title: Patterns of Growth and Decline in Lung Function in Persistent Childhood Asthma.
abstract: BACKGROUND
  Tracking longitudinal measurements of growth and decline in lung function in patients with persistent childhood asthma may reveal links between asthma and subsequent chronic airflow obstruction.
  
  
  METHODS
  We classified children with asthma according to four characteristic patterns of lung-function growth and decline on the basis of graphs showing forced expiratory volume in 1 second (FEV1), representing spirometric measurements performed from childhood into adulthood. Risk factors associated with abnormal patterns were also examined. To define normal values, we used FEV1 values from participants in the National Health and Nutrition Examination Survey who did not have asthma.
  
  
  RESULTS
  Of the 684 study participants, 170 (25%) had a normal pattern of lung-function growth without early decline, and 514 (75%) had abnormal patterns: 176 (26%) had reduced growth and an early decline, 160 (23%) had reduced growth only, and 178 (26%) had normal growth and an early decline. Lower baseline values for FEV1, smaller bronchodilator response, airway hyperresponsiveness at baseline, and male sex were associated with reduced growth (P<0.001 for all comparisons). At the last spirometric measurement (mean [±SD] age, 26.0±1.8 years), 73 participants (11%) met Global Initiative for Chronic Obstructive Lung Disease spirometric criteria for lung-function impairment that was consistent with chronic obstructive pulmonary disease (COPD); these participants were more likely to have a reduced pattern of growth than a normal pattern (18% vs. 3%, P<0.001).
  
  
  CONCLUSIONS
  Childhood impairment of lung function and male sex were the most significant predictors of abnormal longitudinal patterns of lung-function growth and decline. Children with persistent asthma and reduced growth of lung function are at increased risk for fixed airflow obstruction and possibly COPD in early adulthood. (Funded by the Parker B. Francis Foundation and others; ClinicalTrials.gov number, NCT00000575.).
authors.forename: M J
authors.initials: MJ
authors.lastname: McGeachie
authors.forename: K P
authors.initials: KP
authors.lastname: Yates
authors.forename: X
authors.initials: X
authors.lastname: Zhou
authors.forename: F
authors.initials: F
authors.lastname: Guo
authors.forename: A L
authors.initials: AL
authors.lastname: Sternberg
authors.forename: M L
authors.initials: ML
authors.lastname: Van Natta
authors.forename: R A
authors.initials: RA
authors.lastname: Wise
authors.forename: S J
authors.initials: SJ
authors.lastname: Szefler
authors.forename: S
authors.initials: S
authors.lastname: Sharma
authors.forename: A T
authors.initials: AT
authors.lastname: Kho
authors.forename: M H
authors.initials: MH
authors.lastname: Cho
authors.forename: D C
authors.initials: DC
authors.lastname: Croteau-Chonka
authors.forename: P J
authors.initials: PJ
authors.lastname: Castaldi
authors.forename: G
authors.initials: G
authors.lastname: Jain
authors.forename: A
authors.initials: A
authors.lastname: Sanyal
authors.forename: Y
authors.initials: Y
authors.lastname: Zhan
authors.forename: B R
authors.initials: BR
authors.lastname: Lajoie
authors.forename: J
authors.initials: J
authors.lastname: Dekker
authors.forename: J
authors.initials: J
authors.lastname: Stamatoyannopoulos
authors.forename: R A
authors.initials: RA
authors.lastname: Covar
authors.forename: R S
authors.initials: RS
authors.lastname: Zeiger
authors.forename: N F
authors.initials: NF
authors.lastname: Adkinson
authors.forename: P V
authors.initials: PV
authors.lastname: Williams
authors.forename: H W
authors.initials: HW
authors.lastname: Kelly
authors.forename: H
authors.initials: H
authors.lastname: Grasemann
authors.forename: J M
authors.initials: JM
authors.lastname: Vonk
authors.forename: G H
authors.initials: GH
authors.lastname: Koppelman
authors.forename: D S
authors.initials: DS
authors.lastname: Postma
authors.forename: B A
authors.initials: BA
authors.lastname: Raby
authors.forename: I
authors.initials: I
authors.lastname: Houston
authors.forename: Q
authors.initials: Q
authors.lastname: Lu
authors.forename: A L
authors.initials: AL
authors.lastname: Fuhlbrigge
authors.forename: K G
authors.initials: KG
authors.lastname: Tantisira
authors.forename: E K
authors.initials: EK
authors.lastname: Silverman
authors.forename: J
authors.initials: J
authors.lastname: Tonascia
authors.forename: S T
authors.initials: ST
authors.lastname: Weiss
authors.forename: R C
authors.initials: RC
authors.lastname: Strunk
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy / Q000503:physiopathology*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D019819:Budesonide / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008168:Lung / Q000254:growth & development / Q000502:physiology*; D008297:Male; D017835:Nedocromil / Q000627:therapeutic use; D012307:Risk Factors; D012737:Sex Factors; D013147:Spirometry; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D017835:Nedocromil; D019819:Budesonide