| 1. |
- Eriksson, Berne, et al.
(författare)
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Only severe COPD is associated with being underweight: Results from a population survey
- 2016
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Ingår i: ERS Monograph. - Sheffield : European Respiratory Society (ERS). - 2312-508X. ; 2:3
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Tidskriftsartikel (refereegranskat)abstract
- Low body mass index (BMI) and malnutrition in chronic obstructive pulmonary disease (COPD) are associated with a poor prognosis. The prevalence of underweight, as well as overweight, in severity grades of COPD is sparsely investigated in studies of the general population and the associated patterns of risk factors are not well established. The aim of the present study was to determine the association between severity grades of airflow limitation in COPD, and both underweight and obesity when corrected for possible confounding factors. The study is based on pooled data from the OLIN (Obstructive Lung Disease in Northern Sweden) studies. Complete records with lung function, BMI and structured interview data were available from 3942 subjects (50.7% women and 49.3% men). COPD and severity grading were defined using the Global Initiative for Chronic Obstructive Lung Disease criteria. In sensitivity analyses, the lower limit of normal was used. The prevalence of underweight was 7.3% in severe COPD (grades 3 and 4) versus 2.0% in those with normal spirometry. The prevalence of obesity increased from 9.7% in grade 1, to 16.3% in grade 2 and 20.0% in severe COPD, versus 17.7% in those with normal spirometry. In adjusted analysis, of the COPD severity grades, only severe COPD was associated with underweight (OR 3.24, 95% CI 1.0004–10.5), while the COPD severity grades tended to be inversely associated with overweight. © ERS 2016.
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| 2. |
- Almqvist, Linnéa, et al.
(författare)
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Remission of adult-onset asthma is rare: a 15-year follow-up study
- 2020
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Ingår i: Erj Open Research. - : European Respiratory Society (ERS). - 2312-0541. ; 6:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are few long-term clinical follow-up studies of adult-onset asthma. The aim of this article was to study clinical characteristics of adult-onset asthma in relation to remission and persistence of the disease in a 15-year follow-up. Methods: A cohort of 309 adults aged 20-60 years with asthma onset during the last 12 months verified by bronchial variability, was recruited between 1995 and 1999 from the general population in northern Sweden. The cohort was followed-up in 2003 (n=250) and between 2012 and 2014 (n=205). Structured interviews and spirometry were performed at recruitment and the follow-ups. Bronchial hyperreactivity (BHR) and skin-prick tests were performed at recruitment and blood samples were collected at the last follow-up. Remission of asthma was defined as no asthma symptoms and no use of asthma medication during the last 12 months. Results: Of eight individuals in remission in 2003, five had relapsed between 2012 and 2014 and in total, 23 (11%) were in remission, while 182 had persistent asthma. Those in remission had higher mean forced expiratory volume in 1 s % predicted at recruitment than those with persistent asthma (94.6 versus 88.3, p=0.034), fewer had severe BHR (27.3% versus 50.9%, p=0.037) and they had less body mass index increase (+1.6 versus +3.0, p=0.054). Of those with persistent asthma, 13% had uncontrolled asthma and they had higher levels of blood neutrophils than those with partly controlled or controlled asthma. Conclusion: Higher forced expiratory volume in 1 s % predicted and less-severe BHR was associated with remission of adult-onset asthma, but still, the proportion in remission in this 15-year follow-up was low.
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| 3. |
- Andersén, Heidi, et al.
(författare)
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NSAID-exacerbated respiratory disease: a population study.
- 2022
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Ingår i: ERJ open research. - : European Respiratory Society (ERS). - 2312-0541. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Nonsteroidal anti-inflammatory drugs (NSAIDs) may exacerbate respiratory symptoms. A recent European Academy of Allergy and Clinical Immunology position paper recommended the use of an acronym, N-ERD (NSAID-exacerbated respiratory disease), for this hypersensitivity associated with asthma or chronic rhinosinusitis with or without nasal polyposis. Our aim was to estimate the prevalence of N-ERD and identify factors associated with N-ERD.In 2016, a cross-sectional questionnaire survey of a random adult population of 16000 subjects aged 20-69years was performed in Helsinki and Western Finland. The response rate was 51.5%.The prevalence was 1.4% for N-ERD, and 0.7% for aspirin-exacerbated respiratory disease (AERD). The prevalence of N-ERD was 6.9% among subjects with asthma and 2.7% among subjects with rhinitis. The risk factors for N-ERD were older age, family history of asthma or allergic rhinitis, long-term smoking and exposure to environmental pollutants. Asthmatic subjects with N-ERD had a higher risk of respiratory symptoms, severe hypersensitivity reactions and hospitalisations than asthmatic subjects without N-ERD. The subphenotype of N-ERD with asthma was most symptomatic. Subjects with rhinitis associated with N-ERD, which would not be included in AERD, had the fewest symptoms.We conclude that the prevalence of N-ERD was 1.4% in a representative Finnish adult population sample. Older age, family history of asthma or allergic rhinitis, cumulative exposure to tobacco smoke, secondhand smoke, and occupational exposures increased odds of N-ERD. N-ERD was associated with significant morbidity.
