RATIONALE: The contribution by asthma to the development of fixed airflow obstruction (AO) and the nature of its effect combined with active smoking and atopy remain unclear. OBJECTIVES: To investigate the prevalence and relative influence of lifetime asthma, active smoking, and atopy on fixed AO in middle age. METHODS: The population-based Tasmanian Longitudinal Health Study cohort born in 1961 (n = 8,583) and studied with prebronchodilator spirometry in 1968 was retraced (n = 7,312) and resurveyed (n = 5,729 responses) from 2002 to 2005. A sample enriched for asthma and chronic bronchitis underwent a further questionnaire, pre- and post-bronchodilator spirometry (n = 1,389), skin prick testing, lung volumes, and diffusing capacity measurements. Prevalence estimates were reweighted for sampling fractions. Multiple linear and logistic regression were used to assess the relevant associations. MEASUREMENTS AND MAIN RESULTS: Main effects and interactions between lifetime asthma, active smoking, and atopy as they relate to fixed AO were measured. The prevalence of fixed AO was 6.0% (95% confidence interval [CI], 4.5-7.5%). Its association with early-onset current clinical asthma was equivalent to a 33 pack-year history of smoking (odds ratio, 3.7; 95% CI, 1.5-9.3; P = 0.005), compared with a 24 pack-year history for late-onset current clinical asthma (odds ratio, 2.6; 95% CI, 1.03-6.5; P = 0.042). An interaction (multiplicative effect) was present between asthma and active smoking as it relates to the ratio of post-bronchodilator FEV(1)/FVC, but only among those with atopic sensitization. CONCLUSIONS: Active smoking and current clinical asthma both contribute substantially to fixed AO in middle age, especially among those with atopy. The interaction between these factors provides another compelling reason for atopic individuals with current asthma who smoke to quit.
RATIONALE: The contribution by asthma to the development of fixed airflow obstruction (AO) and the nature of its effect combined with active smoking and atopy remain unclear. OBJECTIVES: To investigate the prevalence and relative influence of lifetime asthma, active smoking, and atopy on fixed AO in middle age. METHODS: The population-based Tasmanian Longitudinal Health Study cohort born in 1961 (n = 8,583) and studied with prebronchodilator spirometry in 1968 was retraced (n = 7,312) and resurveyed (n = 5,729 responses) from 2002 to 2005. A sample enriched for asthma and chronic bronchitis underwent a further questionnaire, pre- and post-bronchodilator spirometry (n = 1,389), skin prick testing, lung volumes, and diffusing capacity measurements. Prevalence estimates were reweighted for sampling fractions. Multiple linear and logistic regression were used to assess the relevant associations. MEASUREMENTS AND MAIN RESULTS: Main effects and interactions between lifetime asthma, active smoking, and atopy as they relate to fixed AO were measured. The prevalence of fixed AO was 6.0% (95% confidence interval [CI], 4.5-7.5%). Its association with early-onset current clinical asthma was equivalent to a 33 pack-year history of smoking (odds ratio, 3.7; 95% CI, 1.5-9.3; P = 0.005), compared with a 24 pack-year history for late-onset current clinical asthma (odds ratio, 2.6; 95% CI, 1.03-6.5; P = 0.042). An interaction (multiplicative effect) was present between asthma and active smoking as it relates to the ratio of post-bronchodilator FEV(1)/FVC, but only among those with atopic sensitization. CONCLUSIONS: Active smoking and current clinical asthma both contribute substantially to fixed AO in middle age, especially among those with atopy. The interaction between these factors provides another compelling reason for atopic individuals with current asthma who smoke to quit.
Authors: Prescott G Woodruff; Maarten van den Berge; Richard C Boucher; Christopher Brightling; Esteban G Burchard; Stephanie A Christenson; MeiLan K Han; Michael J Holtzman; Monica Kraft; David A Lynch; Fernando D Martinez; Helen K Reddel; Don D Sin; George R Washko; Sally E Wenzel; Antonello Punturieri; Michelle M Freemer; Robert A Wise Journal: Am J Respir Crit Care Med Date: 2017-08-01 Impact factor: 21.405
Authors: Gregory H Bennett; Laurie Carpenter; Wei Hao; Peter Song; Joel Steinberg; Alan P Baptist Journal: Ann Allergy Asthma Immunol Date: 2017-12-28 Impact factor: 6.347
Authors: Toni Kiljander; Timo Helin; Kari Venho; Antero Jaakkola; Lauri Lehtimäki Journal: NPJ Prim Care Respir Med Date: 2015-07-16 Impact factor: 2.871
Authors: Fatemeh Fattahi; Judith M Vonk; Nicole Bulkmans; Ruth Fleischeuer; Annette Gouw; Katrien Grünberg; Thais Mauad; Helmut Popper; Aloisio Felipe-Silva; Bart Vrugt; Joanne L Wright; Hui-Min Yang; Janwillem W H Kocks; Machteld N Hylkema; Dirkje S Postma; Wim Timens; Nick H T Ten Hacken Journal: Virchows Arch Date: 2015-09-14 Impact factor: 4.064