| 1. |
- Carsin, Anne-Elie, et al.
(författare)
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Regular Physical Activity Levels and Incidence of Restrictive Spirometry Pattern : A Longitudinal Analysis of Two Population-based Cohorts
- 2020
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Ingår i: American Journal of Epidemiology. - : Oxford University Press. - 0002-9262 .- 1476-6256. ; 189:12, s. 1521-1528
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Tidskriftsartikel (refereegranskat)abstract
- We estimated the association between regular physical activity and the incidence of restrictive spirometry pattern. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and physical activity were assessed in 2 population-based European cohorts (European Community Respiratory Health Survey: n = 2,757, aged 39–67 years; and Swiss Study on Air Pollution and Lung and Heart Diseases in Adults: n = 2,610, aged 36–82 years) first in 2000–2002 and again approximately 10 years later (2010–2013). Subjects with restrictive or obstructive spirometry pattern at baseline were excluded. We assessed the association of being active at baseline (defined as being physically active at least 2–3 times/week for ≥1 hour) with restrictive spirometry pattern at follow-up (defined as a postbronchodilation FEV1/FVC ratio of at least the lower limit of normal and FVC of <80% predicted) using modified Poisson regression, adjusting for relevant confounders. After 10 years of follow-up, 3.3% of participants had developed restrictive spirometry pattern. Being physically active was associated with a lower risk of developing this phenotype (relative risk = 0.76, 95% confidence interval: 0.59, 0.98). This association was stronger among those who were overweight and obese than among those of normal weight (P for interaction = 0.06). In 2 large European studies, adults practicing regular physical activity were at lower risk of developing restrictive spirometry pattern over 10 years.
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| 2. |
- Carsin, Anne-Elie, et al.
(författare)
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Restrictive spirometry pattern is associated with low physical activity levels : A population based international study
- 2019
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Ingår i: Respiratory Medicine. - : Elsevier. - 0954-6111 .- 1532-3064. ; 146, s. 116-123
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Restrictive spirometry pattern is an under-recognised disorder with a poor morbidity and mortality prognosis. We compared physical activity levels between adults with a restrictive spirometry pattern and with normal spirometry.Methods: Restrictive spirometry pattern was defined as a having post-bronchodilator FEV1/FVC ≥ Lower Limit of Normal and a FVC<80% predicted in two population-based studies (ECRHS-III and SAPALDIA3). Physical activity was measured using the International Physical Activity Questionnaire. The odds of having low physical activity (<1st study-specific tertile) was evaluated using adjusted logistic regression models.Results: Subjects with a restrictive spirometry pattern (n = 280/4721 in ECRHS, n = 143/3570 in SAPALDIA) reported lower levels of physical activity than those with normal spirometry (median of 1770 vs 2253 MET·min/week in ECRHS, and 3519 vs 3945 MET·min/week in SAPALDIA). Subjects with a restrictive spirometry pattern were more likely to report low physical activity (meta-analysis odds ratio: 1.41 [95%CI 1.07–1.86]) than those with a normal spirometry. Obesity, respiratory symptoms, co-morbidities and previous physical activity levels did not fully explain this finding.Conclusion: Adults with a restrictive spirometry pattern were more likely to report low levels of physical activity than those with normal spirometry. These results highlight the need to identify and act on this understudied but prevalent condition.
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| 3. |
- Emilsson, Össur Ingi, et al.
(författare)
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Snoring and nocturnal reflux : association with lung function decline and respiratory symptoms
- 2019
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Ingår i: ERJ Open Research. - : European Respitory Society (ERS). - 2312-0541. ; 5:2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The study aim was to examine the association of snoring and nocturnal gastro-oesophageal reflux (nGOR) with respiratory symptoms and lung function, and if snoring and/or nGOR associated with a steeper decline in lung function. Methods: Data from the third visit of the European Community Respiratory Health Survey (ECRHS) was used for cross-sectional analysis. Pre- and post-bronchodilator spirometry was performed, and information on sleep, nGOR and respiratory symptoms was collected (n=5715). Habitual snoring and nGOR were assessed by questionnaire reports. Pre-bronchodilator spirometry from ECRHS I, II and III (20 years follow-up) were used to analyse lung function changes by multivariate regression analysis. Results: Snoring and nGOR were independently associated with a higher prevalence of wheeze, chest tightness, breathlessness, cough and phlegm. The prevalence of any respiratory symptom was 79% in subjects with both snoring and nGOR versus 56% in those with neither (p<0.001). Subjects with both snoring and nGOR had more frequent exacerbations (adjusted prevalence 32% versus 19% among "no snoring, no nGOR", p=0.003). Snoring but not nGOR was associated with a steeper decline in forced expiratory volume in 1 s over 10 years after adjusting for confounding factors (change in % predicted -5.53, versus -4.58 among "no snoring", p=0.04) and forced vital capacity (change in % predicted -1.94, versus -0.99 among "no snoring", p=0.03). Conclusions: Adults reporting both habitual snoring and nGOR had more respiratory symptoms and more frequent exacerbations of these symptoms. Habitual snoring was associated with a steeper decline in lung function over time.
