PT  - JOURNAL ARTICLE
AU  - Gang Wang
AU  - Jenny Hallberg
AU  - Dimitrios Charalampopoulos
AU  - Maribel Casas Sanahuja
AU  - Robab Breyer-Kohansal
AU  - Arnulf Langhammer
AU  - Raquel Granell
AU  - Judith M. Vonk
AU  - Annemiek Mian
AU  - Núria Olvera
AU  - Lisbeth Mølgaard Laustsen
AU  - Eva Rönmark
AU  - Alicia Abellan
AU  - Alvar Agusti
AU  - Syed Hasan Arshad
AU  - Anna Bergström
AU  - H. Marike Boezen
AU  - Marie-Kathrin Breyer
AU  - Otto Burghuber
AU  - Anneli Clea Bolund
AU  - Adnan Custovic
AU  - Graham Devereux
AU  - Gavin C. Donaldson
AU  - Liesbeth Duijts
AU  - Ana Esplugues
AU  - Rosa Faner
AU  - Ferran Ballester
AU  - Judith Garcia-Aymerich
AU  - Ulrike Gehring
AU  - Sadia Haider
AU  - Sylvia Hartl
AU  - Helena Backman
AU  - John W. Holloway
AU  - Gerard H. Koppelman
AU  - Aitana Lertxundi
AU  - Turid Lingaas Holmen
AU  - Lesley Lowe
AU  - Sara M. Mensink-Bout
AU  - Clare S. Murray
AU  - Graham Roberts
AU  - Linnea Hedman
AU  - Vivi Schlünssen
AU  - Torben Sigsgaard
AU  - Angela Simpson
AU  - Jordi Sunyer
AU  - Maties Torrent
AU  - Stephen Turner
AU  - Maarten Van den Berge
AU  - Roel C.H. Vermeulen
AU  - Sigrid Anna Aalberg Vikjord
AU  - Jadwiga A. Wedzicha
AU  - Anke H. Maitland van der Zee
AU  - Erik Melén
ED  - ,
TI  - Spirometric phenotypes from early childhood to young adulthood: a Chronic Airway Disease Early Stratification study
AID  - 10.1183/23120541.00457-2021
DP  - 2021 Oct 01
TA  - ERJ Open Research
PG  - 00457-2021
VI  - 7
IP  - 4
4099  - http://openres.ersjournals.com/content/7/4/00457-2021.short
4100  - http://openres.ersjournals.com/content/7/4/00457-2021.full
SO  - erjor2021 Oct 01; 7
AB  - Background The prevalences of obstructive and restrictive spirometric phenotypes, and their relation to early-life risk factors from childhood to young adulthood remain poorly understood. The aim was to explore these phenotypes and associations with well-known respiratory risk factors across ages and populations in European cohorts.Methods We studied 49 334 participants from 14 population-based cohorts in different age groups (≤10, >10–15, >15–20, >20–25 years, and overall, 5–25 years). The obstructive phenotype was defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) z-score less than the lower limit of normal (LLN), whereas the restrictive phenotype was defined as FEV1/FVC z-score ≥LLN, and FVC z-score <LLN.Results The prevalence of obstructive and restrictive phenotypes varied from 3.2–10.9% and 1.8–7.7%, respectively, without clear age trends. A diagnosis of asthma (adjusted odds ratio (aOR=2.55, 95% CI 2.14–3.04), preterm birth (aOR=1.84, 1.27–2.66), maternal smoking during pregnancy (aOR=1.16, 95% CI 1.01–1.35) and family history of asthma (aOR=1.44, 95% CI 1.25–1.66) were associated with a higher prevalence of obstructive, but not restrictive, phenotype across ages (5–25 years). A higher current body mass index (BMI was more often observed in those with the obstructive phenotype but less in those with the restrictive phenotype (aOR=1.05, 95% CI 1.03–1.06 and aOR=0.81, 95% CI 0.78–0.85, per kg·m−2 increase in BMI, respectively). Current smoking was associated with the obstructive phenotype in participants older than 10 years (aOR=1.24, 95% CI 1.05–1.46).Conclusion Obstructive and restrictive phenotypes were found to be relatively prevalent during childhood, which supports the early origins concept. Several well-known respiratory risk factors were associated with the obstructive phenotype, whereas only low BMI was associated with the restrictive phenotype, suggesting different underlying pathobiology of these two phenotypes.Obstructive and restrictive phenotypes are present from childhood to adulthood but without age trends. Established risk factors for airway disease are associated with the obstructive phenotype, whereas low BMI is associated with the restrictive. https://bit.ly/3BMoMtI