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| 4. |
- Bermúdez Barón, Nicolás, et al.
(författare)
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Body mass index increase: a risk factor for forced expiratory volume in 1 s decline for overweight and obese adults with asthma
- 2022
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Ingår i: European Respiratory Journal Open Research (ERJ Open Research). - : European Respiratory Society (ERS). - 2312-0541. ; 8:4
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Tidskriftsartikel (refereegranskat)abstract
- Background With increasing prevalence of overweight and obesity, it is important to study how body mass index (BMI) change may affect lung function among subjects with asthma. There are few prospective studies on this topic, especially with separate analyses of those with normal and high BMI. The aim of the present study was to prospectively study the association between annual BMI change and annual lung function decline, separately among those with normal initial BMI and overweight/obesity, in an adult asthma cohort. Methods A population-based adult asthma cohort was examined at study entry between 1986 and 2001 and at follow-up between 2012 and 2014 (n=945). Annual BMI change was analysed in association with annual decline in forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC separately in those with normal weight (BMI 18.5-24.9) and overweight/obese subjects (BMI >= 25) at study entry. Regression models were used to adjust for sex, age, smoking, inhaled corticosteroids use and occupational exposure to gas, dust or fumes. Results Overweight/obese subjects had lower FEV1 and FVC but slower annual FEV1 and FVC decline compared to those with normal weight. After adjustment through regression modelling, the association between BMI change with FEV1 and FVC decline remained significant for both BMI groups, but with stronger associations among the overweight/obese (FEV1 B-[Overweight/obese]=-25 mL versus B[ normal weight]= -15 mL). However, when including only those with BMI increase during follow-up, the associations remained significant among those with overweight/obesity, but not in the normal-weight group. No associations were seen for FEV1/FVC. Conclusions BMI increase is associated with faster FEV1 and FVC decline among overweight and obese adults with asthma in comparison with their normal-weight counterparts.
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| 5. |
- Hedman, Linnea, 1979-, et al.
(författare)
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Early-life risk factors for development of asthma from 8 to 28 years of age : a prospective cohort study
- 2022
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Ingår i: ERJ Open Research. - : European Respiratory Society. - 2312-0541. ; 8:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: The objective was to estimate the incidence rate of asthma from age 8 to 28 years and evaluate early-life risk factors for asthma onset at different ages.Methods: In 1996, within the Obstructive Lung Disease in Northern Sweden (OLIN) studies, a cohort of 3430 schoolchildren (97% of invited) was recruited at age 8 years to a prospective study about asthma. The cohort was followed annually from age 8 to 19 years and at 28 years by questionnaire surveys (67% of the original cohort participated). Asthma was categorised as never-asthma, onset age ⩽8 years, onset age 9–13 years, onset age 14–19 years or onset age >19 years.Results: Of the 3430 individuals in the cohort, 690 (20.1%) reported asthma in any survey. The average incidence rate was 10.0/1000 per year at ⩽8 years, 11.9/1000 per year at 9–13 years, 13.3/1000 per year at 14–19 years and 6.1/1000 per year at >19 years. The incidence was higher among boys until age 10 years, but from age 15 years, it became higher among girls. Family history of asthma, allergic sensitisation and breastfeeding <3 months were associated with asthma onset throughout the study. Low birthweight, maternal smoking during pregnancy, severe respiratory infection, rhinoconjunctivitis and eczema were associated with asthma onset ⩽8 and 9–13 years.Conclusions: The incidence of asthma was high during childhood and the teenage period, and decreased substantially during young adulthood. Early-life factors were associated with asthma onset throughout childhood but had also a lasting effect on asthma incidence until adulthood.
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| 6. |
- Räisänen, Petri, et al.
