title: Risk factors and early origins of chronic obstructive pulmonary disease.
abstract: Chronic obstructive pulmonary disease is mainly a smoking-related disorder and affects millions of people worldwide, with a large effect on individual patients and society as a whole. Although the disease becomes clinically apparent around the age of 40-50 years, its origins can begin very early in life. Different risk factors in very early life--ie, in utero and during early childhood--drive the development of clinically apparent chronic obstructive pulmonary disease in later life. In discussions of which risk factors drive chronic obstructive pulmonary disease, it is important to realise that the disease is very heterogeneous and at present is largely diagnosed by lung function only. In this Review, we will discuss the evidence for risk factors for the various phenotypes of chronic obstructive pulmonary disease during different stages of life.
authors.affiliation: Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, Netherlands; Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, Netherlands. Electronic address: d.s.postma@umcg.nl.
authors.forename: Dirkje S
authors.initials: DS
authors.lastname: Postma
authors.affiliation: National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bush
authors.affiliation: Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, Netherlands; Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: van den Berge
mesh_terms: D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008168:Lung / Q000254:growth & development; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D029424:Pulmonary Disease, Chronic Obstructive / Q000196:embryology / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology