RATIONALE: Few studies have investigated the factors associated with the early inception of chronic obstructive pulmonary disease (COPD). OBJECTIVES: We investigated COPD risk factors in an international cohort of young adults using different spirometric definitions of the disease. METHODS: We studied 4,636 subjects without asthma who had prebronchodilator FEV(1)/FVC measured in the European Community Respiratory Health Survey both in 1991 to 1993 (when they were 20-44 yr old) and in 1999 to 2002. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease fixed cut-off criterion (FEV(1)/FVC < 0.70), and two criteria based on the Quanjer and LuftiBus reference equations (FEV(1)/FVC less than lower limit of normal). COPD determinants were studied using two-level Poisson regression models. MEASUREMENTS AND MAIN RESULTS: COPD incidence ranged from 1.85 (lower limit of normal [Quanjer]) to 2.88 (Global Initiative for Chronic Obstructive Lung Disease) cases/1,000/yr. Although about half of the cases had smoked less than 20 pack-years, smoking was the main risk factor for COPD, and it accounted for 29 to 39% of the new cases during the follow-up. Airway hyperresponsiveness was the second strongest risk factor (15-17% of new cases). Other determinants were respiratory infections in childhood and a family history of asthma, whereas the role of sex, age, and of being underweight largely depended on the definition of COPD used. CONCLUSIONS: COPD may start early in life. Smoking prevention should be given the highest priority to reduce COPD occurrence. Airway hyperresponsiveness, a family history of asthma, and respiratory infections in childhood are other important determinants of COPD. We suggest the need for a definition of COPD that is not exclusively based on spirometry.
RATIONALE: Few studies have investigated the factors associated with the early inception of chronic obstructive pulmonary disease (COPD). OBJECTIVES: We investigated COPD risk factors in an international cohort of young adults using different spirometric definitions of the disease. METHODS: We studied 4,636 subjects without asthma who had prebronchodilator FEV(1)/FVC measured in the European Community Respiratory Health Survey both in 1991 to 1993 (when they were 20-44 yr old) and in 1999 to 2002. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease fixed cut-off criterion (FEV(1)/FVC < 0.70), and two criteria based on the Quanjer and LuftiBus reference equations (FEV(1)/FVC less than lower limit of normal). COPD determinants were studied using two-level Poisson regression models. MEASUREMENTS AND MAIN RESULTS: COPD incidence ranged from 1.85 (lower limit of normal [Quanjer]) to 2.88 (Global Initiative for Chronic Obstructive Lung Disease) cases/1,000/yr. Although about half of the cases had smoked less than 20 pack-years, smoking was the main risk factor for COPD, and it accounted for 29 to 39% of the new cases during the follow-up. Airway hyperresponsiveness was the second strongest risk factor (15-17% of new cases). Other determinants were respiratory infections in childhood and a family history of asthma, whereas the role of sex, age, and of being underweight largely depended on the definition of COPD used. CONCLUSIONS: COPD may start early in life. Smoking prevention should be given the highest priority to reduce COPD occurrence. Airway hyperresponsiveness, a family history of asthma, and respiratory infections in childhood are other important determinants of COPD. We suggest the need for a definition of COPD that is not exclusively based on spirometry.
Authors: Hans Petersen; Akshay Sood; Francesca Polverino; Caroline A Owen; Victor Pinto-Plata; Bartolomé R Celli; Yohannes Tesfaigzi Journal: Am J Respir Crit Care Med Date: 2018-12-01 Impact factor: 21.405
Authors: Paul A Reyfman; George R Washko; Mark T Dransfield; Avrum Spira; MeiLan K Han; Ravi Kalhan Journal: Am J Respir Crit Care Med Date: 2018-08-15 Impact factor: 21.405
Authors: Richard Hooper; Peter Burney; William M Vollmer; Mary Ann McBurnie; Thorarinn Gislason; Wan C Tan; Anamika Jithoo; Ali Kocabas; Tobias Welte; A Sonia Buist Journal: Eur Respir J Date: 2011-12-19 Impact factor: 16.671
Authors: François Maltais; Marc Decramer; Richard Casaburi; Esther Barreiro; Yan Burelle; Richard Debigaré; P N Richard Dekhuijzen; Frits Franssen; Ghislaine Gayan-Ramirez; Joaquim Gea; Harry R Gosker; Rik Gosselink; Maurice Hayot; Sabah N A Hussain; Wim Janssens; Micheal I Polkey; Josep Roca; Didier Saey; Annemie M W J Schols; Martijn A Spruit; Michael Steiner; Tanja Taivassalo; Thierry Troosters; Ioannis Vogiatzis; Peter D Wagner Journal: Am J Respir Crit Care Med Date: 2014-05-01 Impact factor: 21.405