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| 4. |
- Fuertes, Elaine, et al.
(författare)
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Leisure-time vigorous physical activity is associated with better lung function : the prospective ECRHS study
- 2018
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Ingår i: Thorax. - : BMJ Publishing Group Ltd. - 0040-6376 .- 1468-3296. ; 73:4, s. 376-384
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We assessed associations between physical activity and lung function, and its decline, in the prospective population-based European Community Respiratory Health Survey cohort. Methods: FEV1 and FVC were measured in 3912 participants at 27-57 years and 39-67 years (mean time between examinations= 11.1 years). Physical activity frequency and duration were assessed using questionnaires and used to identify active individuals (physical activity >= 2 times and >= 1 hour per week) at each examination. Adjusted mixed linear regression models assessed associations of regular physical activity with FEV1 and FVC. Results: Physical activity frequency and duration increased over the study period. In adjusted models, active individuals at the first examination had higher FEV1 (43.6 mL (95% CI 12.0 to 75.1)) and FVC (53.9 mL (95% CI 17.8 to 89.9)) at both examinations than their non-active counterparts. These associations appeared restricted to current smokers. In the whole population, FEV1 and FVC were higher among those who changed from inactive to active during the follow-up (38.0 mL (95% CI 15.8 to 60.3) and 54.2 mL (95% CI 25.1 to 83.3), respectively) and who were consistently active, compared with those consistently non-active. No associations were found for lung function decline. Conclusion: Leisure-time vigorous physical activity was associated with higher FEV1 and FVC over a 10-year period among current smokers, but not with FEV1 and FVC decline.
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| 5. |
- Kirkeleit, Jorunn, et al.
(författare)
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Early life exposures contributing to accelerated lung function decline in adulthood – a follow-up study of 11,000 adults from the general population
- 2023
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Ingår i: eClinicalMedicine. - : Elsevier. - 2589-5370. ; 66
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Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to assess whether exposure to risk factors in early life from conception to puberty continue to contribute to lung function decline later in life by using a pooled cohort comprising approx. 11,000 adults followed for more than 20 years and with up to three lung function measurements. Methods: Participants (20–68 years) in the ECRHS and NFBC1966 cohort studies followed in the periods 1991–2013 and 1997–2013, respectively, were included. Mean annual decline in maximum forced expired volume in 1 s (FEV1) and forced vital capacity (FVC) were main outcomes. Associations between early life risk factors and change in lung function were estimated using mixed effects linear models adjusted for sex, age, FEV1, FVC and height at baseline, accounting for personal smoking. Findings: Decline in lung function was accelerated in participants with mothers that smoked during pregnancy (FEV1 2.3 ml/year; 95% CI: 0.7, 3.8) (FVC 2.2 ml/year; 0.2, 4.2), with asthmatic mothers (FEV1 2.6 ml/year; 0.9, 4.4) (FEV1/FVC 0.04 per year; 0.04, 0.7) and asthmatic fathers (FVC 2.7 ml/year; 0.5, 5.0), and in women with early menarche (FVC 2.4 ml/year; 0.4, 4.4). Personal smoking of 10 pack-years contributed to a decline of 2.1 ml/year for FEV1 (1.8, 2.4) and 1.7 ml/year for FVC (1.3, 2.1). Severe respiratory infections in early childhood were associated with accelerated decline among ever-smokers. No effect-modification by personal smoking, asthma symptoms, sex or cohort was found. Interpretation: Mothers’ smoking during pregnancy, parental asthma and early menarche may contribute to a decline of FEV1 and FVC later in life comparable to smoking 10 pack-years. Funding: European Union's Horizon 2020; Research Council of Norway; Academy of Finland; University Hospital Oulu; European Regional Development Fund; Spanish Ministry of Science and Innovation; Generalitat de Catalunya.
