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Am. J. Respir. Crit. Care Med., Volume 160, Number 1, July 1999, 150-156

Risk Factors from Childhood to Adulthood for Bronchial Responsiveness at Age 32-42 yr

MARION H. GROL, DIRKJE S. POSTMA, JUDITH M. VONK, JAN P. SCHOUTEN, BERT RIJCKEN, GERARD H. KOËTER, and JORRIT GERRITSEN

University Hospital Groningen, Groningen; and Departments of Pediatric Pulmonology, Pulmonology, and Epidemiology and Statistics, University of Groningen, Groningen, The Netherlands

Bronchial responsiveness (BR) is an important risk factor for the development and outcome of asthma. This study assessed childhood risk factors for both the severity of BR in adulthood and either improvement or worsening of BR over time. Finally, we studied cross-sectional risk factors of BR in adulthood. Between 1966 and 1969, 119 allergic asthmatic children (5-14 yr of age) were studied. Of these, 101 (85%) subjects were reinvestigated at age 22-32 yr (visit 2), and at age 32-42 yr (visit 3). Spirometry, PC10 histamine, skin tests, blood eosinophils, and serum total IgE were measured and a questionnaire was used. Higher FEV1 values in childhood were associated with less severe BR at age 32-42 yr independent of other potential risk factors. Larger increases in FEV1 values both from visit 1 to 2 and from visit 2 to 3, a longer time interval from visit 1 to 3, and having pets in childhood were associated with less severe BR at age 32-42 yr. The same factors were found to be associated with less deterioration of BR from visit 2 to 3. In nonsmokers a higher IgE level at visit 2 was a risk factor for an increase in BR. At age 32-42 yr, a low level of lung function and the presence of asthma symptoms were associated with more severe BR, and older age and having pets were associated with less severe BR. IgE was related to more severe BR only in nonsmokers. Conclusions: A lower lung function in childhood and less improvement in FEV1 over time were associated with more severe BR in adulthood.




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