(författare)
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High but stable incidence of adult-onset asthma in northern Sweden over the last decades
- 2021
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Ingår i: Erj Open Research. - : European Respiratory Society (ERS). - 2312-0541. ; 7:3
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Tidskriftsartikel (refereegranskat)abstract
- Background The prevalence of asthma has increased both among children and adults during the latter half of the 20th century. The prevalence among adults is affected by the incidence of asthma not only in childhood but also in adulthood. Time trends in asthma incidence have been poorly studied. Aims The aim of this study was to review the incidence of adult-onset asthma from 1996 to 2006 and 2006 to 2016 and compare the risk factor patterns. Methods In the Obstructive Lung Disease in Northern Sweden (OLIN) studies, two randomly selected population-based samples in the 20-69-year age group participated in postal questionnaire surveys about asthma in 1996 (n=7104, 85%) and 2006 (n=6165, 77%). A 10-year follow-up of the two cohorts with the same validated questionnaire was performed, and 5709 and 4552 responded, respectively. Different definitions of population at risk were used in the calculations of asthma incidence. The protocol followed a study performed between 1986 and 1996 in the same area. Results The crude incidence rate of physician-diagnosed asthma was 4.4 per 1000 person-years (men 3.8, women 5.5) from 1996 to 2006, and 4.8 per 1000 person-years (men 3.7, women 6.2) from 2006 to 2016. When correcting for possible under-diagnosis at study entry, the incidence rate was 2.4 per 1000 personyears from 1996 to 2006 and 2.6 per 1000 person-years from 2006 to 2016. The incidence rates were similar across age groups. Allergic rhino-conjunctivitis was the main risk factor for incident asthma in both observation periods (risk ratio 2.4-2.6). Conclusions The incidence of adult-onset asthma has been stable over the last two decades and has remained at a similar level since the 1980s. The high incidence contributes to the increase in asthma prevalence.
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| 7. |
- Schyllert, Christian, 1983-, et al.
(författare)
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Low socioeconomic status relates to asthma and wheeze, especially in women
- 2020
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Ingår i: ERJ Open Research. - : European Respiratory Society (ERS). - 2312-0541. ; 6:3
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Tidskriftsartikel (refereegranskat)abstract
- Low socioeconomic status (SES) has been associated with asthma and wheezing. Occupational group, educational level and income are commonly used indicators for SES, but no single indicator can illustrate the entire complexity of SES. The aim was to investigate how different indicators of SES associate with current asthma, allergic and nonallergic, and asthmatic wheeze. In 2016, a random sample of the population aged 20-79 years in Northern Sweden were invited to a postal questionnaire survey, with 58% participating (n=6854). The survey data were linked to the national Integrated Database for Labour Market Research by Statistics Sweden for the previous calendar year, 2015. Included SES indicators were occupation, educational level and income. Manual workers had increased risk for asthmatic wheeze, and manual workers in service for current asthma, especially allergic asthma. Primary school education associated with nonallergic asthma, whereas it tended to be inversely associated with allergic asthma. Low income was associated with asthmatic wheeze. Overall, the findings were more prominent among women, and interaction analyses between sex and income revealed that women, but not men, with low income had an increased risk both for asthmatic wheeze and current asthma, especially allergic asthma. To summarise, the different indicators of socioeconomic status illustrated various aspects of associations between low SES and asthma and wheeze, and the most prominent associations were found among women.
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| 8. |
- Wang, Gang, et al.
(författare)
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Spirometric phenotypes from early childhood to young adulthood : a Chronic Airway Disease Early Stratification study
- 2021
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Ingår i: ERJ Open Research. - : ERS Publications. - 2312-0541. ; 7:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: The prevalences of obstructive and restrictive spirometric phenotypes, and their relation to early-life risk factors from childhood to young adulthood remain poorly understood. The aim was to explore these phenotypes and associations with well-known respiratory risk factors across ages and populations in European cohorts.Methods: We studied 49334 participants from 14 population-based cohorts in different age groups (⩽10, >10–15, >15–20, >20–25 years, and overall, 5–25 years). The obstructive phenotype was defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) z-score less than the lower limit of normal (LLN), whereas the restrictive phenotype was defined as FEV1/FVC z-score ⩾LLN, and FVC z-score Results: The prevalence of obstructive and restrictive phenotypes varied from 3.2–10.9% and 1.8–7.7%, respectively, without clear age trends. A diagnosis of asthma (adjusted odds ratio (aOR=2.55, 95% CI 2.14–3.04), preterm birth (aOR=1.84, 1.27–2.66), maternal smoking during pregnancy (aOR=1.16, 95% CI 1.01–1.35) and family history of asthma (aOR=1.44, 95% CI 1.25–1.66) were associated with a higher prevalence of obstructive, but not restrictive, phenotype across ages (5–25 years). A higher current body mass index (BMI was more often observed in those with the obstructive phenotype but less in those with the restrictive phenotype (aOR=1.05, 95% CI 1.03–1.06 and aOR=0.81, 95% CI 0.78–0.85, per kg·m−2 increase in BMI, respectively). Current smoking was associated with the obstructive phenotype in participants older than 10 years (aOR=1.24, 95% CI 1.05–1.46).Conclusion: Obstructive and restrictive phenotypes were found to be relatively prevalent during childhood, which supports the early origins concept. Several well-known respiratory risk factors were associated with the obstructive phenotype, whereas only low BMI was associated with the restrictive phenotype, suggesting different underlying pathobiology of these two phenotypes.
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