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| 6. |
- Kirkeleit, Jorunn, et al.
(författare)
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Early life origins of lung ageing : A study of lung function decline the ECRHS and NFBC1966 cohorts
- 2020
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Ingår i: European Respiratory Journal. - : ERS Publications. - 0903-1936 .- 1399-3003. ; 56
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objective: To determine whether early life factors associated with poor lung growth and submaximal attained lung function contribute to accelerated lung function decline later in life.Methods: Participants in the European Community Respiratory Health Survey (ECRHS) and the Northern Finland Birth Cohort 1966 (NFBC1966) with lung function measured in a first (n=10,971), second (n=7,981) and third wave (n=4,849), aged 20 – 68 years, were included. Mean annual decline in maximum forced expired volume in 1 second (FEV1) and forced vital capacity (FVC) were main outcomes. Information on early life factors was provided by standardized interviews and questionnaires. We estimated the effect of early life factors including maternal age, parental smoking, season of birth, parental asthma and respiratory infections using mixed effects models, adjusted for age, FEV1 and FVC at baseline, height, and smoking habits.Results: Decline in FEV1 was accelerated in women born of a mother with asthma (β = 2.4 ml; 95% CI 0.6-4.3) or who smoked during pregnancy (1.9; 0.2-3.6), and in men having a father with asthma (3.5; 0.2-6.9) or born by Cesarean section (7.9; 1.6-14.2). Accelerated decline in FVC was associated with paternal asthma in men (4.3; 0.1-8.5) and early menarche (<12 years) in women (2.4; 0.4-4.4). No statistically significant effect on lung function decline was found for other investigated early life factors.Conclusion: Early life risk factors contribute to an accelerated lung function decline with ageing, following sex-specific patterns. Decline in FEV1 versus FVC showed slightly different patterns.
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| 7. |
- Moitra, Subhabrata, et al.
(författare)
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Effect of asthma on the development of obesity among adults : Results of the European Community Respiratory Health Survey (ECRHS)
- 2018
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Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Obesity has been associated with asthma, however the reverse relation has recently been observed among children.Objective: To investigate whether asthma contributes to obesity incidence in adults.Methods: The ECRHS is a cohort study with two follow-ups around, 10-years (ECRHS-II) and 20-years (ECRHS-III) after enrolment. Participants with obesity (BMI>30kg/m2) at baseline were excluded (n=957), leaving 8618 non-obese subjects who participated in at least one follow-up. Asthmatics were described if the subjects reported ever having asthma and had an asthma attack or woke up by an attack of shortness of breath in last 12 months or on current asthma medication. We evaluated the association between: (1) asthma at baseline (ECRHS-I) and obesity at ECRHS-II; and (2) newly reported asthma at ECRHS-II and obesity at ECRHS-III.Results: 10.2% of asthmatics at baseline developed obesity after 10 years compared to 7.7% of non-asthmatics (Age, sex & country-adjusted relative risk: 1.26; 95% confidence interval: 1.03-1.55). Further adjustment for BMI at baseline slightly reduced this risk (RR:1.2; 95%CI: 1.0-1.4). Obesity risk was highest for those developing asthma in adulthood (RR:1.37; 95%CI: 1.01-1.86) compared to those with childhood onset asthma (RR: 1.13; 95%CI: 0.83-1.53). Asthmatics who were non-atopic at baseline had a higher risk of developing obesity at 1st follow up (RR: 1.47; 95%CI: 1.15-1.86). Similar trend was observed in newly reported asthmatics in ECRHS-II and increased obesity risk at the final follow up ECRHS-III (RR: 1.22; 95%CI: 0.86-1.73).Conclusion: These results suggest that asthmatics are at a higher risk of developing obesity.
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| 8. |
- Nerpin, Elisabet, 1962-, et al.
