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Göteborgs universitets publikationer

Can an airway challenge test predict respiratory diseases? A population-based international study

Författare och institution:
A. Marcon (-); I. Cerveri (-); M. Wjst (-); J. Antó (-); J. Heinrich (-); C. Janson (-); D. Jarvis (-); B. Leynaert (-); N. Probst-Hensch (-); C. Svanes (-); Kjell Torén (Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa); P. Burney (-); R. de Marco (-)
Publicerad i:
Journal of Allergy and Clinical Immunology, 133 ( 1 ) s. 104-110.e3
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
Background: Evidence on the longitudinal association of airway responsiveness with respiratory diseases is scarce. The best indicator of responsiveness is still undetermined. Objective: We investigated the association of airway responsiveness with the incidence of asthma, chronic obstructive pulmonary disease (COPD), and allergic rhinitis. Methods: We studied 3851 subjects who underwent spirometry and methacholine challenge tests both at baseline (1991-1993), when they were 20 to 44 years old, and at follow-up (1999-2002) in the European Community Respiratory Health Survey. Airway responsiveness was defined based on the methacholine dose-response slope on both occasions. Incidence rate ratios for the association of airway responsiveness with disease occurrence were computed by using Poisson regression. Results: With respect to reference (slope of the fourth quintile or greater), subjects with the greatest degree of airway responsiveness (slope less than the first quintile) showed the greatest risk of developing asthma, COPD, and allergic rhinitis (incidence rate ratios of 10.82, 5.53, and 4.84, respectively; all P <.01). A low slope predicted disease occurrence, even in subjects who did not reach a 20% decrease in FEV1 at the cumulative dose of 1 mg of methacholine (PD20 >1 mg). A decrease in slope over time was an independent predictor of disease risk. Conclusion: Airway responsiveness predicted new-onset asthma, COPD, and allergic rhinitis. Our study supports the use of a continuous noncensored indicator of airway responsiveness, such as the slope of the methacholine dose-response curve, in clinical practice and research because it showed clear advantages over PD20. © 2013 American Academy of Allergy, Asthma & Immunology.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin ->
Lungmedicin och allergi
airflow obstruction, Airway hyperresponsiveness, allergic rhinitis, asthma, chronic obstructive pulmonary disease, European Community Respiratory Health Survey, methacholine, adult, airway, article, chronic obstructive lung disease, controlled study, diagnostic test accuracy study, dose response, female, follow up, forced expiratory volume, forced vital capacity, health survey, human, incidence, inhalation test, lung function test, major clinical study, male, multicenter study, Poisson distribution, predictive value, predictor variable, priority journal, respiratory tract allergy, respiratory tract disease, risk factor, sensitivity and specificity, spirometry, young adult
Postens nummer:
Posten skapad:
2014-03-17 11:40
Posten ändrad:
2014-12-10 13:11

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