title: Positive exercise test and obstructive spirometry in young male conscripts associated with persistent asthma 20 years later.
abstract: BACKGROUND
  Asthma often begins in childhood or early adulthood and is a common disease among conscripts. The identification of long-term predictive factors for persistent asthma may lead to improved treatment opportunities and better disease control.
  
  
  OBJECTIVE
  Our aim was to study the prognostic factors of the severity of asthma among 40-year-old male conscripts whose asthma began in youth.
  
  
  METHODS
  We studied 119 conscripts who were referred to the Central Military Hospital during 1987-1990 due to asthma and who attended a follow-up visit approximately 20 years later. Asthma severity was evaluated during military service according to the medical records, and 20 years later during a follow-up visit using Global Initiative for Asthma guidelines. We used the results of lung function and allergy tests at baseline as predictors of current persistent asthma.
  
  
  RESULTS
  Compared with baseline, asthma was less severe at follow-up: 11.8% of subjects were in remission, 42.0% had intermittent asthma, 10.9% had mild persistent asthma, and 35.3% had moderate/severe persistent asthma (p < .001). In multivariate models, a positive exercise test at baseline yielded an odds ratio (OR) of 3.2 (95% CI 1.0-9.8, p = .046), a decreased FEV1/FVC % predicted an OR of 4.0 (95% CI 1.7-9.3, p = .002), and a decreased FEF50% % predicted an OR of 2.8 (95% CI 1.3-6.4, p = .012) for current persistent asthma.
  
  
  CONCLUSIONS
  About half of the men had persistent asthma at the 20-year follow-up. Positive exercise tests and obstructive spirometry results were related to the persistence of asthma and may be useful long-term prognostic factors for asthma severity.
authors.affiliation: Control of Hypersensitivity Diseases, Finnish Institute of Occupational Health, Helsinki, Finland. irmeli.lindstrom@ttl.fi
authors.forename: Irmeli
authors.initials: I
authors.lastname: Lindström
authors.forename: Hille
authors.initials: H
authors.lastname: Suojalehto
authors.forename: Harri
authors.initials: H
authors.lastname: Lindholm
authors.forename: Paula
authors.initials: P
authors.lastname: Pallasaho
authors.forename: Ritva
authors.initials: R
authors.lastname: Luukkonen
authors.forename: Jouko
authors.initials: J
authors.lastname: Karjalainen
authors.forename: Antti
authors.initials: A
authors.lastname: Lauerma
authors.forename: Antti
authors.initials: A
authors.lastname: Karjalainen
mesh_terms: D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology*; D015992:Body Mass Index; D005080:Exercise Test / Q000706:statistics & numerical data*; D005387:Finland; D006801:Humans; D007428:Intradermal Tests; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D011379:Prognosis; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D013147:Spirometry