Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
National Heart and Lung Institute, Imperial College, London, UK.
Allergol Int. 2022 Apr;71(2):200-206. doi: 10.1016/j.alit.2021.09.002. Epub 2021 Sep 30.
Wheezing may lead to asthma and reduced pulmonary function in later life. The study aims to identify wheezing trajectories and investigate their relation with pulmonary function and asthma-related outcomes at 22 years of age.
Individuals from a population-based cohort in Brazil (1993 Pelotas Birth Cohort) with post-bronchodilator pulmonary function data at 22 years (3350) were included in the study. From parentally reported (4 and 11 years) and self-reported (15, 18 and 22 years) history of wheezing in the last 12 months, we used a group-based trajectory modelling approach to derive wheezing trajectories.
Four trajectories were identified: never/infrequent, transient-early, late-onset and persistent wheeze. After adjustments, wheezing trajectories remained associated with lower post-bronchodilator values of pulmonary function. Individuals in the persistent wheeze trajectory had a markedly poorer pulmonary function and also showed greater odds of asthma-related outcomes compared to other trajectories groups. Those following this trajectory had on average -109 ml (95% CI: -188; -35), -1.80 percentage points (95% CI: -2.73; -0.87) and -316 ml/s (95% CI: -482; -150) lower FEV, FEV/FVC ratio and FEF respectively; higher odds of self-reported medical diagnosis of allergy (OR 6.18; 95% CI: 3.59; 10.61) and asthma (OR 12.88; 95% CI: 8.91; 18.61) and asthma medication use (OR 9.42; 95% CI: 5.27; 16.87) compared to the never/infrequent group.
Wheezing trajectories, especially the persistent wheeze trajectory, were related to lower pulmonary function values and increased risk of asthma and allergy diagnosis in early adulthood.
喘息可能导致哮喘，并在以后的生活中降低肺功能。本研究旨在确定喘息轨迹，并研究其与 22 岁时的肺功能和哮喘相关结局的关系。
本研究纳入了巴西一项基于人群的队列研究（1993 年佩洛塔斯出生队列）中的个体，这些个体在 22 岁时具有支气管扩张后肺功能数据（3350 人）。根据父母报告（4 岁和 11 岁）和自我报告（15 岁、18 岁和 22 岁）过去 12 个月的喘息史，我们使用基于群组的轨迹建模方法来确定喘息轨迹。
确定了 4 种喘息轨迹：从未/偶发、早期短暂、晚期和持续性喘息。调整后，喘息轨迹仍与支气管扩张后肺功能较低值相关。持续性喘息轨迹中的个体肺功能明显较差，并且与其他轨迹组相比，哮喘相关结局的发生几率也更高。遵循该轨迹的个体平均 FEV 降低了 109ml（95%CI：-188；-35），FEV/FVC 比值降低了 1.80 个百分点（95%CI：-2.73；-0.87），FEF 降低了 316ml/s（95%CI：-482；-150）；自我报告的过敏（OR 6.18；95%CI：3.59；10.61）和哮喘（OR 12.88；95%CI：8.91；18.61）诊断以及哮喘药物使用（OR 9.42；95%CI：5.27；16.87）的几率明显更高。
喘息轨迹，尤其是持续性喘息轨迹，与较低的肺功能值以及成年早期哮喘和过敏诊断的风险增加有关。
