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Early life origins of chronic obstructive pulmonary disease

Early life origins of chronic obstructive pulmonary disease,10.1136/thx.2008.112136,Thorax,C Svanes,J Sunyer,E Plana,S Dharmage,J Heinrich,D Jarvis,R

Early life origins of chronic obstructive pulmonary disease   (Citations: 15)
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C Svanes, J Sunyer, E Plana, S Dharmage, J Heinrich, D Jarvis, R de Marco, D Norbäck, C Raherison, S Villani, M Wjst, K Svaneshttp://academic.research.microsoft.com/io.ashx?type=5&id=30507392&selfId1=0&selfId2=0&maxNumber=12&query=
Background:Early life development may influence subsequent respiratory morbidity. The impact of factors determined in childhood on adult lung function, decline in lung function and chronic obstructive pulmonary disease (COPD) was investigated.Methods:European Community Respiratory Health Survey participants aged 20–45 years randomly selected from general populations in 29 centres underwent spirometry in 1991–3 (n = 13 359) and 9 years later (n = 7738). Associations of early life factors with adult forced expiratory volume in 1 s (FEV1), FEV1 decline and COPD (FEV1/FVC ratio <70% and FEV1 <80% predicted) were analysed with generalised estimating equation models and random effects linear models.Results:Maternal asthma, paternal asthma, childhood asthma, maternal smoking and childhood respiratory infections were significantly associated with lower FEV1 and defined as “childhood disadvantage factors”; 40% had one or more childhood disadvantage factors which were associated with lower FEV1 (men: adjusted difference 95 ml (95% CI 67 to 124); women: adjusted difference 60 ml (95% CI 40 to 80)). FEV1 decreased with increasing number of childhood disadvantage factors (⩾3 factors, men: 274 ml (95% CI 154 to 395), women: 208 ml (95% CI 124 to 292)). Childhood disadvantage was associated with a larger FEV1 decline (1 factor: 2.0 ml (95% CI 0.4 to 3.6) per year; 2 factors: 3.8 ml (95% CI 1.0 to 6.6); ⩾3 factors: 2.2 ml (95% CI −4.8 to 9.2)). COPD increased with increasing childhood disadvantage (1 factor, men: OR 1.7 (95% CI 1.1 to 2.6), women: OR 1.6 (95% CI 1.01 to 2.6); ⩾3 factors, men: OR 6.3 (95% CI 2.4 to 17), women: OR 7.2 (95% CI 2.8 to 19)). These findings were consistent between centres and when subjects with asthma were excluded.Conclusions:People with early life disadvantage have permanently lower lung function, no catch-up with age but a slightly larger decline in lung function and a substantially increased COPD risk. The impact of childhood disadvantage was as large as that of heavy smoking. Increased focus on the early life environment may contribute to the prevention of COPD.
Journal: Thorax , vol. 65, no. 1, pp. 14-20, 2010
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    • ...The in utero environment is an important determinant of adult NCDs, including diabetes [20], coronary heart diseases [21], and asthma [22] or chronic obstructive pulmonary disease (COPD) [23]...

    Jean Bousquetet al. Systems medicine and integrated care to combat chronic noncommunicable...

    • ...decline of −4 ml/year, and those smoking >20 cigarettes per day had an additional decline of −9.5 ml/year....

    Dan Norbäcket al. Lung function decline in relation to mould and dampness in the home: t...

    • ...even this may be too late. However, as a start, the answers to three simple questions to the mother defines a high risk fetus...

    Neil Barneset al. Howling for the moon

    • ...we found no evidence that it may be an important source of COPD heterogeneity, though the larger number of pack-years reported by subtype 3 may have contributed to their higher prevalence of cardiovascular and metabolic disease. Likewise, other exposures to occupational or environmental factors were not significantly different among COPD phenotypes although, admittedly, limited information was available. Finally, it is worth noting that patients in subtype 1 were, on average, 4 cm shorter than those in subtype 3. Since height is considered a marker of in utero and childhood lung growth, we hypothesise that subjects in subtype 1 might have had impaired lungs since early life and, for the same amount of smoking, developed a more severe respiratory status at the time of their first hospital admission. The latter observation is consistent with recent reports on the early origin of COPD....

    Judith Garcia-Aymerichet al. Identification and prospective validation of clinically relevant chron...

    • ...Moreover, early life events such as parental asthma, maternal smoking and respiratory infections play an unexpectedly large part in determining who will subsequently lose lung function....

    J. R. Hurstet al. Travelling in time with COPD

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