Childhood predictors of lung function trajectories and future COPD risk: a prospective cohort study from the first to the sixth decade of life
Post date: Jul 21, 2018 8:14:47 AM
The authors used six waves of the Tasmanian Longitudinal Health Study (TAHS) to model lung function trajectories measured at 7, 13, 18, 45, 50, and 53 years. Pre-bronchodilator FEV1 z-scores at the six time points using group-based trajectory modelling to identify distinct subgroups of individuals whose measurements followed a similar pattern over time were analysed. The trajectories identified were related to childhood factors and risk of chronic obstructive pulmonary disease (COPD) using logistic regression, and estimated population-attributable fractions of COPD.
Six potential FEV1 trajectories were identified, two of which were novel. Three trajectories contributed 75% of COPD burden and were associated with modifiable early-life exposures hose impact was aggravated by adult factors. The authors postulate that reducing maternal smoking, encouraging immunisation, and avoiding personal smoking, especially in those with smoking parents or low childhood lung function, might minimise COPD risk. Clinicians and patients with asthma should be made aware of the potential long-term implications of non-optimal asthma control for lung function trajectory throughout life, and the role and benefit of optimal asthma control on improving lung function should be investigated in future intervention trials.