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Risk Factors for Lung Function Decline in Pediatric Asthma under Treatment: A Retrospective, Multicenter, Observational Study

Background: Childhood asthma is a major risk for low lung function in later adulthood, but what factors in asthma are associated with the poor lung function during childhood is not known. Objective: To identify clinical factors in children with asthma associated with low or declining lung function d...

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Autores principales: Yamada, Shingo, Fujisawa, Takao, Nagao, Mizuho, Matsuzaki, Hiroshi, Motomura, Chikako, Odajima, Hiroshi, Nakamura, Toshinori, Imai, Takanori, Nagakura, Ken-ichi, Yanagida, Noriyuki, Mitomori, Masatoshi, Ebisawa, Motohiro, Kabashima, Shigenori, Ohya, Yukihiro, Habukawa, Chizu, Tomiita, Minako, Hirayama, Masahiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600699/
https://www.ncbi.nlm.nih.gov/pubmed/36291452
http://dx.doi.org/10.3390/children9101516
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author Yamada, Shingo
Fujisawa, Takao
Nagao, Mizuho
Matsuzaki, Hiroshi
Motomura, Chikako
Odajima, Hiroshi
Nakamura, Toshinori
Imai, Takanori
Nagakura, Ken-ichi
Yanagida, Noriyuki
Mitomori, Masatoshi
Ebisawa, Motohiro
Kabashima, Shigenori
Ohya, Yukihiro
Habukawa, Chizu
Tomiita, Minako
Hirayama, Masahiro
author_facet Yamada, Shingo
Fujisawa, Takao
Nagao, Mizuho
Matsuzaki, Hiroshi
Motomura, Chikako
Odajima, Hiroshi
Nakamura, Toshinori
Imai, Takanori
Nagakura, Ken-ichi
Yanagida, Noriyuki
Mitomori, Masatoshi
Ebisawa, Motohiro
Kabashima, Shigenori
Ohya, Yukihiro
Habukawa, Chizu
Tomiita, Minako
Hirayama, Masahiro
author_sort Yamada, Shingo
collection PubMed
description Background: Childhood asthma is a major risk for low lung function in later adulthood, but what factors in asthma are associated with the poor lung function during childhood is not known. Objective: To identify clinical factors in children with asthma associated with low or declining lung function during the treatment. Methods: We enrolled children with asthma who had been treated throughout three age periods, i.e., 6–9, 10–12, and 13–15 years old, at seven specialized hospitals in Japan. Clinical information and lung function measurements were retrieved from the electronic chart systems. To characterize the lung function trajectories during each age period, we evaluated the forced expiratory volume 1 (FEV1) with % predicted values and individual changes by the slope (S) from linear regression. We defined four trajectory patterns: normal (Group N) and low (Group L), showing %FEV1 ≥80% or <80% throughout all three periods; upward (Group U) and downward (Group D), showing S ≥ 0 or S < 0%. Logistic regression analysis was performed to compare factors associated with the unfavorable (D/L) versus favorable (N/U) groups. Results: Among 273 eligible patients, 197 (72%) were classified into Group N (n = 150)/U (n = 47), while 76 (28%) were in Group D (n = 66)/L (n = 10). A history of poor asthma control, long-acting beta2 agonist use, and a lower height Z-score during 13–15 years were associated with an unfavorable outcome (Group D/L). Conversely, inhaled corticosteroid (ICS) use during 10–12 years and high-dose ICS use during 13–15 years were associated with a favorable outcome (Group N/U). Conclusion: We identified several factors that are associated with unfavorable lung function changes in pediatric asthma. Attention should be paid to the possible relationship between yearly changes in lung function and poor asthma control, use of ICS (and its dose) and use of LABA.
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spelling pubmed-96006992022-10-27 Risk Factors for Lung Function Decline in Pediatric Asthma under Treatment: A Retrospective, Multicenter, Observational Study Yamada, Shingo Fujisawa, Takao Nagao, Mizuho Matsuzaki, Hiroshi Motomura, Chikako Odajima, Hiroshi Nakamura, Toshinori Imai, Takanori Nagakura, Ken-ichi Yanagida, Noriyuki Mitomori, Masatoshi Ebisawa, Motohiro Kabashima, Shigenori Ohya, Yukihiro Habukawa, Chizu Tomiita, Minako Hirayama, Masahiro Children (Basel) Article Background: Childhood asthma is a major risk for low lung function in later adulthood, but what factors in asthma are associated with the poor lung function during childhood is not known. Objective: To identify clinical factors in children with asthma associated with low or declining lung function during the treatment. Methods: We enrolled children with asthma who had been treated throughout three age periods, i.e., 6–9, 10–12, and 13–15 years old, at seven specialized hospitals in Japan. Clinical information and lung function measurements were retrieved from the electronic chart systems. To characterize the lung function trajectories during each age period, we evaluated the forced expiratory volume 1 (FEV1) with % predicted values and individual changes by the slope (S) from linear regression. We defined four trajectory patterns: normal (Group N) and low (Group L), showing %FEV1 ≥80% or <80% throughout all three periods; upward (Group U) and downward (Group D), showing S ≥ 0 or S < 0%. Logistic regression analysis was performed to compare factors associated with the unfavorable (D/L) versus favorable (N/U) groups. Results: Among 273 eligible patients, 197 (72%) were classified into Group N (n = 150)/U (n = 47), while 76 (28%) were in Group D (n = 66)/L (n = 10). A history of poor asthma control, long-acting beta2 agonist use, and a lower height Z-score during 13–15 years were associated with an unfavorable outcome (Group D/L). Conversely, inhaled corticosteroid (ICS) use during 10–12 years and high-dose ICS use during 13–15 years were associated with a favorable outcome (Group N/U). Conclusion: We identified several factors that are associated with unfavorable lung function changes in pediatric asthma. Attention should be paid to the possible relationship between yearly changes in lung function and poor asthma control, use of ICS (and its dose) and use of LABA. MDPI 2022-10-04 /pmc/articles/PMC9600699/ /pubmed/36291452 http://dx.doi.org/10.3390/children9101516 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yamada, Shingo
Fujisawa, Takao
Nagao, Mizuho
Matsuzaki, Hiroshi
Motomura, Chikako
Odajima, Hiroshi
Nakamura, Toshinori
Imai, Takanori
Nagakura, Ken-ichi
Yanagida, Noriyuki
Mitomori, Masatoshi
Ebisawa, Motohiro
Kabashima, Shigenori
Ohya, Yukihiro
Habukawa, Chizu
Tomiita, Minako
Hirayama, Masahiro
Risk Factors for Lung Function Decline in Pediatric Asthma under Treatment: A Retrospective, Multicenter, Observational Study
title Risk Factors for Lung Function Decline in Pediatric Asthma under Treatment: A Retrospective, Multicenter, Observational Study
title_full Risk Factors for Lung Function Decline in Pediatric Asthma under Treatment: A Retrospective, Multicenter, Observational Study
title_fullStr Risk Factors for Lung Function Decline in Pediatric Asthma under Treatment: A Retrospective, Multicenter, Observational Study
title_full_unstemmed Risk Factors for Lung Function Decline in Pediatric Asthma under Treatment: A Retrospective, Multicenter, Observational Study
title_short Risk Factors for Lung Function Decline in Pediatric Asthma under Treatment: A Retrospective, Multicenter, Observational Study
title_sort risk factors for lung function decline in pediatric asthma under treatment: a retrospective, multicenter, observational study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600699/
https://www.ncbi.nlm.nih.gov/pubmed/36291452
http://dx.doi.org/10.3390/children9101516
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