolescence has not been fully described. Using data from a population-based birth cohort in Tucson, Arizona, we previously described four phenotypes based on the occurrence of wheezing lower respiratory illnesses before age 3 yr and active wheeze at age 6 yr: never wheezers (n = 425), transient early wheezers (n = 164), persistent wheezers (n = 113), and late-onset wheezers (n = 124).
We sought to determine the prognosis for these phenotypes, with reference to lung function and symptoms, through adolescence.
Current wheeze was assessed by questionnaire, lung function was measured by conventional spirometry, and atopy was determined by skin prick tests.
The prevalence of atopy and wheeze by age 16 yr was similar for never and transient wheezers and for persistent and late-onset wheezers. Both transient early, and persistent wheezers had significantly lower FEF(25-75) (-259 ml/s, p < 0.001, and -260 ml/s, p = 0.001, respectively), FEV1 (-75 ml, p = 0.02, and -87 ml, p = 0.03, respectively), and FEV1:FVC ratio (-1.9%, p = 0.002, and -2.5%, p = 0.001, respectively) through age 16 yr compared with never wheezers. Late-onset wheezers had levels of lung function similar to those of never wheezers through age 16 yr. There was no significant change in lung function among subjects with any of the four phenotypes, relative to their peers, from age 6 to 16 yr.
Patterns of wheezing prevalence and levels of lung function are established by age 6 yr and do not appear to change significantly by age 16 yr in children who start having asthma-like symptoms during the preschool years. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Originally Published in Press as DOI: 10.1164/rccm.200504-525OC on August 18, 2005 This article has an online supplement, which is accessible from this issue's table of contents at www.atsjournals.org Supported by National Institutes of Health grants HL-14136, HL-56177, and HL-03154. These authors contributed equally to this article. Correspondence and requests for reprints should be addressed to Fernando D. Martinez, M.D., Arizona Respiratory Center, P.O. Box 245030, Tucson, AZ 85724. E-mail: fernando@arc.arizona.edu Conflict of Interest Statement: W.J.M. is chair of the Epidemiology Study of Cystic Fibrosis sponsored by Genentech, Inc., for which he received $7,000 in 2004. D.A.S. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. D.L.S. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. S.G. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. C.J.H. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. T.W.G. received $6,000 in 2004, $3,000 in 2003, and $3,500 in 2002 for serving on advisory boards, consulting on designing clinical trials, and speaking on conferences sponsored by GlaxoSmithKline (GSK). She has received $2,500 in 2005, $1,500 in 2004, and $2,100 in 2002 for speaking at conferences sponsored by AstraZeneca (AZ). She has received $12,000 in 2003 from Genentech as a research grant for participating in a multicenter epidemiology trial. She has received $9,000 from an exchange program for consulting in the design of CME courses for asthma. T.W.G. has participated as a speaker in CME-accredited courses sponsored by the following companies: SOMA Medical Education, Innovia Education Institute, Medical World Conferences, and Health Matters. L.M.T. serves on the Pediatric Expert Panel for GSK and received $1,500 in 2004 for this activity. A.L.W. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. F.D.M. received $13,100 in 2002, $3,000 in 2003, and $6,500 in 2004 from Merck while serving as a member on the Merck Scientific Advisory Board for participation and lecture fees. He received monies from GSK for presenting at a sponsored event in 2003 ($1,500). As a member of the AZ Speaker's bureau, he received $10,000 in 2002 and $2,500 in 2003 for lectures. |
| ISSN: | 1073-449X 1535-4970 |
| DOI: | 10.1164/rccm.200504-525OC |