(författare)
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Bronchodilator response and lung function decline : Associations with exhaled nitric oxide with regard to sex and smoking status
- 2021
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Ingår i: World Allergy Organization Journal. - : Elsevier. - 1939-4551. ; 14:5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fractional exhaled nitric oxide (FeNO) is a marker of type-2 inflammation used both to support diagnosis of asthma and follow up asthma patients. The associations of FeNO with lung function decline and bronchodilator (BD) response have been studied only scarcely in large populations.Objectives: To study the association between FeNO and a) retrospective lung function decline over 20 years, and b) lung function response to BD among asthmatic subjects compared with non-asthmatic subjects and with regards to current smoking and sex.Methods: Longitudinal analyses of previous lung function decline and FeNO level at follow-up and cross-sectional analyses of BD response and FeNO levels in 4257 participants (651 asthmatics) from the European Community Respiratory Health Survey.Results: Among asthmatic subjects, higher percentage declines of FEV1 and FEV1/FVC were associated with higher FeNO levels (p = 0.001 for both) at follow-up. These correlations were found mainly among non-smoking individuals (p = 0.001) and females (p = 0.001) in stratified analyses.Percentage increase in FEV1 after BD was positively associated with FeNO levels in non-asthmatic subjects. Further, after stratified for sex and smoking separately, a positive association was seen between FEV1 and FeNO levels in non-smokers and women, regardless of asthma status.Conclusions: We found a relationship between elevated FeNO and larger FEV1 decline over 20 years among subjects with asthma who were non-smokers or women. The association between elevated FeNO levels and larger BD response was found in both non-asthmatic and asthmatic subjects, mainly in women and non-smoking subjects.
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| 9. |
- Pesce, Giancarlo, et al.
(författare)
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Low dehydroepiandrosterone sulfate (DHEA-S) is associated with worse lung function in women
- 2018
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Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- DHEA-S is the most abundant circulating steroid hormone in humans. Low concentrations of DHEA-S have been linked to several chronic diseases, but it is unclear if DHEA-S affects respiratory health. As part of the ALEC project [EU H2020 grant #633212], the associations of DHEA-S concentrations with lung function levels and decline were evaluated in women from the general population.Serum DHEA-S concentrations were measured in 2,250 women (28-57 years) participating in the European Community Respiratory Health Survey in 1999-2002. Associations of DHEA-S concentrations (categorized by age-adjusted quintiles) with FEV1, FVC, and the FEV1/FVC ratio were investigated using linear regression models adjusted for age, height, active and passive smoking, BMI, physical activity, education, menopausal status, and with study centre included as a random effect. Associations of DHEA-S concentrations with yearly decline in lung function (ΔFEV1, ΔFVC, ΔFEV1/FVC) were assessed in 1,340 women with spirometry data at follow-up in 2010-2014.The median (25th-75th percentile) concentration of DHEA-S was 4.2 µmol/L (2.9-6.0). The concentration of DHEA-S was significantly higher in current smokers and steadily declined with age. In fully adjusted models, women with low DHEA-S concentrations (below the 1st quintile) at baseline had worse FEV1 (-80mL, p<0.001) and FVC (-79mL, p=0.001) compared to women with higher DHEA-S levels. Low DHEA-S concentrations at baseline were associated with ΔFEV1/FVC (-0.08%/year, p=0.006), but not with ΔFEV1 or ΔFVC.The results suggest that low DHEA-S concentrations are associated with worse lung function in women, but have limited effects on lung function decline.
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| 10. |
- Triebner, Kai, et al.
(författare)
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Exogenous female sex steroids may reduce lung ageing after menopause : A 20-year follow-up study of a general population sample (ECRHS)
- 2019
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Ingår i: Maturitas. - : ELSEVIER IRELAND LTD. - 0378-5122 .- 1873-4111. ; 120, s. 29-34
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Menopause involves hypoestrogenism, which is associated with numerous detrimental effects, including on respiratory health. Hormone replacement therapy (HRT) is often used to improve symptoms of menopause. The effects of HRT on lung function decline, hence lung ageing, have not yet been investigated despite the recognized effects of HRT on other health outcomes. Study design: The population-based multi-centre European Community Respiratory Health Survey provided complete data for 275 oral HRT users at two time points, who were matched with 383 nonusers and analysed with a two-level linear mixed effects regression model. Main outcome measures: We studied whether HRT use was associated with the annual decline in forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). Results: Lung function of women using oral HRT for more than five years declined less rapidly than that of nonusers. The adjusted difference in FVC decline was 5.6 mL/y (95%CI: 1.8 to 9.3, p = 0.01) for women who had taken HRT for six to ten years and 8.9 mL/y (3.5 to 14.2, p = 0.003) for those who had taken it for more than ten years. The adjusted difference in FEV1 decline was 4.4 mL/y (0.9 to 8.0, p = 0.02) with treatment from six to ten years and 5.3 mL/y (0.4 to 10.2, p = 0.048) with treatment for over ten years. Conclusions: In this longitudinal population-based study, the decline in lung function was less rapid in women who used HRT, following a dose-response pattern, and consistent when adjusting for potential confounding factors. This may signify that female sex hormones are of importance for lung ageing.
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