Lung function decline in bronchial asthma.
OBJECTIVE
We evaluated the longitudinal changes in lung function and the factors associated with FEV(1) changes over time in a sample of asthmatic subjects.


METHODS
FEV(1) measures were recorded every 3 months over a 5-year follow-up period. To compare all subjects independently of body size, FEV(1) values were normalized for the subject's height at the third power. We evaluated the possible effect of age, baseline FEV(1), disease duration, and FEV(1) variability on the rate of change of FEV(1).


METHODS
We studied 142 subjects with asthma diagnosed on the basis of validated clinical and functional criteria.


RESULTS
FEV(1) showed a linear decay with aging in each subject. For a subject 1.65 m in height, the median overall FEV(1) decay was 40.9 mL/yr. FEV(1) decay slopes were significantly influenced by age and sex, being steeper in younger male subjects. A significant interaction was found between age and baseline FEV(1): the FEV(1) decay was significantly higher among younger asthmatics with a poorer baseline functional condition. A longer disease duration was associated with a lower FEV(1) slope. FEV(1) variability was strongly associated with an increased rate of FEV(1) decline.


CONCLUSIONS
FEV(1) decline in patients with bronchial asthma is significantly influenced by baseline FEV(1), disease duration, and FEV(1) variability. Moreover, the rate of FEV(1) decline seems to increase in younger subjects only when the baseline function is poorer.
Cibella
Fabio
F
Istituto di Fisiopatologia Respiratoria del C. N. R., via U. La Malfa 153, I-90146 Palermo, Italy. cibella@ifr.pa.cnr.it
Cuttitta
Giuseppina
G
Bellia
Vincenzo
V
Bucchieri
Salvatore
S
D'Anna
Silvestre
S
Guerrera
Daniela
D
Bonsignore
Giovanni
G
D000328:Adult; D000367:Age Factors; D000375:Aging / Q000502:physiology; D001249:Asthma / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012737:Sex Factors