Wheeze phenotypes and lung function in preschool children.
Distinct phenotypes can be identified in childhood wheezing illness. Within the context of a birth cohort study, we investigated the association between preschool lung function and phenotypes of wheeze. From parentally reported history of wheeze (interviewer-administered questionnaire, age 3 and 5 years), children were classified as never wheezers, transient early wheezers, late-onset wheezers, or persistent wheezers. Lung function (specific airway resistance [sRaw]; kPa/second) was assessed at age 3 (n = 463) and 5 years (n = 690). Persistent wheezers had markedly poorer lung function compared with other groups. In children who had wheezed by age 3, the risk of persistent wheeze increased with increased sRaw (odds ratio [OR] 5.2, 95% confidence interval [CI] 1.3-22.0; p = 0.02). In a multivariate model, increasing sRaw (OR 5.5, 95% CI 1.2-25.9; p = 0.03) and the child's sensitization (OR 2.8, 95% CI 1.3-5.8; p = 0.008) were significant independent predictors of persistent wheezing. We found no association between lung function at age 3 and late-onset wheeze in children who had not wheezed previously (OR 0.6, 95% CI 0.07-5.3; p = 0.64). In conclusion, poor lung function at age 3 predicted the subsequent persistence of symptoms in children who had wheezed within the first 3 years, but was not associated with the onset of wheeze after age 3 in children who had not wheezed previously.
Lowe
Lesley A
LA
North West Lung Centre, Wythenshawe Hospital, Manchester M23 9LT, UK.
Simpson
Angela
A
Woodcock
Ashley
A
Morris
Julie
J
Murray
Clare S
CS
Custovic
Adnan
A
D000367:Age Factors; D000403:Airway Resistance / Q000502:physiology; D001980:Bronchi / Q000503:physiopathology; D001993:Bronchodilator Agents; D002675:Child, Preschool; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000503:physiopathology; D006985:Hyperventilation / Q000503:physiopathology; D016015:Logistic Models; D008168:Lung / Q000503:physiopathology*; D015999:Multivariate Analysis; D010641:Phenotype; D010991:Plethysmography; D012135:Respiratory Sounds / Q000145:classification / Q000235:genetics* / Q000503:physiopathology; D012307:Risk Factors
D001993:Bronchodilator Agents