title: A Distinct Low Lung Function Trajectory from Childhood to the Fourth Decade of Life.
abstract: Low maximally attained lung function increases the risk of chronic obstructive pulmonary disease irrespective of the subsequent rate of lung function decline.
  
  
  
  We aimed to determine if there were individuals with a distinct, persistently low lung function trajectory in the CRS (Tucson Children's Respiratory Study).
  
  
  
  The CRS, an ongoing birth cohort study, enrolled 1,246 participants between 1980 and 1984. Latent class linear mixed effects modeling of the ratio of FEV1 to FVC was used to identify distinct lung function trajectories among participants with two or more spirometry measurements between ages 11 and 32 years.
  
  
  
  Among 599 participants with 2,142 observations, a model with two distinct trajectories (a low trajectory [n = 56; 9.3%] and a normal trajectory) fit the data significantly better than a model with only one trajectory (P = 0.0007). As compared with those with a normal trajectory, participants with a persistently low trajectory were more likely to have a history of maternal asthma (20.0% vs. 9.9%; P = 0.02); early life lower respiratory illness caused by respiratory syncytial virus (41.2% vs. 21.4%; P = 0.001); and physician-diagnosed active asthma at age 32 years (43.9% vs. 16.2%; P < 0.001). Individuals with a persistently low trajectory also demonstrated lower lung function as measured by average maximal expiratory flow at functional residual capacity during infancy and at age 6 years.
  
  
  
  A distinct group of individuals in a nonselected population demonstrates a persistently low lung function trajectory that may be partly established at birth and predisposes them to chronic obstructive pulmonary disease later in life.
authors: 1 Department of Medicine and.|2 Arizona Respiratory Center and.
authors: Cristine E
authors: CE
authors: Berry
authors: 3 BIO5 Institute, University of Arizona, Tucson, Arizona.|4 Department of Epidemiology and Biostatistics and.
authors: Dean
authors: D
authors: Billheimer
authors: 5 Fred Hutchinson Cancer Research Center, Seattle, Washington; and.
authors: Isaac C
authors: IC
authors: Jenkins
authors: 3 BIO5 Institute, University of Arizona, Tucson, Arizona.
authors: Zhenqiang J
authors: ZJ
authors: Lu
authors: 2 Arizona Respiratory Center and.
authors: Debra A
authors: DA
authors: Stern
authors: 2 Arizona Respiratory Center and.|6 Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona.
authors: Lynn B
authors: LB
authors: Gerald
authors: 1 Department of Medicine and.|2 Arizona Respiratory Center and.
authors: Tara F
authors: TF
authors: Carr
authors: 1 Department of Medicine and.|2 Arizona Respiratory Center and.|7 CREAL Center, Pompeu Fabra University, Barcelona, Spain.
authors: Stefano
authors: S
authors: Guerra
authors: 8 Department of Pediatrics, University of Arizona College of Medicine, Tucson, Arizona.|2 Arizona Respiratory Center and.
authors: Wayne J
authors: WJ
authors: Morgan
authors: 8 Department of Pediatrics, University of Arizona College of Medicine, Tucson, Arizona.|2 Arizona Respiratory Center and.
authors: Anne L
authors: AL
authors: Wright
authors: 8 Department of Pediatrics, University of Arizona College of Medicine, Tucson, Arizona.|2 Arizona Respiratory Center and.|3 BIO5 Institute, University of Arizona, Tucson, Arizona.
authors: Fernando D
authors: FD
authors: Martinez
mesh_terms: D000293:Adolescent; D000328:Adult; D001130:Arizona / Q000453:epidemiology; D001249:Asthma / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D016009:Chi-Square Distribution; D002648:Child; D005192:Family Health; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D012129:Respiratory Function Tests; D013147:Spirometry; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution
keywords: asthma; chronic obstructive pulmonary disease; epidemiology; respiratory function tests